While people’s lives continue to be put at risk by the dearth of organs available for transplantation, we must give urgent consideration to any option that may make up the shortfall. A market in organs from living donors is one such option. The market should be ethically supportable, and have built into it, for example, safeguards against wrongful exploitation. This can be accomplished by establishing a single purchaser system within a confined marketplace.Statistics can be dehumanising. The following numbers, however, have (...) more impact than most: as of 24th November, during 2002 in the United Kingdom, 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.1 It is difficult to estimate how many people die prematurely for want of donor organs. “In the world as a whole there are an estimated 700 000 patients on dialysis . . . . In India alone 100 000 new patients present with kidney failure each year”2 . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . …. (shrink)

Janet Radcliffe Richards is as always to the point and radical. We agree with her that “if it is presumptively bad to prevent sales altogether because lives will be lost . . . it is for the same reason presumptively bad to restrict the selling of organs”. Her complaint against our paper is that we are unnecessarily restrictive. John Harris indeed has argued that there are no sound ethical or philosophical reasons for objecting on principle to the sale of live (...) tissue and organs.1 If a scheme can be devised …. (shrink)