Study: Sellers of Kidneys in India Wind Up Worse Off

Even though India outlawed the sale of kidneys in 1994, the practice continues there and in a number of other developing countries.

The study by Dr. Madhav Goyal of the Geisinger Health System, based on interviews in 2001 with 305 kidney donors in the city of Chennai (formerly Madras) in southern India, provides strong ammunition for opponents of various proposals to provide compensation for donors in the United States.

The study makes it clear, for example, that the primary motivation of "almost all" of those selling their kidneys was to pay off debts (96 percent). Only one in 20 expressed any altruistic interest in helping a sick person with kidney disease.

But the sellers received an average of only $1,070 for a kidney (about one-third less than they were promised). What's more, the average family income declined by one third after the kidney was removed, and the number of families living below the poverty line actually increased.

And unlike living kidney donors in the United States, almost half of the donors in India reported a serious decline in their health. Half of the participants complained of persistent pain at the nephrectomy site and one-third complained of long-term back pain.

Perhaps most telling was the response of donors who were asked what advice they would give someone else with the same reasons they had for selling a kidney.

Four out of five of the Indian donors said they would not recommend selling a kidney.

"The sale of kidneys by poor people in India does not lead to a tangible benefit for the seller. The value of paying for donations must be reexamined in light of these findings," said Goyal. "Although patients with kidney failure deserve access to optimal treatment, such treatment should not be based on the exploitation of poor people."

Dr. David J. Rothman, a medical ethicist at Columbia University, said in the same Journal that the study should sharpen the debate in the U.S. over offering financial incentives as a way to increase the rate of organ donation.

"Goyal explodes the proposition that the sale is a win-win situation that benefits buyer and seller," Rothman wrote.

Other sources: Journal of the American Medical Association