Q&A: 'It should be made legal'

Michael Friedlaender heads the kidney-transplant follow-up unit at Hadassah University Hospital in Jerusalem.

Q. Why should buying a kidney be legal?

A. It should be legal because people are doing it illegally now, and there is no control over it. It should be made legal so that we can control it. Though I hate to compare it, because this saves lives, it's like abortions, where the illegal state of abortion caused terrible things to happen to young women. It became legal and we improved the health of young women.... [For organs], we have no control over standards, over payments, over follow-up healthcare. You can make standards only for things that are legal.

I think there is absolutely no ethical problem with paying for a kidney.... I think it's unethical not to reward someone who saves a life in that way.

Q. How risky is this medical procedure - for the donor and the recipient?

A. A healthy donor runs a very small risk of becoming unhealthy because of becoming a donor.... After 30 years, people who have given a kidney remain healthier than the rest of the population. Of course, they were healthier to begin with because they were allowed to give a kidney.

As for the recipient, they improve their [remaining] life span by at least double, and sometimes more. In the first three months, there is an increased mortality rate. After one year, the risk of a transplant patient dying is about a third of those on dialysis.

Q. What's wrong with making the human body - or parts of it - into a commodity?

A. It depends on your definition of a commodity.... We are commodities. What is a G.I.? Is he a commodity? He is in an army ... getting well paid to put his life on the line. Isn't that a commodity?... What about a surrogate mother? That's a complete invasion of the body.... If you become a surrogate mother, I think that's far more dangerous to the body than donating a kidney. We've found that donating a kidney is about as dangerous as driving a car for two years in Tel Aviv - statistically speaking.

Q. If a legal organ market is established, wouldn't the rich be the only ones who could afford to buy an organ and the poor be the only ones willing to sell?

A. According to my proposal, it would all be done through the health services. The kidney would go to the next person on the list.... You sell it to the state; the state is the broker. And the distribution, that way, is not according to how wealthy you are.