Let's compensate ALL donors.

Kumud Majumder, the father of a preteen boy who died waiting for a bone marrow transplant, writes in the USA Today that Americans should be allowed to offer compensation for bone marrow donors -- currently a federal crime, even when the compensation is simply to reimburse the donor for time lost from work or for housing costs. Mr. Majumder is one of a number of Americans who is challenging the law that makes compensation for bone marrow donation a crime. He correctly asserts that this law has done nothing but create shortages -- just 2% of Americans are registered as bone marrow donors, and many of those decline when actually asked to donate because they can't take time off work for the procedure. Given that a perfect match between two unrelated individuals is so rare, what this means to patients with cancer and other bone marrow diseases is that they may have to wait for years to get a transplant, if they get one at all.

Compensation, Mr. Majumder argues, would alleviate this shortage. If we could just pay donors a modest amount, he says, we could increase the number of people willing to donate. Perhaps scholarships would encourage younger Americans -- who are most likely to have usable marrow -- to give.

I say Mr. Majumder is on the right track, but he hasn't gone far enough. He understands that the bone marrow shortage that killed his son could be remedied, if only the federal government weren't standing in the way. What he doesn't understand is that we need a fully free market in tissue donation -- and organs as well.

It's not just a modest amount of compensation that should be allowed; those who need bone marrow should be allowed to offer as much wealth as they want in exchange for the tissue they need. Leftists would argue that this creates inequities -- why should a rich person have access to marrow if a poor person doesn't? Well, why not? As long as the rich person has earned or inherited his wealth and not stolen it or gotten it by political favors, he can properly use it to buy anything he likes from anyone who will sell it to him -- and that includes bone marrow from someone who wouldn't sell it at a price the poor can afford. Nobody has a right to anyone else's bone marrow; the only way a patient should be able to get some is by mutual agreement between donor and donee (or, in a proper society, buyer and seller). By cutting off the possibility of any kind of compensation at all, the government simply makes it undesirable for nearly all Americans to donate; by allowing compensation but only at a modest level, the government would increase the pool, but not by as much as removing all restrictions would do.

Furthermore, Mr. Majumder makes an error when he argues that bone marrow donor compensation, but not organ donor compensation, should be allowed because bone marrow can be regenerated by the body, but organs cannot. Tell that to the families of those who have died waiting for a kidney, a heart, or a liver. In fact, organ donor compensation is desperately needed precisely because organ donation is more final than bone marrow donation. Currently, if you want an organ from a stranger, that stranger has to die -- what living person would give up, say, one of his kidneys for nothing more than a "thank you"? As I argued in my 2009 post "Not Enough Encouragement," most of us want to have full organ function, and would only give it up in exchange for a greater value, like the life of a loved one -- not the life of a stranger. But if there's money or other compensation involved, perhaps that compensation would be a greater value to some people than the continued use of their organs. What if, with the proceeds from giving up a kidney, a young mother could afford to quit working and stay home with her child for a year? Or a man who's been looking for seed money for his small business could finally have it? It would not be cruel and inhumane to allow this kind of transaction -- in fact, the exact opposite! Both parties would gain an enormous benefit -- the donor, a substantial sum of money; the donee, his health. Yes, allowing financial incentives would mean that many Americans would be confronted with a decision that the government currently makes impossible to them -- the permanent loss of an organ along with a better financial situation, or keeping the organ and the financial difficulties? But we should allow Americans to make that decision for themselves, not assume paternalistically that selling the organ is never the correct choice and that Americans should be forced not to make that choice.

Mr. Majumder is right -- compensation for bone marrow donation should be legal. And he's wrong -- because compensation for organs should be allowed, too.