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Health care and economics are an often volatile mix. Just ask our first ministers. The Canadian ethos is such that rich and poor are to receive (in theory) equal access to treatment. Thus the right to a CAT scan or a heart bypass should be based on criteria totally free from economic bias. Surely most Canadians would be appalled at the notion of selling organs for monetary gain and it is not surprising that such activities are banned in most Western countries. This, however, is not necessarily the Jewish view. While this is a complex and nuanced subject, some broad guidelines are possible.
Contrary to popular misconceptions, in most circumstances, donating one’s organs is a fulfilment of pikuch nefesh, saving another life. This is true both after death and in the case of kidneys while one is alive. Despite the fact that one can lead a perfectly normal life with one kidney Jewish law does not compel one to donate ones kidney. It is after all a procedure that carries some risk, discomfort and pain and we do not demand someone literally give away part of their body even to save another. The fact that there are so many people waiting – some until their untimely death – for organs reflects the difficulty most have in donating organs. One who despite the hardships performs this mitzvah is to be praised, period. While it is most praiseworthy to perform mitzvoth for their own sake the fact that one receives compensation for their efforts does not negate the mitzvah. This is true even if the money is the sole motivator for the donation. How may of us would go to work if we were not paid. Why should the fact that one is performing a mitzvah forbid one from taking money? Even the “agent” who connects donors to recipients may also be paid for their efforts. Care, of course, must be taken to ensure that people, especially the poor, are not preyed upon. How sad from a societal perspective if people feel the economic need to sell organs.
Rather than calling into question the motives of what others may call mercenaries Jewish law has taken a much broader view. If paying people to donate will increase organs available we will ultimately save many lives and that is the highest of Jewish values.