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For Sale, By Owner: The Psychology Of Repugnant Transactions

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There are more than 100,000 people waiting for a kidney transplant in the United States. According to the National Kidney Foundation, 14 new patients join that list every minute.

People can donate one of their kidneys and lead a healthy life afterward. But donation rates are far from meeting the need.

So what if donors were compensated with money?

"You own your kidney, you own it securely enough that you could give it to me if you wished, but you can't sell it to me," says Stanford economist Alvin Roth.

It is illegal in the United States to sell a kidney to another person. Similar bans exist in nearly every other country in the world. Alvin has coined a term to classify taboo exchanges like buying and selling organs: repugnant transactions.

"It's a transaction that some people would like to engage in, and other people don't think they should be allowed to, even if it's hard to see how those other people are harmed," he says.

This week on Hidden Brain, we discuss a range of so-called repugnant transactions, from kidney sales to poor dinner party etiquette. And we'll explore the factors that can turn a repugnant transaction into an acceptable one.

Additional Resources:

1) Alvin Roth blogs regularly about market design. His most recent book is Who Gets What ― and Why: The New Economics of Matchmaking and Market Design .

2) How do incentives impact decision making? This University of Toronto study examines that question.

3) Philosopher Debra Satz makes her case against certain repugnant transactions on a 2011 episode of the podcast EconTalk.

Hidden Brain is hosted by Shankar Vedantam and produced by Jennifer Schmidt, Parth Shah, Rhaina Cohen, Laura Kwerel, and Thomas Lu. Our supervising producer is Tara Boyle. You can also follow us on Twitter @hiddenbrain, and listen for Hidden Brain stories each week on your local public radio station.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Shankar Vedantam is the host and creator of Hidden Brain. The Hidden Brain podcast receives more than three million downloads per week. The Hidden Brain radio show is distributed by NPR and featured on nearly 400 public radio stations around the United States.
Parth Shah is an associate producer at Hidden Brain. He came to NPR in 2016 as a Kroc Fellow.
Tara Boyle is the supervising producer of NPR's Hidden Brain. In this role, Boyle oversees the production of both the Hidden Brain radio show and podcast, providing editorial guidance and support to host Shankar Vedantam and the shows' producers. Boyle also coordinates Shankar's Hidden Brain segments on Morning Edition and other NPR shows, and oversees collaborations with partners both internal and external to NPR. Previously, Boyle spent a decade at WAMU, the NPR station in Washington, D.C. She has reported for The Boston Globe, and began her career in public radio at WBUR in Boston.