[NYT] JUNE 30, 2009 – Need a kidney? You may be able to buy one in Pakistan, which has become one of the world’s largest “kidney bazaars,” according to an article published in the May-June issue of The Hastings Center Report, a bioethics journal.

But who sells their kidneys, and what becomes of these people afterwards? The article, by two doctors and a psychologist from Karachi, paints an ugly picture of the kidney business and challenges the argument made by some that selling organs is a great financial boon to the poor and that they are grateful for the chance to do it.

Organ-selling is illegal in this country, but the idea of allowing it has been debated in the medical world for years, with some arguing that people have a right to sell their organs and others saying that allowing it will inevitably exploit and harm poor people.

The authors conducted lengthy interviews with 32 people who had sold kidneys. All were desperately poor, and most were illiterate and in deep debt to the rich landowners whose farms they worked. Most earned $50 or $60 a month on the farms and netted about $1000 for a kidney, though “none reported receiving the total amount they had been promised,” the article reports.

None of the vendors questioned directly, except one, would recommend selling a kidney to anyone else, including those who had managed to pay off their debts.

Many were troubled after the surgery, with lingering pain and weakness, worries about their health and feelings of regret and deep shame. Some tried to hide what they done, even from their own families, and one said people in the community made fun of those who sold kidneys. Many called hospitals and doctors “kings of thieves,” and felt victimized and deceived.

One seller told his younger brother, “even if you have to suffer humiliation for ten years, do not give your kidney”—and was angry that the brother sold his kidney anyway. Another seller advised, “stay hungry if you have to, do not give your kidney.”

-Denise Grady