I don’t know how it would work. I don’t know how to resolve the potential and likely ethical dilemmas. I don’t know how not to quantify “the worth of a person” versus “the worth of their parts”. But I do know that I favor free markets in everything that is legal—and many things that are currently illegal and unlikely to be legalized soon, including drugs, sex, gambling and other “illicit” activities—so I’d want to explore how this ‘market’ could also be opened somehow.
I am unalterably opposed to central planning, “board” decisions about who lives and who dies because of a critical short supply of organs that would be made available, and the fact that everyone else profits from the current system… except the donor family. (And we do have to face the fact that it’s usually a donor “family” that would profit, because most of our important organs are one-to-a-customer and you pretty much need it for life, yourself.)
Since kidneys are an exception to that general rule, I’d like to start with some kind of “open market” in kidneys, because in that particular case living donors could make their own decisions and still live with the consequences—and benefits. Of course, I’m aware of more ethical problems: informed consent, for one, freedom from force and fraud for another, the disparity between rich beneficiaries of organ supply and poor “donors”. But I think our current system could hardly be made worse than it is, and a sole reliance upon altruism is… stupid, given what we know (or at least should know, by now) about human nature and free markets.
Free markets have made us the richest country on Earth—and are making the rest of the world more prosperous than “board decisions” and “central planning” ever could, would, or did. There’s no reason they couldn’t continue to benefit us in this way, if the infrastructure could be set up to enable it.