Countries with long waiting lists for organ transplants should be able to experiment with a system to allow people to donate a kidney in return for a financial reward, a Dutch criminologist and international lawyer recommends.

Frederike Ambagtsheer, criminologist and international lawyer at the Erasmus University in Rotterdam, included the proposal in her PhD thesis about organ trade. The present ban on organ trading doesn’t work and leads to higher prices and a lack of screening and aftercare for both patients and donors, she claims.

Ambagtsheer thinks the government should be in charge of the reward system. ‘It could come in the shape of free health insurance, tax breaks or money,’ she told the Volkskrant.

In 1987 the trade in organs was banned by the World Health Organisation. It is usually the poor and most vulnerable who illegally offer their organs for money.

‘To say: you are poor and therefore you can’t sell a kidney is frankly paternalistic. The trade in organs may be immoral but so letting people on a waiting list die,’ the paper quotes Ambagtsheer as saying.

But professor of health law Martin Buijsen thinks there is ‘nothing paternalistic’ about the ban. ‘It is morally wrong that you can persuade poor people to part with an organ more easily than rich people. That is why the ban is part of the human rights charter, so the vulnerable in society are protected,’ he told the paper.

A change in the present donor system would be a much more logical choice, Buijsen says. ‘The D66 proposal for active donorship (an opt-out system instead of an opt-in system, DN) is now awaiting approval by the senate. That should yield more organs and respects human rights. It would not get rid of the waiting lists completely but no system would,’ the paper quotes him as saying.

Ambagtsheer’s is not the only voice to advocate a financial reward system for kidney donation. Corinne Dettmeijer, national rapporteur on trafficking of human beings, thinks a discussion about a responsible system merits broader political attention, the paper said