British philosopher Janet Radcliffe Richards at the University of Oxford has written: “If you die through mistakes in moral reasoning, you are just as dead as if you die through mistakes in medicine.” The aim of the authors of this thought-provoking cost-benefit analysis is to estimate and inform us about the cost to American society of the limits—perhaps owing to mistakes in both moral and economic reasoning—on the ability of healthy individuals to donate or supply their second or “extra” kidney to those who have kidney failure.The 1984 National Organ Transplant Act makes it unlawful to share anything of value between organ donor and recipient, prohibiting exchange for “valuable consideration” (meaning, specifically, payments beyond “reasonable” expenses for removal, implantation, etc).