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J. C. Lester (THES, January 24) asks whether there is anything apart from anti-market prejudice that stands in the way of payments to persuade people to donate organs.

There are quite a lot of arguments against the commoditisation of the human body that such a practice would imply; some of them are set out in the Nuffield Council on Bioethics report on Human Tissues: ethical and legal issues, published in April 1995.

One consideration that might be relevant even for those who do not accept the ethical arguments is that incentives to sell organs can end up as incentives for the less healthy to sell less healthy organs.

For a parallel case it is worth looking back at Richard Titmuss's account of commercial incentives to donate blood in The Gift Relationship: from Human Blood to Social Policy.

Onora O'Neill Chairman

Nuffield Council on Bioethics