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In this paper I explore the human organ procurement system. Which is better for saving lives and limiting black market use, the present altruistic system of donations or a free and open sales market? I explain that there is a risk with maintaining the present system, the altruistic vision, and that people may die who might otherwise live if the sale of organs was permitted. But there is no guarantee that permitting organ sales would effectively address the current supply-side shortage and global use of the black market. In addition to discussing the implications of these procurement systems, I look at methods to increase organ donations and I explore the differences between presumed and explicit consent. Ultimately, I conclude that the altruistic donation system, bolstered by the addition of a policy of presumed consent and appropriate financial incentives, is a better choice than a legal sales market in spite of its shortcomings.

Health Matters: Human Organ Donations, Sales, and the Black Market