2026/05/14 by Luke Semrau
paper · doi:10.1002/japp.70100
ABSTRACT Nondirected living kidney donation is safe and life‐saving, yet vanishingly rare. The standard account says this is because altruism is rare and warns against the use of money. I argue this gets things backwards. Donation is rare because, being so extraordinary, it is socially unintelligible: absent a suitable social narrative, we read donors as either pathological or saintly. Neither identity inspires. As a result, the practice fails to live up to the ideals it is supposed to embody. Its social meaning should be revised. I propose a civic model that frames donation as a contribution to the public good. The practice would be governed by the same nonmarket norms that are already in place, with donors receiving a service award that signals recognition, not price. Under these conditions, the award would function not primarily to induce but to restore intelligibility. Money, far from suppressing altruism, can enable it.