Moral Economics: What Controversial Transactions Reveal About How Markets Work

by Alvin E. Roth

A Nobel Prize-⁠winning economist shows us why we have to deal in trade-offs when we can't agree on what's right and what's wrong.

Some of the most intractable controversies in our divided society are, at bottom, about what actions and transactions should be banned. Should women and couples be able to purchase contraception, access in vitro fertilization, and end pregnancy by obtaining an abortion? Should people be able to buy marijuana? What about fentanyl? Can someone be paid to donate blood plasma, or a kidney?

Disagreements are fierce because arguments on both sides are often made in uncompromising moral or religious terms. But in Moral Economics, Nobel Prize-winning economist Alvin E. Roth asserts that we can make progress on these and other difficult topics if we view them as markets-tools to help decide who gets what-and understand how those markets can be fine-tuned to be more functional. Markets don't have to allow everything or ban everything. Prudent market design can find a balance between preserving people's rights to pursue their own interests and protecting the most vulnerable from harms.

Combining Roth's unparalleled expertise as market design pioneer with his incisive, witty accounts of complicated issues, Moral Economics offers a powerful and innovative new framework for resolving today's hardest controversies.

Genres: Economics, Nonfiction, Sociology, Psychology, Audiobook

337 pages, Kindle Edition

Published May 21, 2026

About the author

Alvin Elliot Roth (born December 18, 1951) is an American academician personality, he is the Craig and Susan McCaw professor of economics at Stanford University and the Gund professor of economics and business administration emeritus at Harvard University.

Roth has made significant contributions to the fields of game theory, market design and experimental economics, and is known for his emphasis on applying economic theory to solutions for "real-world" problems.

In 2012, he won the Nobel Memorial Prize in Economic Sciences jointly with Lloyd Shapley "for the theory of stable allocations and the practice of market design".

Reviews

[Thomas · Rating 3 out of 5]

This was an interesting book that I wish went a bit further. Alvin Roth discusses controversial transactions (e.g., donating kidneys or blood plasma, sex work, abortions, etc.) and what these fraught exchanges reveal about markets and emotions. I felt that he explained the concept of repugnance well and that the overview for each of these transactions was well-described.

However there were several areas where I wanted a bit more in-depth discussion. For example he raises the idea of regulating sex work (which he uses the term “prostitution” to describe throughout), though from what I’ve read from actual sex workers it seems that decriminalization of sex work for sex workers may be more ideal… Roth writes that having increased police presence may help bolster the safety of sex workers, though from what I’ve read police themselves can and do abuse sex workers, so, that was a point of contention for me. I also found Roth’s ideas pertaining to how social values/social justice influence these topics to be a bit tepid. He acknowledges for example how greater positive attitudes toward same sex couples influences perceptions of gay marriage. However, when he writes about abortion and in vitro fertilization, he didn’t really address the role of patriarchy and bodily autonomy, which I found puzzling. It’s not so much that I expected him to lampoon the patriarchy (though that would’ve been nice) in regard to abortion, though not explicitly naming it seemed odd to me.

Finally, and I know this wasn’t really the point of the book, though I couldn’t help but think about how in the U.S. our tax dollars are being used to support Israel in their genocide against Palestinians… I suppose this isn’t the type of “transaction” Roth focuses on here, though it definitely brings up feelings for me related to the morality of certain economics.

[Jim Welke · Rating 4 out of 5]

The author discusses things that are legal in some countries and illegal in others. In the US, if you donate blood, you can get paid for your time; not so in most countries. While prostitution is, for the most part, illegal in the US, it is legal in many countries. The author also discusses illegal drugs and same sex couples.

[Jim Gise · Rating 3 out of 5]

I was hoping for more of a Freakonomics vibe with this book. While Roth correctly recognizes the efficiency of prices, he gives too much weight to social repugnance as a constraint, thereby underappreciating prices as signals that coordinate supply, demand, and innovation.

[Antony Monir · Rating 4 out of 5]

This book is what I describe as a fantastic resource for a contemporary issues debate course. By focusing on how “repugnant” markets emerge and how they affect and are affected by social norms, Roth takes an interesting approach to many contemporary issues. Instead of looking at these typically moral issues from an ethics perspective, Roth seeks to study the consequences of said issues. For example, should kidney donors be compensated? Instead of discussing the moral arguments for each side (though there is a bit of philosophy in this book), Roth focuses on the simple principles of economics. He argues that repugnant transactions/markets (such as paying somebody for a kidney) should be studied just like any regular transaction/market. Thus, applying the principles of supply and demand as well as substitute/complementary goods, we can create other arguments to whether these repugnant transactions should be legalized. As it is obvious from what I wrote, this book takes a consequentialist approach with regard to moral issues. Though, it isn’t without nuance. Roth recognizes the moral complexity of these issues and does not necessarily claim to have the answer to the debates, rather he offers a new tool, a new framework of discussion.

This book covers contentious topics such as prostitution, organ donation, medical challenge trials, and so on. In all these cases, Roth shows that due to demand existing for these services (whether or not this demand is a good thing is outside the scope of the book), the simple answer of banning/criminalizing these markets outright fails. It can either create a more harmful black market (due to lack of regulation and oversight) or simply fail to produce a supply to match the demand. In either case, the discussion is on the supply side. I found Roth’s arguments clear and persuasive, and the data is well sourced. Though he does often reach consequentialist conclusions, I believe that most people, even if they disagree with his conclusions, will find that the topics at hand are more nuanced than previously thought.

Overall, this was a great read. It is an interesting and contemporary subject. And who hasn’t had a debate about legalizing drugs/prostitution/compensation for organ donation/etc. before? I think if you care about social issues and especially issues of legalizing currently illicit markets, you will find Roth’s latest book a fantastic resource. 4/5

[Chris Boutté · Rating 5 out of 5]

This book wasn’t what I was hoping for, but it was 100x better than other books written on similar topics. One of my all-time favorite authors is Michael Sandel (he needs to hurry up and write a new book), and one of his great books is What Money Can't Buy: The Moral Limits of Markets. Sandel is a moral philosopher and his book discusses a bunch of different topics involving the morality of different things being for sale. For example, he dives into the moral discussion around buying organs, and how we don’t allow it because it would greatly harm those in poverty. What I love about Sandel’s writing is that it really makes you think about morality.

I thought this book from Roth was going to be along those same lines, but it really wasn’t. Roth’s book basically does the same thing as Sandel, but it doesn’t really have much moral discussion beyond, “Some people find this repugnant.” A lot of this book discusses topics like prostitution, organ sales, adoption, and others, but rather than really diving into the moral discussion around these topics, he kind of gives a history of the laws and different court cases.

Again, this book is 100x better than others I’ve read on similar topics. The author writes in a way that’s easy for anyone to understand, and while I don’t typically like books that discuss a lot of history, this one kept my attention, and I learned a ton. I’m just a huge fan of moral philosophy, so I was hoping this book was a little different. It’s a great book overall, though.

[Kate Black · Rating 5 out of 5]

Stumbled upon (and was intrigued by) this title on my quest to read more non-fiction. Though verbose, it’s a fascinating, enlightening, and clear dialogue of how markets operate when transacting morally contested services.

[Emily Ack · Rating 2 out of 5]

The book doesn't deliver. The writing doesn't even support its catchy byline: "What Controversial Transactions Reveal About How Markets Work."

Overall, Alvin Roth needed to emulate Freakonomics. For those who haven't read Freakonomics, those books are structured with each chapter presenting a "weird" conclusion, with the rest of the chapter discussing the data that created the argument and throwing in economic concepts when needed. That approach creates a memorable and cohesive takeaway.

Here, Roth is doing the equivalent of a survey course. He has a couple of strong opinions that are evident, but there is no deep discussion of logic, economic concepts, or philosophy. While he offers quotes to represent each side, he doesn't do anything to address their core values. For instance, he will quote a Roman Catholic representative, but then not address their fixation on protecting life. All discussions I see on political issues involve differing core values, and ultimately most discussions talk past each other because they can't see that. Roth doesn't bridge those gaps at all; he only describes the fight.

For claiming to be an economics book, he doesn't address any economic concepts (which, there are both economic market forces and behavioral elements that could be discussed. But we get neither!).

If he had been more selective and offered a deeper analysis of some core issues, I think this would have an impact. For example, the closest he gets is a discussion about legal prostitution. There was a loophole created in Rhode Island law that offered a short window of legal prostitution there, while still being illegal in surrounding areas. This is the about the only example where we have any data to compare, but even this takeaway is barely anything.

Overall, it's a lot of words to say, "Public perception changes over time; most of these issues will have a change of perception, I think. I hope we all change to see the world the way I want it to be. I love kidney transplants."

[Daniel Sepúlveda · Rating 5 out of 5]

Puntaje: 4.6 Estrellas.

Antes de comenzar esta reseña, quiero agradecer a Basic Books por enviarme una copia digital avanzada de este libro para su lectura.

La no ficción fue la categoría de la cual más libros leí el año pasado, y quiero mantener esta tendencia en este nuevo año. Es por eso que no solo estoy avanzando con mi TBR físico, sino que también me interesé por ver cuales son esos libros que serán publicados en 2026.

Entre esos libros encontré “Moral Economics”, escrito Alvin Roth, economista y académico quien ha recibido múltiples reconocimientos por sus trabajos de investigación, incluyendo el prestigioso Premio Nobel de Economia. Lo que me llamó la atención de este libro fue su subtítulo: “Desde la prostitución hasta la venta de organos, lo que las transacciones controversiales revelan sobre cómo funcionan los mercados”. Estoy seguro que sólo con esta información ustedes también quedaron con ganas de leer este libro.

Pero qué es lo que realmente vas a encontrar en este libro? El Dr. Roth explicará conceptos y teorías económicas que rodean lo que él llama “Transacciones repugnantes”, que son aquellas en las que los participantes no tienen problema en realizarla, pero que por razones morales o religiosas, otras personas consideran que no se deben llevar a cabo. De hecho en las primeras páginas del libro se expica muy bien este término con los ejemplos del tema de asuntos intimos, los cuales involucran el sexo (Tanto prostitución como el sexo entre parejas homosexuales) , la reproducción (métodos de inseminación in vitro, entre otros) y el matrimonio.

Pero lo que más me gusta de todo esto, es que Roth no sólo explica los términos y nos da ejemplos de lo que ocurre en la vida real, sino que plantea escenarios en los que se explica qué podría ocurrir si se trabajara en leyes que regulen estos asuntos. Veremos ejemplos reales de cómo la legalización y la no legalización de estas prácticas afectan la economía y la salud pública de esos lugares, desmontando mitos que estaban unicamente basados en creencias religiosas.

Por ejemplo, en el primer capitulo se cubre el tema de la prostitución, y se mencionan los efectos tanto positivos como negativos que ha enido la legalización de esta práctica en varios países, y también cómo esta legalización ayuda a mitigar problemas de salud pública y seguridad, así como a disminuir el poder de los mercados negros. Me gustó además la explicación de los términos “Repugnante” y “Disgusto” y de cómo la diferencia entre ambos puede determinar que tanto se regula un acto sexual.

Y es que lo fascinante de este libro es que la lectura está acompañada de casos reales que te dejarán atónito y que , al mismo tiempo, permitirán comprender lo que el Dr. Roth está explicando. Por ejemplo, en la parte dedicada a la reproducción, se habla sobre la inseminación in Vitro y la donación de esperma, por lo que contaremos con la explicación sobre las implicaciones científicas y legales de estas actividades, asú como la privacidad de los donantes y los derechos de los hijos nacidos bajo esta modalidad.

En fin, este es un libro con el que el lector, sí o sí, aprenderá algo nuevo. Ya sea por los términos económicos y las implicaciones de todo lo mencionado en él, o ya sea por los ejemplos y casos reales que ocurren alrededor del mundo y permiten entender más claramente las implicaciones que tienen los diferentes modelos de legalidad que se han aplicado sobre estas prácticas.

Recomiendo que, si leerás este libro, lo hagas de a poco, pues tiene tanta información que lo mejor es que vayas leyendo y procesando lentamente todo lo que encuentras aquí. Además, este es un libro perfecto para lecturas conjuntas y clubes de lectura, pues cada capítulo presenta una multitud de oportunidades para hablar sobre todos estos temas. Justo esta es la razón por la que recomiendo este libro a todo el mundo, no solo a académicos y economistas, sino al público en general, pues los temas explicados aquí hacen parte de la vida diaria, y es importante entenderlos para no dejarnos llevar por las ideas de terceros.

[Alex Chan · Rating 5 out of 5]

“Moral Economics” is one of those vanishingly rare books that changes the way you see the world while also making you laugh out loud. Alvin Roth somehow pulls off an almost impossible feat: he reunites the two Adam Smiths—the hard-headed analyst of markets and the deeply humane moral philosopher—and turns what could have been a dry academic exercise into an intellectual roller coaster.

This book has everything: sex, drugs, organs for sale, political taboos, moral panic, and enough uncomfortable questions to start an argument at every dinner table in America. But what makes it extraordinary is Roth himself. He doesn’t hide behind jargon or sterile theory. He pours his guts onto the page with wit, honesty, and the confidence of someone who has spent a lifetime thinking seriously about how humans actually behave—not how economists wish they behaved.
And somehow—somehow!—it’s a page-turner. An economics book that reads like a thriller and lands jokes like a seasoned columnist. One chapter makes you rethink kidney markets; the next has you laughing at the absurdity of modern moral contradictions. I found myself underlining passages constantly and then immediately texting them to friends.

Most economics books want to impress you. This one grabs you by the collar and forces you to think. Roth doesn’t sermonize; he interrogates. The result is humane, provocative, funny, unsettling, and completely unforgettable.
Mandatory reading for economists, philosophers, policy wonks, and anyone who has ever wondered where morality ends and markets begin. A genuine tour de force.

[Chris M. · Rating 4 out of 5]

Very good overall. Some sections were more well-written than others. Roth is very knowledgeable when it comes to the subject of kidney transplants and the market behind them and how they're handled in different countries. Other sections in the book fall short such as the chapter about alcohol and drugs. He discusses the subject with enough detail, but when discussing narcotics like opioids, he indicated that those who were cut off from their prescription were forced to look at the black market for alternatives. However, this is only partially true. Roth neglected to discuss the pharmaceutical companies and their role in marketing drugs like Oxycontin in the 1990s and 2000s and the kickbacks doctors received from prescribing these medications under the pretense that they were not addictive. We would come to find out that this claim was false, but not until many people became addicted or died.

That said, there is some great information about the role markets play when it comes to transactions that are repugnant ( you will see that word a lot in this book). There are great examples about externalities and second order effects as a result of banning an activity or legalizing it. He makes a great case that outright banning most things that may be repugnant will open the door for black markets to thrive, but at the same time, bans are technically easier to enforce.

I would recommend if you like books like Freakonomics.

[Tyler Jones · Rating 5 out of 5]

What the author describes as repugnancy is basically people in power trying to control other people’s lives because they don’t like something. It’s unfortunate that this power dynamic ends up harming so many people who could otherwise benefit from transactions that have no external harm.

Just because I don’t like pineapple on pizza doesn’t mean it should be made illegal for other people to eat pineapple on pizza. Now substitute pineapple on pizza for any number of examples in the book, and one can hopefully see how ridiculous it is that people try to keep these transactions illegal.

As far as paying vulnerable groups for transactions, such as blood donations goes, the US already has plenty of legal ways that prey on vulnerable groups. For example, military recruitment and other dangerous jobs are disproportionately filled by low socioeconomic status individuals. So why is a line drawn in the sand here when these transactions could help people? Never mind the fact that the medical system could save money by paying people for these transactions versus the cost of long-term care and harm that befalls patients when certain resources (blood products, organs) are limited.

[Molly · Rating 4 out of 5]

3.5 stars. I picked this up because it’s premise and discussions closely mirrored those I was first introduced to in my first year of undergrad in a class called “What Isn't For Sale? And What Shouldn't Be?”, in which we explored many of the same case studies/arguments presented by Roth, but more through a philosophical/ethics lens. It was good to revisit these arguments, especially with the more practical framing of economics and markets, and I think if I had not taken this class in college the book would have been more impactful since they both hit many of the same points. Roth stated that he wanted to present all arguments for each case as fully and impartially as possible, but I do believe I may have actually gotten more out of this had he committed to defending a position on the given topics, and making a more thorough case for each. Nevertheless, I appreciated this book and the concepts it’s discussing, and will be recommending it to friends.

[FT · Rating 4 out of 5]

Not exactly sure what to think of this. The whole book centers around repugnant transactions. That is, when two willing parties want to trade, but others object on moral grounds and may want to ban it.

Paying kidney donors is the classic example. Honestly, the author's expertise in this area is clearly vast and he may have been better served just writing a book about that.

However, the variety of repugnant transaction descriptions was interesting. But my main issue is that there did not seem to be a coherent theme for the book. I don't know. Maybe I kind of missed that.

The pros/cons of things like legalized prostitution, IVF, surrogacy, blood donation, and organ donation were well described. But PEDs and gambling, for instance, were barely discussed. Not sure why they were, other than some filler.

Interesting book. Not sure I'd read it again, though. So probably more like a 3.75.

[Rachael · Rating 5 out of 5]

I loved this. I can't quite tell you why I loved it, but I started recommending it while I was still in the prologue, and stand by that recommendation.

The author did a really good job of presenting both sides to things - even when it was clear that he had a stance - and did it well enough that I begrudgingly acknowledged that maybe the arguments of the "other side" (i.e. the side I don't agree with) had some basis.

Anyways, it was a great audio-book, narrator was great, subjects stayed interesting, I learned a lot, and am a lot more interested in economics than I was a few days ago.

[Surya · Rating 1 out of 5]

Mr Roth has been a very influential thinker, writer, and doer.. Alas this book does not represent his best work.
This could have been an essay, a podcast, an interview, or even a Ted Talk.
He has written down a bunch of known issues, given a background almost entirely based on a US or a US Centric view.
At some point, thinkers, even of Mr. Roth's stature, must get out of this US view and write about the world at large. Or, they can put in the cover as a limiter - only for US audiences or a US story..

I am disappointed

[Christian · Rating 2 out of 5]

It’s well-written and entertaining but at 70 pages in I just couldn’t understand what the point was any longer. Maybe it’s just me but these questions about repugnant markets doesn’t really make for a particularly insightful reading experience. They’re interesting to debate and get you thinking differently, but as others have referenced wishing it was like Freakonomics, I too felt like I was just reading a survey of topics with no greater insight.

[Mike · Rating 4 out of 5]

Moral Economics explores the uneasy line between what people want to sell and what society wants to ban. Sex, kidneys, blood donations, IVF, hitmen, and assisted suicide all get pulled into the debate.

Roth shows how repugnance, our collective disgust toward certain transactions, often shapes what society allows people to buy and sell. Thought-provoking, accessible, and packed with examples that show how messy markets become when morality sets the rules.

[Marisa · Rating 4 out of 5]

Definitely Interesting enough, but it feels like the first 80% of the book is a set up for the author to talk about Kidney exchange. Maybe he should have just written a book specifically about the repugnancy around various policies surrounding kidney donation?

[Michelle · Rating 4 out of 5]

Take a shot every time this book uses a form of the word “repugnant” and you will die quickly. Jokes aside, interesting topics and well researched. overall I liked the book.

[Rae Simpson · Rating 4 out of 5]

Minuteman. Due before had time to read in depth.

[Steve Brock · Rating 5 out of 5]

I have selected this book, in its hardcover edition, as Stevo's Business Book of the Week for the week of 6/28, as it stands heads above other recently published books on this topic.

[Tessy · Rating 3 out of 5]

Not quite as informative as I would have thought. A lot of it is very intuitive. While the content is interesting to think about and the writing is good, I don't feel as though I learned much.

[Bob Cutler · Rating 5 out of 5]

A lot to think about but the author makes good arguments about whether "repugnant" transactions should be allowed

[Pablo Paniagua Prieto · Rating 4 out of 5]

wonderful book about the moral and economic tradeofs of repugnant markets, worth a read!

[Professor E. Mackaay · Rating 3 out of 5]

Original in what it discusses, but too wordy

Original in setting out the link between bans, regulation and social norms in framing markets for delicate goods and services, and the drawbacks of black markets. The book suffers from poor quality English that a proper editing job could have corrected, whilst also shortening the text a bit.

[Augusto Alves · Rating 3 out of 5]

I’m all for having honest debates about the cost of bans and I agreed with many of the author’s arguments. However, he could have engaged more directly (or at all) with the moral issues underlying many of the existing rules. It would be naive to think that you can simply sidestep them and assume the utilitarian perspective as given. This was a conscious omission that will undoubtedly reduce the book’s reach and impact. A worthwhile and engaging read nonetheless.