Why Should We Compensate Organ Donors When We Can Continue to Take Organs for Free? A Response to Some of My Critics

Abstract

In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective-and morally justified-means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where "market-place morality" is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves.