Take a look at the following conflicting facts:
There are currently 113,198 [U.S.] patients on the United Network for Organ Sharing wait list for organ transplants. With only 28,535 transplant surgeries performed in the United States last year, it is clear that actions need to be taken to increase the supply of available organs. Around 7,000 Americans die each year while waiting for a suitable transplant (source).
In a study of India’s kidney market, 86 percent of donors had major health issues after their surgery. … The same study of kidney sales in India revealed that 79 percent of sellers regretted their decision to donate an organ and a shocking 71 percent of sellers were married women. Because poor women in India have little power, they can be easily forced by their husbands to sell their organs. (source).
Good health and survival are human rights. Those of us who have objections to unregulated markets in human organs have to show that markets fail, on balance, to further human rights protection and that alternative systems of organ provision perform at least as well as organ markets in terms of human health and survival. It’s important to note here that the comparison of the cases for and against organ sales will have to take the human rights of all – buyers as well as sellers – into consideration, and will also have to factor in all human rights and not just the rights to health and survival if the case against organ markets can show that other human rights may suffer if markets are implemented.
The typical argument against organ sales – and, by extension, against other types of commodification and other instances of the “imperialism” of the market – consists of three parts:
- some “things” are degraded or corrupted if turned into commodities
- if some “things” are traded for money then the profit motive may crowd out other types of motivation, and those other types of motivation are often morally valuable
- organ markets are typically coercive given the fact that poor people will be coerced by economic necessity to sell their organs.
The first point has been stated most clearly by Michael Sandel:
[M]arkets don’t only allocate goods; they express and promote certain attitudes toward the goods being exchanged. Paying kids to read books might get them to read more, but might also teach them to regard reading as a chore rather than a source of intrinsic satisfaction. Hiring foreign mercenaries to fight our wars might spare the lives of our citizens, but might also corrupt the meaning of citizenship. Economists often assume that markets are inert, that they do not affect the goods being exchanged. But this is untrue. Markets leave their mark. … We don’t allow children to be bought and sold, no matter how difficult the process of adoption can be or how willing impatient prospective parents might be. Even if the prospective buyers would treat the child responsibly, we worry that a market in children would express and promote the wrong way of valuing them. Children are properly regarded not as consumer goods but as beings worthy of love and care. Or consider the rights and obligations of citizenship. If you are called to jury duty, you can’t hire a substitute to take your place. Nor do we allow citizens to sell their votes, even though others might be eager to buy them. Why not? Because we believe that civic duties are not private property but public responsibilities. To outsource them is to demean them, to value them in the wrong way. (source)
Market values can indeed change how we look at things. If a human body is viewed as an organ mine, then ultimately this can destroy the dignity of the body, of the human person and of life itself. There is an inescapable incompatibility between the view that something has a financial exchange value and that the same thing has dignity. The horror of slavery wasn’t merely defined by the pain, the oppression and the lack of freedom suffered by slaves, but also by the fact that slaves were viewed as commodities rather than human beings. And although it’s unfair to compare organ trade to slavery, the same commodification and financial market logic underlies both. Commodification of the human person, whether as a whole or in part, is a failure to treat human beings with dignity and respect. Human beings shouldn’t be used as tools, instruments or resources.
Not even if it means saving people’s lives? Yes, not even if it means saving people’s lives, on the condition that there are other feasible ways of saving people’s lives. And there are. The fact that current rates of donation are not always and everywhere sufficient to meet the growing demand does not imply that all possible donation schemes are insufficient. Rather than giving up completely on donation just because current schemes don’t always work well we should focus on improving it, especially given the serious drawbacks of the market system that is hastily and sometimes lazily proposed by some.
I do understand the tendency of some to look for market solutions, especially given the success of markets in other areas of life. But there’s no good reason to assume that all social relationships should be financial ones.
The second objection to organ sales is that market values crowd out non-market values worth caring about such as altruism and solidarity. Not only is this intuitively persuasive – if people get money for things it’s likely that they’ll stop giving it away for free, and that giving in general will become rare when market values invade every part of life – but there’s also some evidence. This paper argues that donation rates would decline in a market, with detrimental consequences for social relationships. And this paper also finds evidence of crowding out.
I’ve dealt with the third objection – the coercion objection – in an older post.