The ethics of legalizing organ sales for transplantation

Commercialization of Organ Transplants

Throughout the history of organ transplantation, organs have become available in two different ways: when a person who was an organ donor has died, and when an organ that can be removed from a living body has been offered for donation to a friend or family member. There are also registries for items like bone marrow, which can be donated to someone who is not a friend or a member of the family. However, there have also been arguments made that it should be legal to sell organs for transplantation if the individual consents to doing this. These organs could be sold to a particular patient who was in need, or they could be sold to a medical institution to use in any patient that institution saw fit.

Naturally, many people believe this to be completely acceptable. One person has something another person needs, and the person who has it sells it to the other person who needs it. There does not seem to be much concern with that in general, but when it comes to organs, the ethical quagmire becomes much more difficult to navigate and there are serious moral implications that do not have to be considered when selling an inanimate object but should be considered when a person is considering selling a part of himself or herself to another. The sale of organs is wrong and unethical, and should remain against the law despite recent attempts to legalize it

The Argument for Selling Organs

Those who argue that it is acceptable to commercialize organ transplantation make several arguments in favor of this practice. These include the statement that the organs belong to the person, and if he or she wishes to sell them, it should not be the business of the government and lawmakers to say that this is not acceptable. There is also an argument that these people would be saving lives by selling their organs, so they are actually doing a good deed in a world that sees far too few of those in recent years. The fact that they receive money for this is not, technically, relevant to their argument about saving lives or doing something good for society as a whole.

Of course, another argument for selling organs is that the value of society outweighs the value of a particular person, and the person who is saved by a particular organ that was sold to him or her may go on to do much more for society than the person donating the organ. This utilitarian belief that the most happiness is achieved by everyone in this scenario is the most common moral argument generally used for issues of this nature. In general, all of the arguments that are made in favor or organ donation follow this ethical leaning. However, there have been many who have discredited the idea of utilitarianism.

Utilitarianism states that the thing that achieves the most happiness for everyone involved is the thing that is the right choice from a moral standpoint (Brody, 1988; Shaw, 2014). Those who believe that organs should be able to be sold commercially for transplantation often use that argument because they want to show that allowing for these kinds of sales will not only make people happy because they get needed organs, but will make other people happy because they get money. On the surface, this makes sense.

However, there is more to the issue than that. Those who argue under utilitarian principles often fail to take into account the reasons behind why people make their choices (Epstein, 2009). In other words, they focus only on the happiness they perceive people to have, but they do not focus on the issues that that alleged happiness may also create (Veatch, 1988). Where medical ethics is concerned, there are many gray areas and things are not as black and white as they seem (Brody, 1988; Epstein, 2009). This is often ignored, but should be clearly addressed.

The Argument Against the Commercialization of Transplants

Those who argue against the commercialization of organs for transplantation, as does this research, do not accept the utilitarian argument for happiness of all as being a satisfactory reason for allowing the legal selling of organs. There are too many flaws in that argument to make it a logical one for this particular issue. Instead, those who believe that organs should not be sold for transplantation believe in a more Kantian approach. Kant believed that it was not necessary to know anything about the results of a particular choice in order to know that choice was not moral (Shaw, 2014).

With medical ethics, it is not always about the outcome of something, but about what would have to take place throughout the process, that makes it morally unacceptable (Brody, 1988). Yes, a person would receive money, and another person would receive an organ. On its surface, it appears to be an acceptable trade. Despite that, though, the trading of a part of oneself for cash seems, within its core, to be an immoral proposition (Epstein, 2009; Veatch, 1988). The organs that make up a person's physical body being for sale to the highest bidder really goes against everything human beings stand for in the majority of cases, and is not something that should be viewed in the same manner as selling a house, a car, clothing, or something inanimate in nature (Veatch, 1988).

Kant believed that the only thing that was good will (Shaw, 2014). In other words, even something like vast intelligence could not be good in and of itself. If that intelligence was held by an evil person, it would be a bad thing, and not to be prized or appreciated. With that in mind, there would not be a reason for people to get money for their organs. If they were truly exercising good will, they would give freely and not expect compensation -- much like they already do. By asking for (or even accepting) money for organs that are used for transplantation, these people would be removing good will from the equation and reducing the value of their organs to something that was only monetary, which does not have the same type of value.