PSSST… WANNA BUY AN ORGAN?: Charles Murtaugh has some very good stuff on organ-selling and why we should welcome it. I’d add that I think some of the resistance to organ sales is based on one mistaken belief and one real danger. The mistaken belief is that we’re discussing selling your organs while you live–like donating blood for cash, a la Midnight Cowboy. Poor people would line up to trade a kidney for the rent. I’m sure there are many libertarians out there who would love to see this marketplace of entrails, but that’s not what the current policy debate is about.
The real danger is fairly grim: Whenever a family benefits from the death of one of its members, there’s an incentive to provide less care, to hasten Grandma to that undiscovered country. When I was working on this story (about recoveries made by patients in comas and so-called “persistent vegetative states”), I heard many horror stories of lackadaisical care and relatives (especially spouses, I hate to report) who were practically sifting the gravedirt through their fingers with anticipation. [Edited to add: I realized that this sounds really, really callous to family members who want to spare their dying relatives pain. I didn't even think of that, because most of the horror stories I heard were about spouses who were, frankly, relieved rather than sorry that death would soon part them. But obviously that's not why most people rush their relatives through treatment--many times, doctors give inaccurate information about what kinds of pain relief are available and what prospects for recovery the patient has. Anyway, I'm really sorry if I caused any pain.] Doctors got in on the act as well, prematurely declaring patients dead so that the organ-mining could commence. But in all honesty, I don’t think this is a problem organ-selling will do much to exacerbate. It requires a bigger shift in how we think about pain relief at the end of life, and how we train doctors.
Murtaugh also quotes the often-acute Gilbert Meilaender to the effect that organ-selling would divorce a person from his body, making the body a commodity “owned” by the person rather than an element of personhood. It seems to me that in fact, because whether or not your organs are sold would be entirely dependent on your will (in both senses of the word), organ-selling would maintain the connection between person and body. Just as organ donation and requests for specific types of burial emphasize the connection between person and body, so too, I think, would organ sales. Unless, that is, you believe that selling an organ is somehow tainted in a way that donating one is not (insert prostitution analogy here); and I haven’t read any arguments on that score, but for the moment it seems pretty weak.
I’m not sure what Murtaugh’s getting at with his claim that the organ-selling debate parallels the drug-legalization one, though.