I can sell my house, the things I make, and the services I provide. So why can't I sell one of my kidneys?
Our topic this week is Bodies for Sale.The buying and selling of vital organs is illegal in most developed countries. But there is a thriving, global black market in body parts. Should the buying and selling of organs be legalized and brought into the above ground economy? Or is something inherently wrong about treating the human body and its parts as mere commodities?
One thing for sure. There is huge pent-up demand for body parts. In the US alone, according to the National Kidney Foundation, over ninety-five thousand people are currently waiting for an organ transplant, with another four thousand added to the wait list every month. In 2006, more than six thousand people died awaiting life-saving organ transplants. And of the twelve thousand dying people who could donate organs, only about half actually do. The numbers are just staggering – utterly staggering. In 2002, the World Health Organization pegged the number of people suffering from diabetes around the world at a hundred seventy one million. By 2030 the number will climb to nearly four hundred million. Those folks are prime candidates for kidney transplants.
So… we’ve got a huge global demand for bodily organs and an inadequate supply of donations. Is it any wonder there's a thriving black market? Legend has it that a healthy kidney can fetch up to a hundred fifty thousand dollars. That’s a mighty tempting number. Doesn’t that suggest that if there were open, legal, well-regulated markets in bodily organs the supply problem would just disappear? And we might do a lot to alleviate third world poverty while we’re at it.
But legend and reality don’t always match. Take that hundred fifty thousand price tag for a kidney, for example. Numbers like that are sometimes thrown around on internet chat rooms, but the reality is quite different. In places like the Philippines or Iran -- where the buying and selling of organs is not against the law -- the price for a kidney is pretty low -- a few thousand dollars at most. It’s true that black market brokers will sometimes charge as much as ninety thousand dollars to their rich Western clients for third-world kidneys. But hardly any of that money reaches the person who offers up the kidney for sale.
You might think that the problem is the black market itself, but it also could be that even an open global market in kidneys might do more to enrich those who exploit the poor than it would do to help the poor themselves. Even open global organ markets have great potential to exploit the poor and desperate around the world by turning their bodies into repositories of spare parts for the well-off, without really doing much to improve their own lot. After all, not many middle or upper class Westerners are going to sell a kidney for a few thousand bucks -- even on a legal open market. And not many of the world’s desperately poor are going to be able to afford to buy kidneys on ANY market. So even in an open market the burden would fall disproportionately on the poor, while the benefit would fall disproportionately on the rich.
So the situation is deeply morally fraught. It seems pretty nearly completely upside down to the egalitarian liberal in me. And then there’s the intrinsic yuckiness of thinking about your own body parts as mere commodities. I tend to be a Kantian and the Kantian in me tends to recoil at the very idea of treating my own body as a mere thing, a mere tool to be bought and sold like any other commodity. Kant would probably say the buying and selling of organs is inherently wrong. When you sell an organ, you're treating yourself as a mere means, rather than as an end in itself. And Kant thought you should always treat yourself and others as ends in themselves. And my gut instincts almost always go with Kant on these matters.
But, of course, it turns out to be more complicated than Kant realized. When I sell my labor, for example, I allow my employer to treat me as a mere means. If it’s morally okay to sell your bodily labor, why isn’t it morally okay to sell your bodily organs? I'm not sure the Kantian has a satisfactory answer to that question.
We’ll put that question and much more to our guest, Debra Satz, author of the very fine book, Why Some Things Should Not Be For Sale: On The Limits of Markets. Tune in to see what she has to say.