Owning organs: Theory, bioethics, and public policy

This study examines arguments for and against the sale of human organs for transplantation by exploring the ways in which one can conceptualize the ownership of organs. The conclusions I offer lead to bringing into question current prohibitions against the selling of human organs. Despite the considerable disparity between the number of patients who could significantly benefit from organ transplantation and the number of organs available for transplant, as well as the apparent potential of a market in human organs to increase the efficiency and effectiveness of organ procurement and the number of organs available for transplantation, an emerging consensus holds such a market to be morally impermissible and promotes global prohibition. This study critically assesses the grounds for such proscription. I examine the moral, ontological, and political theoretical concerns at issue in a human organ market. The various advantages and disadvantages of such a market are explored. In each chapter, I mark out the grounds for holding that the global consensus to proscribe organ sales does not have the force usually assumed; indeed, how it may be misguided. First, it fails adequately to appreciate the phenomenological and physiological distinctions among different body parts, the relative strength of ownership rights, as well as the general significance of forbearance and privacy rights. Second, the global consensus fails as well to take adequate account of the closeness of the analogy between dominion/possession/ownership of one's body and dominion/possession/ownership of other types of things, or of the ground and e0xtent of moral political authority. Moreover, third, maximizing health care benefits, promoting equality, liberty, altruism, and social solidarity, protecting persons from exploitation, and preserving regard for human dignity are more successfully supported through permitting a market rather than through its prohibition. Finally, I consider foundational arguments from the history of philosophy, including the positions of Aquinas, Locke, and Kant, which would usually be held to prohibit the sale of organs. In each case the arguments on closer examination do not unequivocally preclude the selling of redundant internal organs or those from cadaveric sources. On balance the analysis supports a market in human organs, rather than its prohibition. Indeed, such prohibition likely causes more harm than benefit