Get Off Your Dead Horse, Moral Arguments a Necessity

Logical Fallacies Rampant in Bioethics Debate on Organ Trading

An essay which was recently published in the Straits Times is an excellent example of such logical fallacies. The article, written by Michelle Tan Su May, is entitled, "Get Off Your High Horse, Moral Arguments a Luxury." As the title insinuates, when it comes to certain dire circumstances in life, we are justified in putting our moral values aside. Worse, such moral or ethical arguments are not even relevant to the bioethical issue at hand. Tan Su May wrote, "Moral arguments are a luxury that healthy people indulge in before misfortune befalls them too." This is one of the most ridiculous statements made in any bioethics debate in organ trading.

The writer's original words are in italics; my comments follow each paragraph of Tan's writings.


Get Off Your High Horse, Moral Arguments a Luxury
by Michelle Tan Su May

(The writer is a businesswoman in her mid-30s. A lawyer by training, she runs a property investment firm and owns an antiques shop. She is married with two children.

This article was first published in The Sunday Times on July 6, 2008.)

I am so sick and tired of hearing people who truly know nothing about the situation debate this issue in a vacuum, in principle, in theory, as a hypothetical ethics essay.

Comments: This is an ethical issue, and moral philosophers have to address the bioethical aspects of organ trading. Morality is about right and wrong. If morality has nothing to do with organ trading, then there is nothing right or wrong about it. Why, then, are you complaining about the status quo? There is nothing right or wrong (amoral) about the status quo then.

I was 14 when my dad's kidneys started to fail. It was the realisation of our worst fears, the culmination of a lifetime of worrying.

Comments: Not to sound too callous, but what has your father’s Chronic Kidney Disease to do with the question, “Is Organ Trading Moral or Immoral?” Aren’t you appealing to pity (argumentum ad misericordiam)?

My whole childhood was filled with fear that my dad would die. Having been a diabetic since he was 20 years old, potential loss of sight, loss of his limbs and subsequent kidney failure were the perennial phantoms that lurked in the shadows of his entire adult life, and thus my whole childhood.

Comments: I sympathize with your childhood fear. Perhaps you could have seen a child counsellor or psychiatrist. But again, what has your “fear” to do with the question at hand, “Is Organ Trading Moral or Immoral?” Could you be attempting to sway public opinion on this issue by appealing to the sympathy of the readers (playing the victimization card)?

His burden of daily injections of insulin, never being able to eat anything sweet and a strictly restricted diet were suddenly compounded by kidney failure. Now, in addition to no sugar, he could not take any salt or water. His daily quota of water was only two tiny shot glasses a day - and these small mouthfuls had to wash down more than 10 pills daily.

Comments: What has your father’s insulin usage, daily dose of secretagogues, and low eGFR to do with the question, “Is Organ Trading Moral or Immoral?”

The simple things that we take so much for granted became unattainable luxuries to him. Drinking, eating, walking without assistance, being able to urinate normally, being able to see your kids finish their O levels or PSLE (my younger brother).

Comments: Argumentum ad misericordiam, again.

He was only 39 at the time. He went on the two types of dialysis available to cleanse his blood of toxins. The first type (peritonial dialysis), which involved having a tube dangling out of a hole cut into his tummy, worked quite well for him but because of his diabetic condition, the hole kept becoming infected. So after a few months, he had to go on the more tedious type - hemodialysis. This involved him being hooked up to a machine daily for up to three hours at a time after having metal tubes the size of knitting needles inserted into his arm.

Comments: Again, for the umpteenth time, what has your father’s dialysis experience to do with the question, “Is Organ Trading Moral or Immoral?”

This did not work for him. So the symptoms of kidney failure returned full force. Constant retching, yellowed eyeballs, constant weakness, the inability to walk without assistance, and the inability to work. He was a Simex trader, and an outgoing man.

Comments: We get the picture. So he was a retching Simex trader with jaundice and uremia. What is the point?

After a few months, we were given the bad news and the worse news. The bad news was that the dialysis was not working for him and he needed a transplant. The worse news: Because he had diabetes as well, he was not eligible to be placed on the Singapore organ waiting list! Without dialysis or a transplant, he would die within months. The doctor was basically delivering the news of a death sentence.

Comments: Do you know the clinical reasons which made him ineligible for waiting list placement?

Fortunately, we were informed that it was possible to find a donor in India and have a transplant operation carried out there. After months of blood tests and groundwork, my dad flew to Mumbai to have the transplant. Despite putting on a brave front, he was terrified that he would not survive the operation. He told me later that he had brought extra money, 'in case I had to come home in a box'. I can only imagine what it feels like to say goodbye to your children at the airport thinking it may be the last time you ever see them.

Comments: An appeal to consequence.

So, getting a new lease of life via organ trading makes organ trading morally right?

The donor was a poor young man with a young family from India. He earned approximately $30,000 for his kidney. He used the money to buy a shop and start a business to support his young family. This young man and my dad gave each other a new lease of life.

Comments: Again, appeal to consequence

So, earning $30,000 morally justifies organ trading, right?

My dad lived for seven years after that transplant. He died aged only 49, but he lived to see my brother turn 20 and to attend my university graduation. Never a day went by that he wasn't grateful for this second chance at life. Seven years is a lifetime when you have faced death and managed to get a second chance. Going through all that has also made me a stronger person today.

Comments: Appeal to emotions. So what has that got to do with the question, “Is Organ Trading Moral or Immoral?” We are not wondering if organ trading brings great dividends, or if organ trading can lend you seven more years to see the kids grow up. Is organ trading moral or immoral?

Madam Lam Yar Ee, in The Straits Times Forum page, said: 'The Health Ministry should discipline Singaporeans who return after participating in organ trading.' I say she should visit the homes of dying people who have no other option before she spouts such nonsense. She should look into the eyes of their loved ones, their young children, and get off her high horse.

Comments: Appeal to emotions; argumentum ad odium.

What “nonsense” are you referring to? What if Madam Lam is promoting that which is moral?

You mean, if we look into the eyes of our loved ones, we will find the impetus to do that which is immoral?

Mr Jeffrey Chan said organ sales are wrong because they are 'exploitation of the poor'. Let me ask him this: If you were told that you could have someone abandon their children for years to come and live in your house and to wash your dirty underwear, to wait on you hand and foot, and to clean up your bedridden relatives' faeces, for up to 16 hours a day at 60 cents an hour, wouldn't you think such a situation sounded inhumane and unacceptable? Yet that is what our foreign domestic workers are forced to accept by coming here to work in Singapore.

Comments: OK. So two wrongs make a right? Does the alleged "exploitation" of the domestic helper justifies your exploitation of the poor in organ trading?

Plus fallacies of fake precision & dicto simpliciter.

You mean all maids clean feces for 16 hours each day? You mean every one who employs a maid employs them to clean feces 16 hours each day? You mean every maid in Singapore is married with children?

Do they like it? No.

Comments: How do you know that? Are you omniscient? Emotional appeal and victimization card.

Do they have a choice? Yes and no. They could stay at home and have nothing to feed their children. Or they could come over here in the hope of a better future eventually for their children. Yes, they are poor. Yes, they are desperate. By the same token, Mr Chan would have to argue that we ban the use of domestic workers because it is also exploitation of the poor.

Comments: False dilemma (false choice).

You sure those maids come to Singapore simply because they have nothing to feed their children with (oh, and how do you know if all of them have children?)?

And how do you know if their children would have a better future in Singapore? Aren't these statements mere bare assertions?

It is time to wake up. The world is unfair, life is unfair. It is unfair that some people can live in good health until their 90s, while others like my father die at 49 or earlier. It is unfair that we get to be surrounded by our children and loved ones, while people like my Indonesian maid (whom we treat as part of our family and pay $500 a month instead of the standard $350) have to leave their kids for years in order to eke out a living in a foreign land so their children won't starve.

Comments: So what has this apparent unfairness to do with the question, “Is Organ Trading Moral or Immoral?”

Inequality is a fact of life. Therefore, the role of a sophisticated society should be to regulate all dealings to ensure that the poor, the unhealthy and the desperate know their rights, and their risks versus their potential returns before they embark on any life-changing decisions. Taking the choice out of their hands in the name of protecting them is paternalistic and patronising. Being poor does not equal being stupid.

Comments: But taking that Hobson’s choice out of their hands is to protect them (the poor) from exploitation by moneyed patients like yourself. Since inequality is a fact of life, all the more we should see to it that distributive justice is upheld. That means that donor kidneys should not come only from the poor.

I wonder, did your kidney matched your father’s MHC complex? Never considered that option, yes?

My stance is: 'Get off your high horse.' Till something terrible happens to you, you don't know what you would do to survive.

Comments: Again, an appeal to consequence. Oh, if something terrible happens to me, it justifies my immoral dealings, whatever that might be.

Life is unfair. Poverty is unfair. Ill health is unfair. But we can do something to alleviate the misfortunes of those who are unlucky by allowing them the freedom of choice to save a life and better their own at the same time.

Comments: You mean we ought to "alleviate the misfortunes" by doing something inherently immoral? That’s fantastic advice from a mother of two. No wonder Singaporean kids are behaving like demons.

Freedom of choice results in human beings maintaining their dignity.

Comments: Dignity in what? In doing something immoral? So you gain your “dignity” by performing immoral acts with your autonomous “free” choice?

The dying man who can buy a little more time, and the poor man who can better his family's life by selling an organ that he will be perfectly healthy without - they can both regain some dignity by entering into such a transaction with their eyes wide open and being well-informed of their rights.

Comments: Finally, how does that answer the question, “Is Organ Trading Moral or Immoral?”

Moral arguments are a luxury that healthy people indulge in before misfortune befalls them too.

Comments: Logical fallacies ad infinitum ad nauseam. This is a scare tactic and argumentum ad metum (appeal to fear).

They are some who choose to do that which is morally right even when “misfortune” befalls them. Your statement reminds me of that doctor who hides at home during the SARS crisis.

By ignoring the morality of one’s actions, one becomes a cancer of society, a tumor that seeks to justify its own evil with pragmatic considerations and financial incentives divorced from ethics, altruism and justice. Surely no civilized society wants to be part of that tumor.