Thursday, July 10, 2008

Is Organ Trading Moral or Immoral?


I have recently been actively debating on the Straits Times Online Forum concerning the aforementioned issue. The following are some of my thoughts on this matter. (In view of the parliamentary sitting, I have submitted this letter recently to the Straits Times, and is published online here at ST Online Forum 22nd July 2008)

Why I Oppose Legalisation of Organ Trading

THERE are several reasons why I oppose legalization of organ trading.

a. Commodification in bioethics

First, there is the problem of commodification of humans and their body parts which, as ethicist Paul Ramsey has aptly commented, 'will only erode still more an apprehension that man is a sacredness in the biological order'.

Unlike altruistically motivated donation, the sale of organs with the expectation of financial incentives is to commodify humans as mere objects or things, thereby violating the sanctity, dignity and respect due to humans within the living, biological order.

This point is further elaborated by Dr Thomas George, an orthopaedic surgeon, in the Indian Journal Of Medical Ethics, “On a superficial level it does appear that the sale of human organs benefits both the buyer and the seller. The sale of a kidney undoubtedly provides financial relief to a family in abject poverty. I am sure that many poor individuals in India and other Third World countries will exercise their ‘autonomy’ and ‘consent’ to sell their organs. When we oppose the sale of kidneys, we do so in the full realisation of this fact but also feel that humankind should not be thus degraded. We believe that by equitably distributing wealth and curbing the greed of the industrialised West, it is possible to provide a reasonable standard of living for all. This is not wishful thinking, it is a political agenda. We are aware that in the meantime there is much pain for many. Wishy-washy liberals with their piecemeal reform miss the wood for the trees. They are busy applying a BandAid here and some medicines there, ignoring the basic causes that compel large segments of mankind to live in such degradation.” - George, “Organs for sale, philosophy for hire,” Indian Journal of Medical Ethics 4 (1996)

b. Ontology and metaphysical concerns

In conjunction with the problem of commodification of humans is the ontological question, how should we view human beings within the biological order, and what about the purported sanctity of human life? I suspect that how we value humans (and their bodies), and whether we perceive them as sanctified creations or evolved organic molecules, will somehow determine the way we understand the issue of organ trading.

I am convinced that humans, and particularly human lives, have intrinsic value, and thus should not be degraded by means of their commodification.

c. Victims of circumstances, or recipients of distributive justice?

Ceteris paribus, what would be the main reason for the sale of one's organs? From current statistics and a study of the much-touted Iranian model of organ 'sharing', it seems clear that poverty is the chief motivating factor. I believe that even liberal bioethicists like Janet Richards would agree on this point.

The existence of such financial duress in the procurement of organs as commodities from the poor communities is a travesty of distributive justice. Surely something can be done by the Government to avoid this.

Another question we have to address is, should we ration organ availability by need or ability to pay? This is another key issue in the discussion of organ trading and distributive justice.

d. Social justice for the poor

The argument that money received helps the seller-donor rise above his poverty is gravely flawed. It must be the duty of a civilized society to ensure that none of its citizens is in such a dire state of poverty that the poor have to be reduced to selling themselves piecemeal for survival.

e. A genuine slippery slope which is not a fallacy

If we do permit the sale of body parts piecemeal, what then is the overarching moral or ethical principle which would furnish us with a limit to such organ sales? Hypothetically, if we were to respect the autonomy of organ donors-sellers ad infinitum, should we then permit the sale of a kidney, and subsequently the cornea, a limb, the liver and so on?

In other words, if the commodification of human organs is allowed as an ethical practice in Singapore, what then should be the transcendental moral basis to disallow such a slippery slope in the piecemeal disassembly-cum-commodification of a human being?

In view of these points, I seriously think organ trading must remain an unethical vestige of human exploitation.

PS: These points are open for debate and discussion. A guiding discussion framework which we can use are the four principles espoused by Raanan Gillon - autonomy, beneficence, non-maleficence, and justice. Please let me know your thoughts on this, if any.

6 comments:

watchdog on science said...

I find your blog on Organ Trading very worthwhile. I believe most people are not aware of this unethical practice and how it affects the poor. I wonder if you can relate this subject to women who donate their eggs for IVF practices. These women, mostly who are poor, even in the U.S., also receive large sums of money for selling their eggs, but cloak their incentives with “doing good for others”. It is all the same…a kidney or an egg.

The only thing that I find objectionable in this blog is your reference to “wishy-washy liberals”. I believe polarizing the arguments by using political statements greatly does more harm than good and will sway good people from your site.. There are many liberals who find organ trading offensive. And I am sure there are conservatives who are as “wishy-washy” as the liberals you depict in your blog and who could care less about the poor and their plight.

One’s political bent is not what measures a man. It is his character, intentions and actions that make the measure. I don’t think God gives a damn if you are liberal or conservative. And neither should you.

vincit omnia veritas said...

Hi Watchdog on Science,

Good point.

Will keep that in mind.

By the way, I guess you were referring to the quote I used (by Thomas George)?

God bless,
Vincent

Mike Messerli said...

Vincit,

I had no idea! I guess I should have known this was going on, but it never entered my mind. It's sad that when we have nothing else we sell our children or ourselves. What a sad fallen world we live in.

And by the way, it's good to have you back. I hope all is going well for you.

wenxian said...

Hello vincent,

LoL i thought there were only three principles in bioethics: autonomy, justice and benificience.
(Belmont Report)

Anyway, organ trading is obviously immoral (bioethically) because it violates the prinicple of authonomy (over-excessive reward) and the principle of justice (unfair advantage to wealthy folks who need organs, who can queue in two lines instead of the usual one).

What do you think?

vincit omnia veritas said...

hey Brother Wenxian,

Greetings in Christ's precious name!

Yes, I do agree with your observations.

I think bioethics will be an exciting (and needful) area to be in ... just look at the number of issues we have to face in Singapore!

And of course, we need Christians who can stand up to the rabid influx of pragmatism in this rapidly advancing area of Science. I guess both Jenson and yourself would be good people to discuss such issues with :P

Of late, organ trading is the hot potato in the Straits Times.

yours truly,
VC

Evangelical books said...

Hi Vincent,

Welcome back to blogsphere.

Perhaps when I am in dire straits, I might sell one of my kidneys. But till then, this body stays intact, awaiting the resurrection body.

Sincerely,
Jenson