Why We Are Not Allowed to Sell organs Some Common Arguments in Favor of Organ Commodificati A number of arguments in favor of allowing for a market, especially in kidneys, have surfaced in the increasingly heated debate surrounding trans- plant organs. Broadly speaking, such arguments can be split into two groups consequence-and rights-based ones. It should be noted that very few people, however, go all the way and propose an unregulated global market for organ transplantation. Arguments are commonly put forward in defense of a limited market, one that is rigged such that the active participants can be protected against the most blatant forms of harmful exploitation. For example, one could imagine a scenario where both the buyer and the seller had to be part of the same healthcare system, where there would be only one procurement unit in che system, where the prices would be set and nonnegotiable, and where the queuing system for the recipients remained the same as today. Such a limitation is said to be especially reasonable from a consequentialistic standpoint, as it is assumed to have more favorable consequences than its unregulated counter part. Whether such a system would, in fact, provide protection for the esp ially vulnerable is, of course, an empirical question. It is, however, doubtful if any of these arguments are convincing in the sense of being capable of giving an account of people's moral intuitions Consequentialist arguments are often structured along the following lines: It is fact that most people do not donate their organs, at least not to the extent that is required to make up for the organ shortage. It is said to follow that we ought to create a market for selling and buying organs because that would have the best consequences in the sense that fewer people would suffer, and die, in line for a transplant. The underlying assumption is that payment would result in more available organs. It is suggested that many people who are not prepared to part with their organs given the current legislation might well rethink their decision if they were paid. Evidently this is an empirical assumption, but it does not seem to be too far-fetched 5 A standard critique is to draw a parallel with the case made for blood donation by Titmuss in his book The Gift Relationship. b In that text, he argued that paying for blood would not increase the supply significantly, as those who had previously donated would be repulsed by the introduction of money in this transaction. The available empirical data do not suffice to determine whether this is true in the case of organ transplantation. However, it should be noted that donations are in this case-contrary to blood donation -essentially restricted to close relatives. It is a plausible hypothesis that the choice of giving one's kidney to a close relative is less influenced by a parallel market than the act of donating one's blood to an unknown recipient. Moreover Titmuss argued hat such a financial compensation would attract the wrong kind of people, for example, drug addicts, and thus threaten the quality of the blood. The scientific progress made since the 1970s has made it possible to test for a much larger range of diseases, a development that disqualifies Tit tmuss' s concerns that commercialization would increase the spreading of infectious diseases The second broad category of arguments consists of rights-based ones. The underlying assumption is that we have a right to our own bodies such that we are also entitled to sell parts thereof that we can make do without. It is suggested that the ruling out of a market in organs is, in fact, a grave violation of peoples most fundamental rights. Briefly, the gist of the argument is theSome Common Arguments in Favor of Organ Commodification A number of arguments in favor of allowing for a market, especially in kidneys, have surfaced in the increasingly heated debate surrounding trans￾plant organs. Broadly speaking, such arguments can be split into two groups: consequence- and rights-based ones. It should be noted that very few people, however, go all the way and propose an unregulated global market for organ transplantation. Arguments are commonly put forward in defense of a limited market, one that is rigged such that the active participants can be protected against the most blatant forms of harmful exploitation. For example, one could imagine a scenario where both the buyer and the seller had to be part of the same healthcare system, where there would be only one procurement unit in the system, where the prices would be set and nonnegotiable, and where the queuing system for the recipients remained the same as today. Such a limitation is said to be especially reasonable from a consequentialistic standpoint, as it is assumed to have more favorable consequences than its unregulated counter￾part.4 Whether such a system would, in fact, provide protection for the espe￾cially vulnerable is, of course, an empirical question. It is, however, doubtful if any of these arguments are convincing in the sense of being capable of giving an account of people’s moral intuitions. Consequentialist arguments are often structured along the following lines: It is a fact that most people do not donate their organs, at least not to the extent that is required to make up for the organ shortage. It is said to follow that we ought to create a market for selling and buying organs because that would have the best consequences in the sense that fewer people would suffer, and die, in line for a transplant. The underlying assumption is that payment would result in more available organs. It is suggested that many people who are not prepared to part with their organs given the current legislation might well rethink their decision if they were paid. Evidently this is an empirical assumption, but it does not seem to be too far-fetched.5 A standard critique is to draw a parallel with the case made for blood donation by Titmuss in his book The Gift Relationship. 6 In that text, he argued that paying for blood would not increase the supply significantly, as those who had previously donated would be repulsed by the introduction of money in this transaction. The available empirical data do not suffice to determine whether this is true in the case of organ transplantation. However, it should be noted that donations are in this case—contrary to blood donation—essentially restricted to close relatives. It is a plausible hypothesis that the choice of giving one’s kidney to a close relative is less influenced by a parallel market than the act of donating one’s blood to an unknown recipient. Moreover Titmuss argued that such a financial compensation would attract the wrong kind of people, for example, drug addicts, and thus threaten the quality of the blood. The scientific progress made since the 1970s has made it possible to test for a much larger range of diseases, a development that disqualifies Titmuss’s concerns that commercialization would increase the spreading of infectious diseases. The second broad category of arguments consists of rights-based ones. The underlying assumption is that we have a right to our own bodies such that we are also entitled to sell parts thereof that we can make do without. It is suggested that the ruling out of a market in organs is, in fact, a grave violation of people’s most fundamental rights. Briefly, the gist of the argument is the Why We Are Not Allowed to Sell Organs 61