[Psudo]

If someone needs a kidney to survive and you've got an extra that's a perfect match, it would be a widely considered a morally respectable action to offer it to them. Some might even call you a hero, saving their life like that.

Similarly, if someone's house is nearing foreclosure and you choose to pay few payments on their behalf, you've saved something for them that they deep precious. An honorable deed, agreed?

But if both of those troubled folks trade those favors, it becomes a financial transaction that includes a kidney; buying and selling kidneys is illegal by US and Canadian law. Is this truly a case where two rights make a wrong, or is this just another case of government intruding where it doesn't belong?

Harvard economy professor and alleged Republican Party hack Greg Mankiw argues that the informed, consensual transaction harms nobody and helps both traders, and thus is morally acceptable.

I'm also an alleged Republican Party hack, though I lack Dr. Mankiw's credentials (or any, really). However, I have a criticism of his reasoning. For most market-traded commodities, that which is traded legitimately is also stolen and illegally sold. Thus, a completely free market for organs would also incentivize organ theft, a violent and morally abhorrent cultural side effect.

I'm not sure if I support or oppose an organ market at all. I sometimes consider the principle that one's body should remain legally one's own, inalienable and exempt to transaction. This principle ensures my opposition to slavery, prostitution, organ sales, and arguably abortion and fetal research. However, I am hard pressed to explain why I believe that (it just feels icky), and the same principle would also oppose organ and tissue sales and donations, things that are commonly agreed to be moral (or at least acceptable) acts. I've even donated blood myself, thus contradicting my own principle. Clearly, I have other priorities greater than this principle, and an organ market could conceivably be argued convincingly as serving a greater principle (such as saving lives).

If one were to exist, though, I would insist on a ban of organ resell -- that is, it should be illegal to sell organs that are not biologically and naturally your own. This would be easily enforceable, I think; any doctor would be able to identify whether an organ in a person was naturally or surgically theirs, and any already harvested organ could be compared by DNA testing or similar, established methods.

What do you think? Should the ban on organ sales continue, or is that... heartless?

Edited to change title.

[Pseudonym]

It seems like it would be a relatively easy matter to use DNA testing and cut off organ theft. Free market sale of organs would open up transplantation lists for many men and women around the world. On pragmatic grounds, I think its easy for me to say I support opening up organ sales, provided sufficient legal protections exist.

However, with respect to moral principles applicable in this area, I am less certain. I vaguely recall that Mormon teaching holds the physical body to be sacred, and while I do not want to presuppose you holding that view, it seems like it would fairly clearly contradict open sale of organs.

However, if you draw the line at the sanctity of life rather than the sanctity of the body, you can justify the sale of supplementary organs or the sale of major organs if some functional mechanical replacement is available.

[Psudo]

Pseudonym wrote:

I vaguely recall that Mormon teaching holds the physical body to be sacred, and while I do not want to presuppose you holding that view, it seems like it would fairly clearly contradict open sale of organs.

That does ring a bell, and I can think of some semi-related Mormon traditions (such as avoidance of tattoos or body piercings). However, most of the Mormons I know are organ donors; if it's doctrinally wrong to donate organs it's not popularly known or obeyed.

It's an interesting point. I'll do a little research and get back to you. Either way, though, I don't see how that should affect the views of the non-Mormon population of this forum.

[Bacardi4206]

I think it should stay illegal, tbh I prefer professionalism. When it comes to organ donations. That is one subject where professionalism is required. When you are getting your heart from some professional government ran organization. They generally make sure you only recieve quality donations.

However if you release this market to the general public, any guy can just grab a heart from someplace no matter its condition. They wouldn't care about quality, they would only care about the money they are going to make. Anybody that's desperate for a organ wouldn't give twoshits to ask. The current system is working fine, the only downside is the lack of donors compared to people who require them but that will soon change thanks to science where hearts don't need to be donated, they can be made.

[Pseudonym]

Most synthetic organ replacements I am aware of act only as a bridge to transplant rather than a permanent replacement. While tissue engineering is showing promise (I have seen really interesting stuff on cardiac tissue grafts and articular cartilage), we may be a bit further off of a permanent organ replacement than you think. Nature can make some ridiculous stuff, and man can barely scratch the surface.

[Psudo]

Bacardi4206 wrote:

[organ donation] is one subject where professionalism is required.

Agreed.

Bacardi4206 wrote:

However if you release this market to the general public, any guy can just grab a heart from someplace no matter its condition. They wouldn't care about quality, they would only care about the money they are going to make. Anybody that's desperate for a organ wouldn't give twoshits to ask.

I would certainly ask, and any doctor would ask on behalf of his patient. If someone's desperate enough not to ask, maybe their need justifies taking a second-rate organ; maybe they're not going to live long enough to find a better one.

Also, "any guy" wouldn't be allowed to "grab a heart from someplace" to make money. I already said that people can only sell their own organs if there is to be an organ market at all. People would be severely limited on how many organs they can sell because there are only so many organs you can live without. It couldn't possibly be a career.

Bacardi4206 wrote:

The current system is working fine, the only downside is the lack of donors compared to people who require them

Maybe if people stood to make money they'd be more willing to give up their nonessential organs for others' benefit. The current system is working pretty well, but with every case being a human life at stake I don't know that "pretty well" justifies contentment.

Bacardi4206 wrote:

that [shortage] will soon change thanks to science where hearts don't need to be donated, they can be made.

The SynCardia Total Artificial Heart was invented in 1994 but not approved by the US Food and Drug Administration for use until a 10-year clinical trial was over. Think of the lives that could have been saved during those ten years if we didn't have to wait for the professionalism of the United States Federal Government to give the green light.

You're right that the technology for artificial organs will likely make the question of an organ market moot in few decades, much longer for livers.

___________________________
Pseudonym, I did that research on the Mormon view of organ donation. Seemingly, organ donation is popular among Mormons but there is neither a restriction nor a mandate issued by the Church leadership on the topic. It's left up to the individual adherent to follow their own conscience.

An LDS regional leader and medical doctor wrote a Q&A article that says that "The Church has taken no official position on organ transplants," that "organ transplantation does not affect one’s resurrection, since [...] we are promised that 'every limb and joint shall be restored to its body, yea, even a hair of the head shall not be lost.' (Alma 40:23)" and that "tremendous blessings have come to countless thousands and their families through organ donation and replacement." (The author's position within the church is roughly comparable to an unpaid Catholic Bishop. Alma is one of the books of scripture in the LDS canon, alongside the Bible.)

There are also anecdotal stories of organ transplants in the Ensign, including this one. Here's another article about tattoos and body piercings in relation to the LDS teaching of the sanctity of the body, in a Q&A format with a doctor similar to the article from my first paragraph (though this second doctor is a rank lower in LDS church authority, a leader over several congregations).

But, apart from scripture quotes, these are personal statements by church members, not doctrinal statements from authorities. The first LDS doctor says there are no such official statements on organ donation, which was probably fact-checked and is very likely true. As for the sanctity of the body generally, that is clearly LDS doctrine. This article by the head of the LDS Church's women's organization, outlines the LDS doctrine on the topic and includes a quote from LDS Church founder, Joseph Smith: "The great principle of happiness consists in having a body. The Devil has no body, and herein is his punishment." She condemns various affronts to the body's sanctity, including "unchastity, immodesty, self-indulgence, and addictions [...] pornography and abuse," but not organ donation.

[CKASlacker]

Pseudonym wrote:

Most synthetic organ replacements I am aware of act only as a bridge to transplant rather than a permanent replacement. While tissue engineering is showing promise (I have seen really interesting stuff on cardiac tissue grafts and articular cartilage), we may be a bit further off of a permanent organ replacement than you think. Nature can make some ridiculous stuff, and man can barely scratch the surface.

Agreed - we're actually a fairly long way off from "growing a kidney in a jar" type of scenario. There are a host of factors to consider when trying to grow an organ outside of the body. Internally, our organs our supported by arterial/venous structures which transport nutrients/waste materials to/from the organ. These sorts of things can prove to be very tricky ex-vivo.

On the initial question posed by Psudo, I don't have any objection to these sorts of transactions as they mesh quite well with my libertarian leanings. I don't see how anyone's life, liberty or property are being impinged on by the mutual, consensual transaction and thus don't have an issue with it.

I would add the stipulation (already mentioned) that one should only be allowed to sell one's own DNA -- too many possibilities for corruption exist otherwise. I'm thinking specifically of harvesting and selling organs of a family member over which you have power of attorney. That would be creepy.

[Psudo]

As I understand it, part of the libertarian philosophy is that the body is inherently one's own. One's self is to be protected, both bodily and by rights. One is entitled to the fruits of one's own labor except as traded by mutual, uncoerced agreement. To what extent does libertarian philosophy allow one to trade away one's 'self'? May a person trade their rights for money, or are their rights unalienable? May they trade away their life to the slaveholder? May they trade their body parts to the law-abiding cannibal?

If all three answers are "no" (as I expect, but not with certainty), by what reasoning are organs exempt to that inalienability of some traits?

[Quantum_Wizard]

Psudo wrote:

by what reasoning are organs exempt to that inalienability of some traits?

I don't consider myself a libertarian, but I don't think that many of them would consider organs (at least ones you can survive without) inalienable. Otherwise one could not donate e.g. one your kidneys even without compensation (say, to save a person you care about). Such a position would not be inconsistent but it would be rather surprising to me.

[CKASlacker]

Psudo wrote:

If all three answers are "no" (as I expect, but not with certainty), by what reasoning are organs exempt to that inalienability of some traits?

Quantum_Wizard said it better, but it's inconceivable that voluntary organ donation would be against libertarian principles, since they usually forgo "forced charity" (ie. higher taxes, welfare, transfer payments) in lieu of voluntary charitable donations as aids to the less well-off.

In principle, even the law-abiding cannibal scenario doesn't violate the mutual consent law -- although that would be pretty disturbing, and it would call into question the sanity of the organ-seller (thereby violating the mutual consent principle).

Of course, these situations ignore the reality that any surgeon actually performing an organ-removal-for-money scheme would be violating the Hippocratic oath (ie. do no harm), making these transactions likely black-market anyways... in which case the law is irrelevant.

[Psudo]

I follow your logic (except that the Hippocratic oath is nonbinding and, thus, irrelevant), but I want to play in the gray areas of those principles of "life, liberty or property" and "mutual consent".

Are there any conditions or terms under which a principled libertarian may consent to forgo his right to consent without abandoning his principles?

Can a man abandon his right to property such that he cannot later retrieve it?

Imagine a reality show in which everyone in the world tries to kill one man. The man concedes to abandon his right to life in exchange for fame and fortune as this show's star. He later changes his mind, wishing never again to be pursued by would-be murderers for public entertainment. He is then killed. Is it murder?

Generally, does contractual consent trump rights or do rights trump contractual consent? Or are there schools of thought within libertarianism debating this point?