Kantian Condemnation of Commerce in Organs
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1. Kantian ethics condemns the practice of organ selling through transplant tourism based on his categorical imperative that humanity should never be treated merely as a means. 2. Specifically, Kant argues that selling parts of one's body treats the person as a commodity and undermines their dignity. 3. While some argue organ sales could be acceptable if voluntary and safe, critics maintain the practice still promotes the notion that the poor can be used by the wealthy for profit, violating human worth.
Kantian Condemnation of Commerce in Organs
- 2. Small Group Discussion: 10-12 minutes 1. What is transplant tourism? What do you know about the current issue? 2. What is your opinion about creating a regulated market? Is it ethical to pay someone for their organs? 3. What are the potential dangers of transplant tourism? 4. WWKD (What would Kant do?) Why do many critics of the practice maintain that this practice violates a categorical imperative? 5. Would this practice likely be acceptable through a utilitarian lens? Why? One person in the group should record responses and names.
- 6. Small Group Discussion: 3-5 minutes 1. What stood out to you in the videos? 2. Did any of your opinions change, or were any reinforced by what you saw? One person in the group should record responses and names.
- 7. Transplant Tourism Problem: Growing, unregulated market 1. Some want a regulated market. 2. Opponents make Kantian arguments on formula for humanity Kant implies selling off your organs wrong…
- 8. Can choosing to sell one’s kidney be morally permissible? Kant would say, “No.” There are limitations on what a person can permissibly do to her body and on how she may allow others to use her for their purposes.
- 9. Humanity, whether in one’s own person or that of any other, must never be treated merely as a means, but always at the same time as an end, is Kant’s instruction. He thought that organ sale violates this imperative: “To deprive oneself of an integral part or organ (to maim oneself); for example, to give away or sell a tooth to be transplanted to another’s mouth … are ways of partially murdering oneself.”
- 10. 1. “A man is not entitled to sell his limbs for money…. One may dispose of things that have no freedom, but not of a being that itself has free choice. If a man does that, he turns himself into a thing, and then anyone may treat him as they please, because he has thrown his person away; as with sexual inclination, where people make themselves an object of enjoyment and hence into a thing.” 2. … man is not his own property, and cannot do as he pleases with his body; for since the body belongs to the self, it constitutes, in conjunction with that, a person; but now one cannot make one’s person a thing…. Now, it is evident that if someone concedes a part of himself to the other, he concedes himself entirely. It is not possible to dispose over a part of oneself, for such a part belongs to the whole. 3. “Man cannot dispose over himself, because he is not a thing. He is not his own property—that would be a contradiction; for so far as, he is a person, he is a subject, who can have ownership of other things. But now were he something owned by himself, he would be a thing over which he can have ownership. He is, however, a person, who is not property, so he cannot be a thing such as he might own; for it is impossible, of course, to be at once a thing and a person, a proprietor and a property at the same time.”
- 11. Problems with the Interpretation Opponents don’t specify what dignity is, what ends are, what are permissible means, etc. For example, the author asks whether the person is being used as a means if permission is given, if both parties are treated with respect, etc. Thus, the Kantian argument needs interpretation: Examples to work with: 1. Entrepreneur: Two well-off people in rich country, both fully informed. 2. Transplant tourist: The broker is a good one, and pays for the surgery and recovery. 3. Regulated Market: The government market in a developing country; the guy does the surgery and gets cash and insurance for life.
- 12. Entrepreneur A 30-year-old man who is in good health sells one of his kidneys for $50,000 in order to finance a new business. He has a secure job, but not enough savings to get his venture off the ground. The buyer is a 45-yearold woman in end-stage kidney failure whose health is deteriorating to the point that her doctors soon will deem her too sick to remain on the national waitlist for an organ. Both buyer and seller have a thorough understanding of the health risks each will incur. The buyer pays for the organ with her own funds, without giving up her financial well-being or that of her family. She has excellent insurance, which covers all the rest of her medical expenses. She pays the medical expenses that the seller incurs, and guarantees him health insurance for the rest of his life. Both are cared for by first-rate physicians in a state-of-the-art facility.
- 13. Transplant Tourism A 25-year-old, married man in a developing country has struggled as a laborer to make ends meet. Expenses for food, housing, and, especially, medical care for his wife have landed him in debt. His creditors are harassing him to pay what he owes. He agrees to sell one of his kidneys to a broker for $2,500. As the seller is aware, the broker is an agent of a nearby clinic, one that provides services to transplant tourists from wealthy countries. The broker tells the seller that it is easy to explain the risks he will face: the surgery necessary to harvest the kidney poses little threat to his well-being; in all likelihood, he will be fine in a few weeks. In addition to giving the laborer the cash, the broker pays for the surgery, as well as for the medical expenses incurred during the seller’s recovery. The surgeon is experienced and competent, and the facilities for surgery and recovery are adequate.
- 14. Regulated Market A 25-year-old, married man in a developing country has struggled as a laborer to make ends meet. Expenses for food, housing, and, especially, medical care for his wife have landed him in debt. His creditors are harassing him to pay what he owes. But in his country, the government has established a regulated market in organs. A government employee gives the man a thorough and comprehensible description of the short- and long-term health risks posed by kidney extraction as well as of the benefits he will receive if he sells an organ, including $2,500 and health insurance for life. The man goes ahead with the procedure and indeed receives the cash and insurance coverage.
- 15. Value-Based Account Two accounts– Possible Consent and Value-Based Possible Consent– specifies a sufficient condition for an agent’s violating the Mere Means Principle. Value-Based— Expressing Respect for the worth of humanity Means that something is an end in itself: 1. It’s an objective end (as opposed to subjective): would count as an end for all rational agents. 2. Has absolute, unconditional worth – no matter what context it’s in, how it emerged, or what its effects may be 3. Has dignity (Kant contrasts with “price”) a) Means it has incomparable worth – something with dignity can never be equivalently traded for something with price b) And you can’t sacrifice/trade something with dignity for something else with dignity
- 16. Value-Based Account: Expressing Respect for the worth of humanity Thus an action needs to “express respect for the worth of humanity.” (157) Kant’s example: wrong to sell a tooth 1. Rich people in late 18th century Europe would sometimes purchase teeth from the poor. High fees Mostly aesthetic for the buyer – nice, white teeth were in fashion Potentially dangerous to the seller
- 17. Value-Based Account: Expressing Respect for the worth of humanity 2. Assuming that it was consensual, Kant would still condemn it. Possible justifications: a) Involves putting self/health at considerable risk for somebody’s beauty-- (1) Therefore not respecting your own humanity (2) Answer: It's no health risk for us today. (What if the risks aren’t great?) b) Teeth are important-- (1) They occupy an intimate part of your body. (2) So the act signals you’re willing to sell even an intimate part of yourself (160) (3) Answer: this conflates tooth and personhood. Can you really compare a tooth to a kidney? c) This sort of action tends to promote others of its type— (1) Thus would presumably be true even if a given act of selling a tooth doesn't actually cause anybody else to do so (2) But it needs to be empirically plausible (3) So it's empirical, but plausible, to say that in K’s time this reinforced the notion that the poor were tools for the rich, and could make themselves available as such (4) Comparable to organ transplants- For the author, this is the best argument.
- 18. Do Organ Transactions Express Respect for the Worth of Humanity? Following the third argument: 1. The key premise is that “at least in a certain historical context, actions of the type-- ‘selling a tooth to increase comfort’ -- tend to promote a notion that is inconsistent with the idea that humanity has dignity, namely the notion that a person is available for the right price for others to use as they will” (162). 2. “The question is whether the types of actions performed by the buyers and sellers in the examples of organ sales would tend to promote this notion” (162). Consider any problems with the three scenarios. 3. If so, then there'd be a Kantian problem. It is the author’s position that a Kantian problem does exist.
- 19. Do Organ Transactions Express Respect for the Worth of Humanity? Organ Buyers: 1. They’re buying from somebody who’s very poor. 2. They’re unlikely to see that person as their moral equal. 3. It does not seem a stretch to maintain that “actions of this type tend to encourage the notion that such laborers themselves, and not merely parts of their body, can be had for price and so lack Kantian dignity” (162). 4. Whether that slide happens would be context-dependent.
- 20. Do Organ Transactions Express Respect for the Worth of Humanity? The government: 1. Might also violate – Still poses the issue that only poor people would do this. The wealthy would have no reason to. 2. And so government policy sanctions the idea that poor people themselves are to be for sale for the comfort of others. The entrepreneur situation: 1. Unclear what encouragement that would get (163) 2. Since he is socially privileged, it might not necessarily encourage others to see him as mere means. 3. However, he is still selling an intimate part of himself for profit. Organ sellers--- This would be like the tooth selling??? How might it be different?
- 21. Final Points 1. This is empirical – It’s hard to get data in this area. 2. Just because, say, the laborer does something wrong does not imply we have to blame him for it – he may not know. 3. Even with possible gray area and variant circumstances, there are still huge problems within Kantianism for accepting this practice as ethically permissible-- 1. Encourages a general rule that some can be treated as a means for betterment of others 2. Encourages poor treatment and opinions about the sellers 3. Even in a government-regulated market, it could encourage government abuse. What if the government is responsible for the economic circumstances that create a need to sell organs for profit in the first place. 4. Just because this is mostly condemned by Kantianism, does not mean that you could not argue it’s ethical permissibility through your own interpretation or by using an opposing theory.