A legal market in organs: the problem of exploitation

Abstract

The article considers the objection to a commercial market in living donor organs for transplantation on the ground that such a market would be exploitative of the vendors. It examines a key challenge to that objection, to the effect that denying poor people the option to sell an organ is to withhold from them the best that a bad situation has to offer. The article casts serious doubt on this attempt at justifying an organ market, and its philosophical underpinning. Drawing, in part, from the catalogued consequences of a thriving kidney market in some parts of India, it is argued that the justification relies on conditions which are extremely unlikely to obtain, even in a regulated donor market: that organ selling meaningfully improves the material situation of the organ vendor. Far from being axiomatic, both logic and the extant empirical evidence point towards the unlikelihood of such an upshot. Finally, the article considers a few conventional counter-arguments in favour of a permissive stance on organ sales.

Impact of gender and professional education on attitudes towards financial incentives for organ donation: results of a survey among 755 students of medicine and economics in Germany

“…For quite some time various authors have suggested the introduction of ‘incentives’ [4-6]. The broad spectrum of suggested models ranges from direct cash payments, free market solution or indirect money saving options, here defined as ‘financial incentives’, to incentives that mirror reciprocal non-financial compensation including tokens to express social acknowledgement, bonus points in cases of being on a waiting list, or the coverage of incurred health expenses for the donor.…”

Regulated Markets of Kidneys in Developed Countries or How to Increase Health Inequities

“…It may be obvious that bodily integrity is violated if an organ is removed from an individual without his or her consent, but even in a regulated market vendors often face conditions that limit the validity of their consent. As Greasley (2014) writes, it seems clear that poverty contributes to the irrational decision making of kidney vendors. True consent would require freedom from coercion, which is not possible if the basic capabilities of would-be vendors are not secured.…”

Exploitation: A primer

“…Brewer () and De‐Shalit () are accessible introductions to the connections between exploitation and imperialism, on the one hand, and global justice, on the other. Greasley () offers a cogent summary of the debate on exploitation in commercial organ donation. Structural exploitation is discussed in Zwolinski () and Young ().…”