Yes, Let’s Pay for Organs
Not from the living, which would be degrading. But the dead are a different story
Pennsylvania plans to begin paying the relatives of organ donors $300 toward funeral expenses. It would be the first jurisdiction in the country to reward organ donation. Indeed, it might even be violating a 1984 federal law that declares organs a national resource not subject to compensation. Already there are voices opposing the very idea of pricing a kidney.
It is odd that with 62,000 Americans desperately awaiting organ transplantation to save their life, no authority had yet dared offer money for the organs of the dead in order to increase the supply for the living. If we can do anything to alleviate the catastrophic shortage of donated organs, should we not?
One objection is that Pennsylvania’s idea will disproportionately affect the poor. The rich, it is argued, will not be moved by a $300 reward; it will be the poor who will succumb to the incentive and provide organs.
So what? Where is the harm? What is wrong with rewarding people, poor or not, for a dead relative’s organ? True, auctioning off organs in the market so that the poor could not afford to get them would be offensive. But this program does not restrict supply to the rich. It seeks to increase supply for all.
Moreover, everything in life that is dangerous, risky or bad disproportionately affects the poor: slum housing, street crime, small cars, hazardous jobs. By this logic, coal mining should be outlawed because the misery and risk and diseases of coal mining disproportionately fall on people who need the money. The sons of investment bankers do not go to West Virginia to mine. (They go there to run for the Senate.)
No, the real objection to the Pennsylvania program is this: it crosses a fateful ethical line regarding human beings and their parts. Until now we have upheld the principle that one must not pay for human organs because doing so turns the human body–and human life–into a commodity. Violating this principle, it is said, puts us on the slippery slope to establishing a market for body parts. Auto parts, yes. Body parts, no. Start by paying people for their dead parents’ kidneys, and soon we will be paying people for the spare kidneys of the living.
Well, what’s wrong with that? the libertarians ask. Why should a destitute person not be allowed to give away a kidney that he may never need so he can live a better life? Why can’t a struggling mother give her kidney so her kids can go to college?
The answer is that little thing called human dignity. According to the libertarians’ markets-for-everything logic, a poor mother ought equally to be allowed to sell herself into slavery–or any other kind of degradation–to send her kids through college. Our society, however, draws the line and says no. We have a free society, but freedom stops at the point where you violate the very integrity of the self (which is why prostitution is illegal).
We cannot allow live kidneys to be sold at market. It would produce a society in which the lower orders are literally cut up to serve as spare parts for the upper. No decent society can permit that.
But kidneys from the dead are another matter entirely. There is a distinction between strip-mining a live person and strip-mining a dead one. To be crude about it, whereas a person is not a commodity, a dead body can be. Yes, it is treated with respect (which is why humans bury their dead). But it is not inviolable. It does not warrant the same reverence as that accorded a living soul.
The Pennsylvania program is not just justified, it is too timid. It seeks clean hands by paying third parties–the funeral homes–rather than giving cash directly to the relatives. Why not pay them directly? And why not $3,000 instead of $300? That might even address the rich/poor concern: after all, $3,000 is real money, even for bankers and lawyers.
The Pennsylvania program does cross a line. But not all slopes are slippery. There is a new line to be drawn, a very logical one: rewards for organs, yes–but not from the living.
The Talmud speaks of establishing a “fence” around the law, making restrictions that may not make sense in and of themselves but that serve to keep one away from more serious violations. (For example, because one is not allowed to transact with money on the Sabbath, one is not allowed even to touch money on the Sabbath.) The prohibition we have today–no selling of any organs, from the living or the dead–is a fence against the commoditization of human parts. Laudable, but a fence too far. We need to move the fence in and permit incentive payments for organs from the dead.
Why? Because there are 62,000 people desperately clinging to life, some of whom will die if we don’t have the courage to move the moral line–and hold it.
By Charles Krauthammer
Krauthammer, Charles. “Yes, Let’s Pay For Organs.” Time 153.19 (1999): 100. Academic Search
Complete. Web. 10 Nov. 2014.