As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being (...) and that he or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused. (shrink)

There is a libertarian argument for live donor organ markets, according to which live donor organ markets would be permitted if we simply refrained from imposing any substantive and controversial moral assumptions on people who reasonably disagree about morality and justice. I argue that, to the contrary, this endorsement of live donor organ markets depends upon the libertarians’ adoption of a substantive and deeply controversial conception of strong, extensive property rights. This is shown by (...) the fact that these rights would prevent states intervening in cases of preventable and intuitively impermissible wronging of others that can arise when free individuals engage in voluntary offers and exchanges. I outline two forms of such wronging: discrimination and disrespectful demands. I argue that although these types of acts are morally impermissible, the policy question of whether and how they should be regulated by states is non-trivial. I then argue that there is good reason to think that organ markets would rely on disrespectful demands. This may help explain the widespread moral repugnance people feel toward organ trading. It also provides a prima facie, though not decisive, case for states to prohibit such markets. (shrink)

In my recent article in the Journal of Medical Ethics, I attacked the Laissez Choisir Argument in defence of letting individuals choose whether to sell kidneys or other organs as living donors, and I argued that such transactions should generally remain prohibited.1 The LC Argument arises as a response to a prohibitionist claim that I endorse: organ sales should be banned to protect potential poverty-stricken vendors, even if a free market could provide great benefits to potential organ recipients. (...) The LC Argument says that this is misplaced paternalism, since banning the market only takes away from willing vendors what they must regard as their best option, thereby leaving them even worse off, at least as they see things. My refutation of the LC Argument pointed out, on the contrary, that giving some people the option to sell their organs may harm them in ways they would reasonably prefer not to be harmed—even though they would reasonably prefer to take the option once it is presented. The upshot is that many potentially willing organ vendors might themselves reasonably prefer prohibition. I argued that the harms of a live donor organ market to this group would in fact be significant and unavoidable, and that it would be morally impermissible to impose these harms. And I suggested that this argument for prohibition best explicates an inchoate but widely shared moral concern about the exploitative nature of live donor organ trading.I thank Gerald Dworkin, Janet Radcliffe Richards and Adrian Walsh for their engaging and often insightful commentaries.2–4 I agree with a lot, but I will …. (shrink)

A prominent defence of a market in organs from living donors says that if we truly care about people in poverty, we should allow them to sell their organs. The argument is that if poor vendors would have voluntarily decided to sell their organs in a free market, then prohibiting them from selling makes them even worse off, at least from their own perspective, and that it would be unconscionably paternalistic to substitute our judgements for individuals' own judgements about what (...) would be best for them. The author shows that this ‘Laissez-Choisir Argument’ for organ selling rests on a mistake. This is because the claim that it would be better for people in poverty to sell their organs if given the option is consistent with the claim that it would be even better for them to not have the option at all. The upshot is that objections to an organ market need not be at all paternalistic, since we need not accept that the absence of a market makes those in poverty any worse off, even from their own point of view. The author goes on to argue that there are strong theoretical and empirical reasons for believing that people in poverty would in fact be harmed by the introduction of a market for live donor organs and that the harm constitutes sufficient grounds for prohibiting a market. (shrink)

The traditional command and control approach and the more recent free market have proven inadequate for promoting ecological agricultural development in China. Organic certification represents a regulated market mechanism with the potential to stimulate ecologically based agricultural research, extension, and investment. Recent linkages between the global organic food industry and local agricultural development in China provide an opportunity to test this potential. The article examines China’s two largest organic certification systems for their potential to promote the adoption of integrated pest (...) management (IPM) as a key component of ecological agriculture. Organic certification is providing a format for research, extension, and implementation of IPM principles and practices, and has the potential to do much more. However, possible contradictions between ecological and market rationality, inherent in organic certification and marketing systems, may be exacerbated by the authoritarian political economy of rural China. (shrink)

The ongoing bioethical debate about organ markets rests not only on theoretical premises, but also on assumptions regarding public views of and attitudes toward organ donation that need closer socioempirical examination. Summarizing results from our previous qualitative social research in this field, this paper illustrates the ethical significance of such public moralities in two respects: On one hand, it analyzes the implicit bias of the common rhetoric of “organ scarcity” which motivates much of the commercialization debate. (...) On the other hand, it explores the blind spots of the paradigm of “altruistic donation” which informs many arguments against commercialization. We conclude that the ethical discourse has to appreciate the social nature of organ donation as a reciprocal interaction between different parties with irreducibly different but equally relevant viewpoints. We criticize the neglect of such well-founded public considerations in certain philosophical-ethical approaches and stress the need for further systematic and comparative socioempirical studies about peoples’ actual perspectives in bioethics. (shrink)

Advocates of paid living kidney donation frequently argue that kidney sellers would benefit from paid donation under a properly regulated kidney market. The poor outcomes experienced by participants in existing markets are often entirely attributed to harmful black-market practices. This article reviews the medical and anthropological literature on the physical, psychological, social, and financial harms experienced by vendors under Iran's regulated system of donor compensation and black markets throughout the world and argues that this body of research not (...) only documents significant harms to vendors, but also provides reasons to believe that such harms would persist under a regulated system. This does not settle the question of whether or not a regulated market should be introduced, but it does strengthen the case against markets in kidneys while suggesting that those advocating such a system cannot appeal to the purported benefits to vendors to support their case. (shrink)

One common objection to establishing regulated live donor organ markets is that such markets would be exploitative. Perhaps surprisingly, exploitation arguments against organ markets have been widely rejected in the philosophical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to organ sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation, and outline two (...) additional ways that the charge of exploitation can be understood. I argue that while increasing payments to organ sellers may mitigate or eliminate fair benefits exploitation, such measures will not necessarily address fair process exploitation or complicity in injustice. I further argue that each of these three forms of wrongdoing is relevant to the ethics of paid living organ donation, as well as the design of public policy more generally. (shrink)

This is an excellent article, probably the best there is in defence of prohibiting the sale of organs, and it deserves a much fuller discussion of detail than there is space for here.1 My concerns, however, are with generalities rather than detail. Although some such argument might justify prohibition of organ selling in particular places and at particular times, it is difficult to see how it could support the kind of general, universal policy currently accepted by most advocates of (...) prohibition.Whenever the subject of organ selling is discussed, it is useful to keep in mind the natural history of the debate. Prohibition was instituted by most governments and professional bodies just about as quickly as possible after it was discovered that payment for kidneys was going on, and was a direct response to feelings of moral outrage. It all happened without time for debate. It was only later, as challenges appeared, that justifications began to be produced; and when they did they followed a pattern long familiar to philosophers, and more recently recognised by moral psychologists, of determined efforts to find a justification for the initial intuition that organ selling must be wrong. New arguments kept appearing in the cause as earlier attempts were shown to fail, and many were so weak that they could not have seemed plausible unless their advocates had already been committed to their conclusion. This does not mean, of course, that a good justification could never be produced. It does, however, suggest a widespread feeling that organ selling must be intrinsically …. (shrink)

In debates over the legitimacy of markets for live human organs, much hinges on the moral standing of desperate exchanges. Can people in desperate circumstances genuinely choose to sell their organs? Alternatively if they do choose to sell, then surely is it their choice? While sales are banned in most of the Western world due to fears that the poor will be exploited, advocates of these markets find such prohibition unconscionably paternalistic; and from the standpoint of contemporary liberal (...) theory, paternalism is anathema. Is it possible to provide grounds for blocking such desperate exchanges which are not at the same time paternalistic?In ‘Imposing Options on People in Poverty: the Harm of a Live Donor Organ Market', Simon Rippon argues that some options in the market do in fact harm. According to Rippon, if we focus on possible negative consequences of increasing an agent's options, one can develop an argument against human organ markets which is not paternalistic or focused on the idea of exploitation. Whether his account is, as stated, non-paternalistic is an open question, but his analysis of the implications of increased commercial options provides an illuminating and original critique of the human organ markets.Rippon labels his opponents' view the ‘Laissez-choisir Argument’ . According to LC, blocking exchanges …. (shrink)

Julian Koplin, drawing extensively on empirical data, has argued that vendors, even in well-regulated kidney markets, are likely to be significantly harmed. I contend that his reasoning to this conclusion is dangerously mistaken. I highlight two failures. First, Koplin is insufficiently attentive to the differences between existing markets and the regulated markets proposed by advocates. On the basis of this error, he wrongly concludes that many harms will persist even in a well-regulated system. Second, Koplin misunderstands the (...) utilitarian assessment of the market. He focuses on the costs and benefits of the transaction for the vendor. But, the relevant comparison is between an individual’s welfare across different courses of action, namely, vending and the nonvending alternative. Although Koplin’s empirically informed contribution is a welcome addition to this literature, the mistakes that pervade his interpretation of the data demand correction. (shrink)

As the world’s population grows and urbanization continues, the global waste crisis is becoming more severe, especially in developing countries. Without proper waste management, they may encounter various environmental and health risks. Biological technologies are regarded as promising waste management and recycling approaches in developing countries due to their cost-effectiveness and capability to handle diverse waste categories. One prominent technology in this aspect is the vermicomposting of organic waste utilizing the black soldier fly larvae. Nevertheless, significant financial resources are still (...) necessary to advance and expand biological waste treatment, which requires the participation of businesses. By examining waste management companies listed on the Vietnamese stock market, we highlight two challenges that hinder the adoption and scaling of the waste treatment system using black soldier flies and potentially other biological technologies in Vietnam. Specifically, the business regards the environmental services they offer primarily as a means to generate profit rather than as a genuine commitment to environmental preservation, and the values of companies operating in the environmental sector, particularly in waste management, have been significantly undervalued by the Vietnamese investing public. Therefore, we advocate for societal shifts toward the eco-surplus culture and apply the semiconducting principle of monetary and environmental values exchange to address the problem. (shrink)

Nancy Scheper-Hughes is one of the most prominent critics of markets in human organs. Unfortunately, Scheper-Hughes rejects the view that markets should be used to solve the current shortage of transplant organs without engaging with the arguments in favour of them. Scheper-Hughes’s rejection of such markets is of especial concern, given her influence over their future, for she holds, among other positions, the status of an adviser to the World Health Organization on issues related to global transplantation. (...) Given her influence, it is important that Scheper-Hughes’s moral condemnation of markets in human organs be subject to critical assessment. Such critical assessment, however, has not generally been forthcoming. A careful examination of Scheper-Hughes’s anti-market stance shows that it is based on serious mischaracterisations of both the pro-market position and the medical and economic realities that underlie it. In this paper, the author will expose and correct these mischaracterisations and, in so doing, show that her objections to markets in human organs are unfounded. (shrink)

Business firms have been explained as internal markets or as communities. To be sustainable, however, they need to reconcile these two constituting elements that have mainly been touted as opposite and part of a dualistic relationship. We suggest that organizations may, in alternative, view market and community as part of a duality, interdependent and mutually constituting processes that may not only contradict each other but also enable one another. The implications of a duality view for business ethics, which articulates (...) market and community elements in a fruitful, mutually enabling relationship, are considered, and duality is presented as a way of transcending what is commonly viewed as opposition, moving organizations both in the direction of humane and competitive finalities. (shrink)

Due to the shortage of organs, it has been proposed that the ban on organ sales is lifted and a market-based procurement system introduced. This paper assesses four prominent proposals for how such a market could be arranged: unregulated current market, regulated current market, payment-for-consent futures market, and the family-reward futures market. These are assessed in terms of how applicable prominent concerns with organ sales are for each model. The concerns evaluated are that organ markets will (...) crowd out altruistic donation, that consent to sell organs is invalid, that sellers will be harmed, and that commodification of organs will affect human relationships in a negative way. The paper concludes that the family-reward futures market fares best in this comparison but also that it provides the weakest incentive to potential buyers. There is an inverse relationship between how applicable prominent critiques are to organ market models and the increase in available organs they can be expected to provide. (shrink)

The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: What are the direct and indirect health care costs and benefits of such a voucher system in human organs? Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? Do vouchers contribute to the inappropriate (...) commodification of human body parts? Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges, would save more lives and further reduce human suffering. (shrink)

When organizations face the coexistence of multiple institutional logics for environmental management (e.g., maximizing market profit, protecting the environment), how do firms configure green human resource management (GHRM) practices to achieve sustainability in both environmental and market domains? Leveraging the fuzzy-set qualitative comparative analysis (fsQCA) technique, this study adopts a configurational approach to analyze the complex interdependence of GHRM practices with the underlying institutional logics for achieving firm sustainable performance. Employing a multi-source matched sample of 179 firms, the findings reveal (...) the existence of multiple configurations of institutional logics and GHRM practices that equally result in high environmental performance, market performance, or both. The analysis also identifies that firms vary in their selection between environment protection and market profit logics, and the need to match different control- or commitment-based GHRM practices to achieve high environmental and market performance. (shrink)

Observers of agriculture and theenvironment have noted the recent remarkable growth ofthe organic products industry. Is it possible for thisgrowth in the organics market to contribute toprogressive environmental and social goals? From theperspective of green consumerism, the organics marketis a powerful engine for positive change because itpromotes greater environmental awareness andresponsibility among producers and consumers alike.Given its environmental benefits and its ability touse and alter capitalist markets, organic agricultureis currently a positive force for environmentalism.Still, there are contradictions between organic (...) idealsand practice – e.g., the reductionism of organicstandards, the limitations of private organiccertification, and the widespread practice ofinput-substitution – that emerge through thedynamics of the capitalist market. As the marketmatures, these contradictions will increasinglyundermine the very environmental benefits that are thefoundation of organic agriculture. Fundamental change,therefore, is not likely to occur through the marketalone. There are ways, however, that the organicsmarket could contribute to a broader movement leadingto collective action. For instance, the organicsmarket tends to undermine commodity fetishism in theagrifood system, thereby strengthening civil society.In addition, the market provides space and resourcesfor social movement activity, such as in the struggleover the National Organic Standards. (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is (...) addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

In times of erosion and dissolution of social structures and institutions, described by Bauman as the interregnum, there arises both a need and a possibility of developing alternative approaches to the most fundamental organizational practices. Marketing, a simultaneously tremendously successful and much criticized sub-discipline and practice, is a prime candidate for such a redefinition. Potential prefigurations of future processes of organizing and institutionalizing can be found within dissenting organizations, the alternative organizations built at the fringes of, and in opposition to, (...) the mainstream businesses as reported by Parker et al.. In this paper, we present an exploration of the alternative yet already enacted practice we call earnest marketing. Drawing on an ethnographic study of a number of dissenting organizations in the United Kingdom and Poland, we focus on the radical reconstitution of marketing evidenced in their practice, defined by an attitude of earnestness and dedication to the dissemination and demonstration of their self-defined goodness: ideas and values. As organizations engage in earnest marketing, they also become receptive to reciprocal messages from their environments. We conclude by reflecting on the possibilities of a dissenting management model developing the principles of earnest marketing beyond disciplinary confines. (shrink)

Creation of for-profit markets in organs for transplantation ignites in many deep moral repugnance. Proposals to broker organs have been denounced by the US Congress and professional groups alike. Financial incentives are believed to undermine consent, coercing the poor into selling their organs, violating human dignity, and improperly commodifying the human body; such concerns are held to trump the possibility of increasing life-sustaining transplants. While such views summarize the apparent global consensus which marks worldwide prohibition of the sale of (...) human organs, I argue that closer examination reveals significant grounds for concluding that markets would be more successful in preventing exploitation, preserving human dignity, and protecting against improper commodification than governmental bureaucratic procedures for procuring and allocating organs. (shrink)

While people’s lives continue to be put at risk by the dearth of organs available for transplantation, we must give urgent consideration to any option that may make up the shortfall. A market in organs from living donors is one such option. The market should be ethically supportable, and have built into it, for example, safeguards against wrongful exploitation. This can be accomplished by establishing a single purchaser system within a confined marketplace.Statistics can be dehumanising. The following numbers, however, have (...) more impact than most: as of 24th November, during 2002 in the United Kingdom, 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.1 It is difficult to estimate how many people die prematurely for want of donor organs. “In the world as a whole there are an estimated 700 000 patients on dialysis . . . . In India alone 100 000 new patients present with kidney failure each year”2 . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . …. (shrink)

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. (shrink)

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people’s organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some (...) major unaddressed efficiency concerns. This article presents this class of concerns and discusses the implication for organ futures markets. It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals, moral hazard and strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals. (shrink)

One of the most widespread objections to legalizing a market in human organs is that such legalization would stimulate the black market in human organs. Unfortunately, the proponents of this argument fail to explain how such stimulation will occur. To remedy thus, two accounts of how legalizing markets in human organs could stimulate the black market in them are developed in this paper. Yet although these accounts remedy the lacuna in the anti-market argument from the black market neither of (...) them provide reason to believe that legalizing an organ markets would stimulate the black market in organs. Despite its prevalence, then, the argument from the black market should be rejected. (shrink)

The accurate delineation of various forms of business organization requires a comparative analysis of their objectives, functions, and organizational structures. In particular, this paper highlights differences in managerial work between business firms and non-profits exemplified by the charitable organization. It adopts as its template the theory of the marketing firm, a depiction of the modern corporation as it responds to the imperatives of customer-oriented management, namely consumer discretion and consumer sophistication. It describes in §2 the essentials of the theory and (...) its basis in consumer behavior analysis, and outlines its unique position as the organization responsible for marketing transactions, based on objective exchange, competitive markets and prices, and the deployment of the entire marketing mix. §3 deals in greater depth with the objective, strategic functions, and organization of the marketing firm in terms of the concepts of metacontingency and bilateral contingency. §4 discusses how the marketing firm differs from charities in terms of goal separation, market-based pricing and competition, the entrepreneurial process, the pursuit of customer-oriented management, and organizational structure. Particular attention is accorded the organizational differences between marketing firms and charities, which arise as a direct consequence of the distinct patterns of contingency they entail. §5 discusses the implications of the foregoing analysis and draws appropriate conclusions. (shrink)

UK universities have gone through drastic changes driven by the marketization of higher education. From the perspective of critical discourse analysis, Fairclough hypothesizes that university discourse will be colonized by business discourse. While a number of studies have been conducted, to my knowledge no study has compared university discourse and business discourse both synchronically and diachronically. This article compares how employer organizations are discursively constructed synchronically and diachronically in 240 academic and business job advertisements. The analytical frameworks are transitivity analysis (...) and modality. The results indicate that academic job advertisements have changed from not mentioning organizations to discursively constructing organizations in a promotional manner like business job advertisements. In addition, universities reframe themselves as businesses, entrepreneurs and service providers. This article contends that universities should be selective in adopting business discourse and maintain their identity as educational institutions. (shrink)

This paper offers a positive suggestion for the management of a market in organs for transplant; and in doing so provides a useful opportunity for clarifying the structure of the Great Organ Sales Debate.The issue is in constant need of clarification, because it is usually aired as a political question of the For and Against variety: should organ selling be legal or not? This format usually encourages protagonists to collect into an unsorted heap whatever arguments look as though (...) they might have any persuasive force on their side, and because people may be on the same political side for different moral reasons, or have the same moral principles but reach different political conclusions, the political arguments tend to obscure both the real issues and the logical structure of the controversy.Although attitudes to organ selling seem to have relaxed somewhat since the subject first came to light about a dozen years ago, most professional and political opinion is still against it. But what is the moral basis of this opposition? If you think organ selling should remain illegal, what exactly is your reason? Is it that you regard selling body parts as wrong in itself, irrespective of consequences? Or is it because you think that although it is not wrong in itself, in practice the harms will usually or always outweigh the benefits? Either of these quite different views might support the same political conclusion.In practice, it is not clear that many opponents of organ selling have ever recognised the distinction. Most of …. (shrink)

In this paper I shall be arguing against the claim made by Erin and Harris and others, that creating a “regulated market” in organs for transplantation taken from living vendors is both viable practically and a moral imperative. No-one can doubt that there is currently a crisis in the provision of organs for transplantation, with a massive gap between supply and demand. There are a number of reasons for this crisis. Since its development as a life-saving measure in the second (...) half of the last century, organ transplantation has expanded exponentially, both in terms of survival rates, the number of people on the waiting list for the procedure, and the range of transplantable organs. Advances in immuno-suppression and in prevention of infection have led to improvement in both the survival of the recipients and of the transplanted organs. At the same time, there has been an increase in repeat transplantations and in multiple organ transplants. The range of conditions for which transplantation is offered has widened, and transplantable organs now include: kidney, liver, pancreas, heart and lung. Brain-dead donors can provide all of these organs, while the kidney and sections of the liver and pancreas can also be obtained from living donors. Survival outcomes are better from living donors than from cadaveric donors, and, in the case of kidney failure, better from transplantation than from dialysis. [End Page 164] The relevant question, however, is whether permitting a market in human organs is morally justifiable, and, even if it were, whether it would provide a solution to the current crisis. I argue in this paper that organ trading is wrong in principle, since it commodifies the human body and inevitably exploits the poor and the socially vulnerable, and that, far from alleviating the crisis, it is likely to make it worse. First we should note that there is an uncompromising opposition to all forms of organ trading from two major international healthcare organisations. (shrink)

This paper offers a positive suggestion for the management of a market in organs for transplant; and in doing so provides a useful opportunity for clarifying the structure of the Great Organ Sales Debate.The issue is in constant need of clarification, because it is usually aired as a political question of the For and Against variety: should organ selling be legal or not? This format usually encourages protagonists to collect into an unsorted heap whatever arguments look as though (...) they might have any persuasive force on their side, and because people may be on the same political side for different moral reasons, or have the same moral principles but reach different political conclusions, the political arguments tend to obscure both the real issues and the logical structure of the controversy.Although attitudes to organ selling seem to have relaxed somewhat since the subject first came to light about a dozen years ago, most professional and political opinion is still against it. But what is the moral basis of this opposition? If you think organ selling should remain illegal, what exactly is your reason? Is it that you regard selling body parts as wrong in itself, irrespective of consequences? Or is it because you think that although it is not wrong in itself, in practice the harms will usually or always outweigh the benefits? Either of these quite different views might support the same political conclusion.In practice, it is not clear that many opponents of organ selling have ever recognised the distinction. Most of …. (shrink)

I offer consequentialist and deontological arguments for a competitive market in human organs, from live as well as dead donors. I consider the objections that a market in organs will frustrate altruism, coerce the desperate, expose under-informed agents to unacceptable risks, exacerbate inequality, degrade those who participate in it, involve a kind of slavery, impose invidious costs, and impair third-party choice sets. I show that each of these objections is without merit and that, in consequence, the opposition to markets (...) in organs is an untenable endorsement of death, suffering and the suppression of freedom. (shrink)

Recent break-throughs in surgery and the discovery of an effective immunosupressive drug called cyclosporin, have brought a Renaissance in organ transplants. These medical advances have also heightened concern over the already critical shortage of body organs. Several alternatives have been suggested which may help alleviate the organ shortage. One such alternative is to allow commerce in human organs. This article discusses the morality of commercialization of human organs within the framework of several ethical theories.