pageok
pageok
pageok
"Singapore to Compensate Kidney Donors":

BioEdge reports:

Singapore is to allow compensation for kidney transplants and for eggs. A government proposal has been approved by a bioethics committee and legislation will be introduced early next year. The committee declared that reimbursement for kidney donation was acceptable as long as it is not "an undue inducement, nor amounting to organ trading".

What exactly this means for kidneys is difficult to fathom. According to the BMJ, a sum of S$10,000 [currently about $6500 US -EV] was mentioned. According to the Straits Times, the health minister, Mr Khaw Boon Wan, mentioned "at least a five-figure sum, possibly even six-figure" as appropriate reimbursement. This would include expenses, such as transport and medical costs, as well as loss of earnings. Also, the donor should be covered for follow-up medical costs and higher insurance premiums as a result of losing a kidney....

The committee has recommended that the reimbursement scheme begin with donors who are Singapore citizens and permanent residents....

I'm not sure that sums like these are adequate or fair, but it sounds to me like a step in the right direction. For my thinking on the subject, see this chain of posts, especially those starting with "Medical Self-Defense and Bans on Payment for Organs."

UPDATE: James Wimberley (at The Reality-Based Community) blogs about Spain's way of increasing organ donations, which seems to focus on internal hospital procedures. If it works, that's great; but I'm pretty sure it wouldn't be enough to clear out the waiting lists, so compensation would still be needed -- and eminently justified -- on top of the Spanish solution. Thanks to Victor Steinbok for the pointer.

PatHMV (mail) (www):
I'm still opposed to buying organs for reasons I've mentioned in your previous posts and here. I believe that there will be plenty of cases where intimidation and pressure, if not outright threats, will be placed on individuals to sell their living organs. These threats and pressures will be of the sort that largely cannot be effectively policed by screening procedures, no matter how thorough.

For example, suppose a gambler owes his bookie $50,000. He has no money, so the bookie directs him to the neighborhood transplant hospital, and gives the gambler the choice: sell your kidney for cash, or we break your knees. Of course, Prof. Volokh argues generally that the gambler should be given that choice; he might prefer to raise $50,000 by selling his kidney rather than having his knees broken, and the $50,000 or your knees is a threat that will be made anyway... this just gives the gambler a new way to raise money to save his knees. I disagree. I don't think it is appropriate for someone to have a financial incentive to dismember themselves.

As another example, consider a domineering, abusive husband. He wants a new F-150 pickup. He coerces his wife into selling her kidney to raise the money for it. Maybe he lies to her and tells her that they'll use that money to finish paying for the house, but then he takes it and gambles or whores it away. This type of intimate intimidation can't be policed against, but it undoubtedly occurs.

Elective surgery to remove a healthy body part is a big deal. It's something very different from any other sort of transaction. We should not permit it to become just some ordinary part of commerce, one more way (along with selling sperm or plasma) for somebody to earn some quick money. The human body is a unique creation. We shouldn't create a system where parts of it can be bought and sold. I think that cheapens, not enhances, our respect for the individual.
11.19.2008 6:15pm
David Schwartz (mail):
PatHMV: Cars can be used to run people down. Perhaps we should outlaw them.
11.19.2008 6:21pm
Sarcastro (www):
David Schwartz is people want to work 20 hours a week for just about no pay, we should let them.
11.19.2008 6:32pm
Let 'em die:
Elective surgery to remove a healthy body part is a big deal.

And dying is not a big deal to you?

It's something very different from any other sort of transaction.

Yes, it is a transaction that can immediately save a life.

We should not permit it to become just some ordinary part of commerce, one more way (along with selling sperm or plasma) for somebody to earn some quick money. The human body is a unique creation. We shouldn't create a system where parts of it can be bought and sold. I think that cheapens, not enhances, our respect for the individual.

Those f#@%ing dying people make you sick. Let them die, because Pat has this fetish fear that someone might make money in the process of saving their lives. That about it?
11.19.2008 6:54pm
Observer:
PatHMV: Isn't this problem of coercion just as relevant in the current system, where one is allowed to give, but not to sell, organs?
11.19.2008 7:05pm
David Welker (www):
PatHMV,

Excellent analysis. I think your post brings into the fold some real-world issues that make the proposal to allow organ sales impermissible.

Most people do not make important decisions like this in some sort of vacuum. I think that model of decision-making that Volokh has in his head is extremely flawed. I believe that model is of an autonomous individual who wisely weighs the costs and the benefits and then goes ahead and makes a decision. Who are we to question whether that decision by that particular individual is best. It would be arrogant to judge etc. etc. You know, the typical libertarian view.

The real world is very different. People often feel pressure from others. People often find themselves in toxic relationships with others that lead them to make decisions that aren't in their best interests. People also sometimes make bad short-term decisions because they aren't in a good emotional state (even if they are not clinically depressed) or feel some sort of pressure. To some people, selling their organ might seem like a good idea in the short-term. They have to live with that decision the rest of their lives.

It is one thing when someone makes a bad financial decision because they are in a toxic relationship or because of some other issue that results in them losing a car or even a house. These are all replaceable. Live and learn. An organ is not replaceable.

Furthermore, we should draw categorical lines here. Some things should not be allowed to be sold or be subject to market transactions. Ever. It seems to me that Mr. Volokh is something of a pure utilitarian, who perhaps does not recognize categorical prohibitions on certain market transactions (although I am fairly certain he has heard such arguments before).

If there is a draft, should someone who is drafted be able to hire someone of equal or greater fitness to stand in their place? If your answer is yes, you do not understand categorical prohibitions on certain market transactions. The duty to defend your country, if called upon, should not be subject to market transactions, no matter your financial situation.

Human dignity is enhanced by forbidding certain market transactions. I am curious what Mr. Volokh's position is on this. Are there any market transactions between "consenting" adults that he would forbid. If so, what and why? If not, does that not show that he is coming at this from a deeply different perspective than those of us who take a contrary position?
11.19.2008 7:17pm
David Welker (www):

Let them die, because Pat has this fetish fear that someone might make money in the process of saving their lives.


I do not believe that Pat said he is opposed to transplant surgeons being compensated for their services. Any other straw men you would like to slay to show us your intellectual prowess?
11.19.2008 7:20pm
David Welker (www):

Isn't this problem of coercion just as relevant in the current system, where one is allowed to give, but not to sell, organs?


I would say no. Obviously, the threat or potential of coercion is pretty much ever present in life. Crime is always a possibility.

However, the utilitarian argument that PatHMV is making is that with market transactions being possible, there will be new financial incentives for coercion that leaves a person to be physically less than whole for the rest of their lives.

I think any economist will agree. If you increase the reward of a certain behavior, all other things being equal, you are likely to see more of that behavior.

Besides the coercion problem, I believe there is also the utilitarian argument about people making unwise short-term decisions.

And finally, there is also the categorical argument that certain market transactions should simply be forbidden.
11.19.2008 7:24pm
Brian K (mail):
People often feel pressure from others. People often find themselves in toxic relationships with others that lead them to make decisions that aren't in their best interests. People also sometimes make bad short-term decisions because they aren't in a good emotional state (even if they are not clinically depressed) or feel some sort of pressure.

so basically what you are saying is that no one should ever make a decision.



Furthermore, we should draw categorical lines here. Some things should not be allowed to be sold or be subject to market transactions. Ever.

and on what basis should we draw these lines? why should i privilage your line drawing over my own?


And finally, there is also the categorical argument that certain market transactions should simply be forbidden.

what is this argument that you repeatedly speak of?
11.19.2008 7:51pm
FoolsMate:
I strongly concur with the "utilitarian" argument and believe that most people are too stupid to understand the potential adverse implications of organ donation. I don't imagine either any practical donor compensation scheme that would allow the donor to recover the true value of their organs or to negotiate directly with the transplantee (acceptor?) or to negotiate at all for that matter.

I'm willing to be convinced on the categorical argument but it needs more flesh than "it demeans human dignity." How does it do so?
11.19.2008 7:56pm
Michelle Dulak Thomson (mail):
Sarcastro,

David Schwartz is people want to work 20 hours a week for just about no pay, we should let them.

You'd let them do it for literally no pay, wouldn't you?
11.19.2008 8:06pm
David Welker (www):

so basically what you are saying is that no one should ever make a decision.


If you attribute extreme views to me, does that make you feel better? Do we live in a binary world? I really do not understand the appeal of this particular approach, which I have seen quite a bit here among commenters here at the Volokh Conspiracy.


and on what basis should we draw these lines? why should i privilage your line drawing over my own?


On what basis do we typically draw lines when it comes to issues of criminal law. By democratic vote, of course.


I'm willing to be convinced on the categorical argument but it needs more flesh than "it demeans human dignity."


I don't have more time to give it justice. But here it goes. Human relations should consist of more than market transactions where each party tries to get the best deal possible for themselves. By drawing boundaries around certain areas of life where market transactions may not occur, we send the message that, even though much of modern life is in fact mediated by market transactions, that is not all we are about. If you want an organ donation, you are going to have to appeal to human relationships in a way that has nothing to do with money.

Furthermore, it is quite clear that with respect to the distribution of resources, much is arbitrary. The fact that you were born in the United States (if you were born in the United States) means that you automatically have access to more resources than if you were born in many other places elsewhere. Not all of the most important transactions in life should be based on this initial lottery, which is totally disconnected to any conception of intrinsic merit. By disallowing certain transactions, we make it clear that not everything is for sale. Even though there is certainly someone somewhere who is in a desperate enough situation that they would be willing to sell just about anything.

Basically, one should not be able to sell their own dignity. Thus, one should not be able to sell themselves into slavery. Even if, on the whole, both the slave and the slave owner's long-term happiness increased as a result of that particular transaction. Perhaps that particular slave-owner is particular benign, and really needs the services of the slave. The same logic applies to organ donation.
11.19.2008 8:20pm
Tatil:

For example, suppose a gambler owes his bookie $50,000. He has no money, so the bookie directs him to the neighborhood transplant hospital, and gives the gambler the choice: sell your kidney for cash, or we break your knees.

This threat is illegal now and it will be illegal even if we allow kidney sales. The enforcement and screening agencies that you don't trust are not able to police against such coercion now, either. At the moment, bookie can still force the gambler to sell his kidney to bookie's uncle or go through some black market transaction.

Besides, it seems the gambler in your example is bound to suffer some bodily harm anyways, why not let him pick the one where he will be under professional medical care?

Your abusive husband example is more persuasive.
11.19.2008 8:33pm
PatHMV (mail) (www):
David Welker... thank you for picking up the debate. After many years of computer forum battles (dating back to when Compuserve had only User ID numbers, not names, all over a 1200 baud modem), I've lost patience for dealing with the binary thinkers. At any rate, I agree with all your comments thus far; right on the money.
11.19.2008 9:01pm
David Schwartz (mail):
However, the utilitarian argument that PatHMV is making is that with market transactions being possible, there will be new financial incentives for coercion that leaves a person to be physically less than whole for the rest of their lives.
With market transactions being impossible, coercion is all that's left. You think making drug possession and sales legal would result in more coercion surrounding drugs? Do you think making alcohol sales legal increased the coercion surrounding the production, distribution, and sale of alcohol?
11.19.2008 9:16pm
DrO:
...Human relations should consist of more than market transactions where each party tries to get the best deal possible for themselves..
Sorry, but I am just not willing to sacrifice so many lives so that you can feel good about the type of interactions humans have.

If the snarky definition of puritarianism is the fear that someone, somewhere might be enjoying themselves, what is this? The fear that someone, somewhere is engaging in consensual behavior with another adult to save their own life?
11.19.2008 9:42pm
Elliot123 (mail):
"As another example, consider a domineering, abusive husband. He wants a new F-150 pickup. He coerces his wife into selling her kidney to raise the money for it. Maybe he lies to her and tells her that they'll use that money to finish paying for the house, but then he takes it and gambles or whores it away. This type of intimate intimidation can't be policed against, but it undoubtedly occurs."

Sad but true. Look at all those husbands in F-150s driving their wives from one blood bank to another. How do you think they make those monthly payments? I propose we cut out payments for blood, or mandate Ford to make only Rangers.
11.19.2008 9:52pm
David Warner:
David Welker,

"Human dignity is enhanced by forbidding certain market transactions."

That human being is named David Welker, and what he calls dignity I call over-inflated self-regard. I went through two and a half years of life-sucking dialysis to preserve his fucking* dignity. Maybe he should choose a different market transaction to pick on if he needs one to puff himself up.

DrO,

"The fear that someone, somewhere is engaging in consensual behavior with another adult to save their own life?"

Secular Popery.

* - pardon my French. I think my language accurately reflects just how dignified living on dialysis is.
11.19.2008 10:28pm
Brian K (mail):
If you attribute extreme views to me, does that make you feel better? Do we live in a binary world? I really do not understand the appeal of this particular approach, which I have seen quite a bit here among commenters here at the Volokh Conspiracy.

it is not an extreme view. it is your view. you are making some arbitrary distinction that you have provided no support for. your description of coercion and/or undue pressure can apply to any decision one makes, not just those related to kidney sales. if i'm mischaracterizing your view then explain how a person can only "make bad short-term decisions [to sell a kidney] because they aren't in a good emotional state" and not, say, buy a quart of chunky monkey ice cream. if we are to outlaw kidney sales because some people might "feel pressure from others" then why don't we also outlaw political donations or bars or essentially everything?
11.19.2008 10:48pm
Brian K (mail):
The same logic applies to organ donation.

in what way is selling a kidney identical to selling yourself into slavery? the connection is not obvious.
11.19.2008 10:49pm
David Welker (www):

I went through two and a half years of life-sucking dialysis to preserve his fucking* dignity.


I am sorry that you went through dialysis. But, you are not entitled to another person's kidney.
11.19.2008 11:16pm
David Welker (www):

it is not an extreme view. it is your view.


I will be the authority on what my view is, thank you very much.

If you can't see the difference between selling "a quart of chunky monkey ice cream" and selling your kidney, I don't know what to say except that you should stop adopting extreme binary views. There are more than just two possible and mutually exclusive answers to many questions.
11.19.2008 11:20pm
FoolsMate:

With market transactions being impossible, coercion is all that's left. You think making drug possession and sales legal would result in more coercion surrounding drugs? Do you think making alcohol sales legal increased the coercion surrounding the production, distribution, and sale of alcohol?


Is kidney theft a problem in the U.S. ???
11.19.2008 11:20pm
Elliot123 (mail):
"I am sorry that you went through dialysis. But, you are not entitled to another person's kidney.'

He is if I sell mine to him.
11.19.2008 11:31pm
another anonVCfan:
I am sorry that you went through dialysis. But, you are not entitled to another person's kidney.

Translation: You and a third party are not entitled to enter into a voluntary transaction of which I disapprove.

Can you let us know now which other voluntary transactions we need your permission for? Just make a list of things that give you the heebie-jeebies so we know to ask you first.
11.19.2008 11:32pm
Sagar:
when a poor person sells a part of his life (i.e. his time) for a small fraction of money that a higher earning person makes for selling a similar amount of time, we have no problem with that.

my body organs are a part of my person and they belong to me. i should be able to do whatever I want with them. if my friends or relatives need it and i am a match, i am free to donate them (and if my "friend" wants to compensate me or show his gratitude, that is nobody's business). all the people so worried about coersion if organ selling is made legal, are you congratulating yourselves that there are no victims being exploited by pimps since we have made prostitution illegal?

David Welker,

David Warner didn't say or imply that he is entitled to someone else's kidney; he wants the freedom to trade what he can (money, time, favors, anything he has) to some willing donor for that person's "spare" kidney. who are you to sanctimoniously come between two consenting adults? do you also have a problem if two gays are doing it? how about adultry? what else do you want to ban in the name of human dignity?
11.19.2008 11:40pm
David Warner:
David Welker,

"I am sorry that you went through dialysis. But, you are not entitled to another person's kidney."

Entitled? Is your worldview so pathetically narrow that the only two options are what David Welker decides, in his infinite wisdom, to permit, and therefore to which lesser mortals are therefore entitled, and everything else, which it goes without saying is forbidden?

I'll tell you what I'm entitled to, and the title of the document in question is the Constitution of the United States of America, and that is the freedom from the interference of the state in areas not specifically enumerated in that document. For better or worse, so are you, and so are organ donors.

I don't believe that those powers include appointing busy-bodies like David Welker to dictate their views of human dignity onto the rest of us.
11.19.2008 11:44pm
Brian K (mail):
If you can't see the difference between selling "a quart of chunky monkey ice cream" and selling your kidney, I don't know what to say except that you should stop adopting extreme binary views.

you keep saying this, but i'm not sure you know what it means. you can't get more binary than "kidney bad, everything else good"


There are more than just two possible and mutually exclusive answers to many questions.

you're the one resting your arguments that readily apply to any decision. why don't you answer my questions? although i'm really surprised that you are unable to come up with a logical reason to differentiate kidney sales from everything other object we sell.
11.19.2008 11:46pm
Tatil:

Can you let us know now which other voluntary transactions we need your permission for?

Prostitution, drugs, sale of alcohol to people between 18 and 21, contracting labor below minimum wage, many services in construction subject to state licensing requirements etc. etc. There are many areas government prevents voluntary transactions. Of course, some of these restrictions are opposed by many reasonable people.
11.19.2008 11:48pm
Brian K (mail):
whoops:

you're the one resting your distinction on arguments that readily apply to any decision.
11.19.2008 11:48pm
Michelle Dulak Thomson (mail):
David Welker,

It's no good chewing other people out for their "extreme binaries" if you only substitute your own. I'm inclined to agree with you that some things simply oughtn't to be for sale, but to write, e.g.,

There are more than just two possible and mutually exclusive answers to many questions

while going on to propose a "right" answer that (like all "right" answers) necessarily forecloses all the alternatives seems a bit cheeky.

I am curious, though: Above you write

On what basis do we typically draw lines when it comes to issues of criminal law. By democratic vote, of course.

Does that mean that you'll accept a line that permits kidney-selling if a democratic majority draws it? Or will it still be wrong, so far as you're concerned?
11.19.2008 11:50pm
FoolsMate:
Sagar,
Actually, if you are compensated financially for donating a body organ, it is everyone's business since a crime has been committed. You may believe it is a harmless crime, a victimless crime, or should obviously be legal -- that may or may not be true -- but right now the law conflicts with your opinion. Anything goes between consenting adults sounds nice but it's not the law in this case and in some others.

And the silly season is supposed to be over now...you are suggesting David Welker is a homophobe b/c he's against compensation for organ donation? It's not an extreme position to be against this -- rather the opposite.
11.19.2008 11:55pm
David Warner:
Foolsmate,

"And the silly season is supposed to be over now...you are suggesting David Welker is a homophobe b/c he's against compensation for organ donation? It's not an extreme position to be against this -- rather the opposite."

The same could be said evidently for SSM. Do you support the majority's restriction of liberty there as well? By what principle do you distinguish between the two?
11.20.2008 12:03am
David M. Nieporent (www):
I went through two and a half years of life-sucking dialysis to preserve his fucking* dignity.

I am sorry that you went through dialysis. But, you are not entitled to another person's kidney.
As you say, it's someone else's kidney -- as in, Not David Welker's. So David Welker is not entitled to decide what happens to that kidney. Only the person who owns it is.

You certainly don't explain how it enhances the "dignity" of the kidney owner for David Welker to say, "You are not competent to make decisions about your own life and your own body; I will make them for you."
11.20.2008 12:06am
Ricardo (mail):
However, the utilitarian argument that PatHMV is making is that with market transactions being possible, there will be new financial incentives for coercion that leaves a person to be physically less than whole for the rest of their lives.

I think any economist will agree. If you increase the reward of a certain behavior, all other things being equal, you are likely to see more of that behavior.

Besides the coercion problem, I believe there is also the utilitarian argument about people making unwise short-term decisions.


A proper utilitarian analysis considers costs and benefits for society as a whole, not only for the person on one side of a transaction. If coercion is more likely with organ sales, it's not clear when you compare that to the number of saved lives (and your "economic" argument essentially concedes that we would have more donated organs if donors were compensated) which side the utilitarian calculus supports. If it supports your side, that would require additional evidence or argument. Lives that are lost due to lack of resources weigh pretty heavily in my view.

Moreover, if the main concern is coercion, there are ways to minimize it. Aside from ruthlessly pursuing those who coerce organ donations through the criminal justice system, other alternatives could include mandating that payment be in the form of a health savings account, Roth IRA or a time deposit of some kind that eliminates the incentive to go under the knife for quick cash. But maybe your real objection is categorical rather than utilitarian in nature in which case we get to...

And finally, there is also the categorical argument that certain market transactions should simply be forbidden.

In your follow-up, you use human dignity as the basis for this categorical prohibition. Steven Pinker has a nice rebuttal to many arguments made on the basis of dignity as either not adequately defining what dignity is or treating it as something other than just one of many values that we may have to trade off against others. There's also simply the point that the burden of proof ought to be on those making categorical arguments.

Pinker article here.
11.20.2008 12:29am
FoolsMate:
David Warner,
I believe it's constitutionally acceptable for the majority to restrict liberty in certain cases to achieve a public good or to prevent a public harm. It's reasonable to see many issues: euthanasia, affirmative action, SSM, organ donation compensation -- through that lens, though I'm not going to get off topic. My objection to organ donor compensation (in a sentence)lies in the belief that it's going to be a bad deal for donors, who will be exploited because they are stupid. Compensation for cadaver organ donation is okay -- depending on how that (hypothetically) works out I might change my mind.
11.20.2008 12:50am
David Welker (www):
Michelle,


It's no good chewing other people out for their "extreme binaries" if you only substitute your own.


If I appear to be chewing him out, that is not my intent. Of course, I could give a more complete answer. But, I don't feel that someone who is asking me what is the difference between selling a kidney and selling chunky monkey ice cream is asking a question worthy of a detailed response.

I am not going to spend a whole lot of time on that question unless he first makes an argument where I feel I have to treat these things as remotely similar. Because I think the answer of how they are different is pretty obvious. But here is the quick and dirty answer to that question: From a utilitarian standpoint, the harm from even a foolish seller deciding to part with their chunky monkey ice cream is minimal. We do not need to worry about someone "coercing" someone to sell their chunky monkey ice cream, nor do we have to worry about someone making a decision to sell their ice cream that harms them in the long term. From a categorical standpoint, the selling of ice cream does not in any way even arguably compromise human dignity. That is how chunky monkey ice cream is different thank human organs.


Does that mean that you'll accept a line that permits kidney-selling if a democratic majority draws it? Or will it still be wrong, so far as you're concerned?


I still think it would be wrong. However, I would accept the law as decided by fair democratic procedures. The question was "who decides" and the answer is in our society, a democratic majority. In general, I do not have a problem with a majority deciding certain questions of morality. In fact, it is inevitable. There is nothing morally neutral about criminal law, for example.
11.20.2008 1:26am
David Welker (www):

As you say, it's someone else's kidney -- as in, Not David Welker's. So David Welker is not entitled to decide what happens to that kidney. Only the person who owns it is.


I do not agree that people "own" their kidney in the same way they own a car.


You certainly don't explain how it enhances the "dignity" of the kidney owner for David Welker to say, "You are not competent to make decisions about your own life and your own body; I will make them for you."


You are free to have your own conception of human dignity and try to impose it through the democratic process. Apparently, you believe that human dignity is maximized by allowing desperate people to compromise themselves.

By the way, just to be clear, I am not advocating a dictatorship here. I have my conception of right and wrong and I am advocating for that. I am interested in convincing my fellow citizens of that view and making law with them that reflects that view. Just as you seem to be interested in advocating for a different view and changing law to reflect your view.

There is no way to avoid taking a moral stand. You can say I am trying to impose my world view. I can say you are trying to impose yours. Who decides? Well, as to what is right and wrong, my views are clear on that. Regardless of what a majority says, I believe that allowing organ sales are wrong. But as to what the law should and will be, I feel we all have a right to advocate for our own view. If you want to try to change the law, so be it. Just don't violate it in the meantime -- or if you do, be ready to face the consequences.
11.20.2008 1:34am
theobromophile (www):
PatHMV's argument is based upon the idea that organ donation will not always be voluntary. It is somewhat silly to answer an argument that points out the lack of volitional action with the presupposition that this always happens between consenting adults.

If you were to perform nothing but the utilitarian calculation of lives saved versus lives lost, or relative quality of life, you would disapprove of every healthy person who is alive and likes it that way. If I - or any other healthy twenty-something - were to volunteer to have all her organs harvested (two kidneys, the lungs and heart of a distance runner, pancreas, liver, bone marrow, blood, etc), many lives would be saved, at the expense of one and only one life - a utilitarian good.

Obviously, the calculation must be more than simply lives lost versus lives saved, or the relative quality of each life: there must be some moral value attached to non-interference in the functioning of the world. Human beings have a moral right to their own organs, their own bodily integrity, first and foremost.

Now, taking this opportunity to add to PatHMV's examples: we already live in a society in which people with O-negative blood are routinely harassed to donate and in which long-haired women are shamed into cutting their tresses (for the children, of course). Will we end up with a society that pressures people into giving up their organs (the money, of course, removing any apparent disincentive to the procedure)? You can donate a lung, a kidney, bone marrow, blood, plasma, and part of your liver and still be alive. Where is the principled line between any of that and O-negative potential blood donors?
11.20.2008 1:55am
David Warner:
Foolsmate,

"My objection to organ donor compensation (in a sentence)lies in the belief that it's going to be a bad deal for donors, who will be exploited because they are stupid."

So if we establish a poll tax IQ test to make sure the donor is plenty smart, then you're good? Sounds like a plan.


David Welker,

In reply to:

"You certainly don't explain how it enhances the "dignity" of the kidney owner for David Welker to say, "You are not competent to make decisions about your own life and your own body; I will make them for you."

You say:

"You are free to have your own conception of human dignity and try to impose it through the democratic process. Apparently, you believe that human dignity is maximized by allowing desperate people to compromise themselves."

So are all non-David Welker people by definition desperate or are you stealing a base here? Perhaps a reverse means-test could be applied to make sure no desperate donors are compromised (by themselves, as you fear). Or are we all just leading lives of quiet desperation?
11.20.2008 2:11am
FoolsMate:
"My objection to organ donor compensation (in a sentence)lies in the belief that it's going to be a bad deal for donors, who will be exploited because they are stupid."


So if we establish a poll tax IQ test to make sure the donor is plenty smart, then you're good? Sounds like a plan.


Troll.
11.20.2008 2:17am
Brian K (mail):
David Welker,

so you aren't answering my question because you are insufficiently imaginative?

in any case it is besides the point. the statements i quoted of yours apply to every single transaction we make. anyone can be coerced or pressured into buying and/or selling anything. yet you are not advocating shutting down our entire economy. what makes kidney donation unique from other sales? on what basis are you making the distinction? this shouldn't be hard for you to answer.

your "human dignity" argument is flawed for reasons that have already been pointed out. nor does it answer the question...it pushes it a step back. what is your definition of dignity? what would violate someone's dignity? and, yet again, what sets the sale of a kidney apart from everything else?
11.20.2008 2:22am
Brian K (mail):
we already live in a society in which people with O-negative blood are routinely harassed to donate and in which long-haired women are shamed into cutting their tresses (for the children, of course).

if by "harassed" you mean asked and by "shamed" you mean "asked", then i agree completely. we live in a society where people are generally free to do with their body as they please.
11.20.2008 2:25am
David Welker (www):

Steven Pinker has a nice rebuttal to many arguments made on the basis of dignity as either not adequately defining what dignity is or treating it as something other than just one of many values that we may have to trade off against others.


Well, those who take categorical views in certain contexts, needless to say, reject the premise that is is merely "one of many values that we may trade off against others." That move is nothing more than to basically take categorical thinking and transform it into utilitarian thinking. In other words, this premise simply does not take categorical concepts like right and wrong, good and evil, seriously. While I certainly am not an enemy of utilitarianism in particular contexts (for example, on the question of whether we should bail out the auto makers or not), I think it is entirely inapplicable in other contexts. Furthermore, I do think that some everyday concepts that some would class under the rubric of dignity are reasonable to trade for other things. (i.e. Pinkers example asserting that "[g]etting out of a small car is undignified.") But, other things are so fundamental as to be inalienable. Human organs should be classed as one of those things.


There's also simply the point that the burden of proof ought to be on those making categorical arguments.


This strikes me as an entirely arbitrary statement. I happen to think the burden of proof ought to be on those who make utilitarian arguments...

Actually, not. I think that both utilitarian and categorical arguments in this particular case lead to the same conclusion. Organ sales ought not be allowed.

As for the Pinker article, I think it is easy to rebut. Without a concept of dignity, why should we accept any concept called "autonomy." I could, after all, conceptualize men and women as only so many atoms that happen to be bonded together in a particular arrangement for a finite amount of time anyway. So what if I take actions that happen to disrupt or destroy this particular arrangement of atoms? So what if I don't respect what this particular arrangement of atoms seems to "want" with respect to itself? Why, I don't see any reason to look at that particular collection of atoms as special, because I am pretty sure that that oxygen molecule there and that water molecule there and all the other molecules that make up the human body don't care in the slightest as individual molecules whether they are bonded in this way or that.

The concept of autonomy, from this perspective, is really quite radical. What does it mean to respect the "autonomy" of a bunch of atoms that happen to be in a particular arrangement? Who cares? Why respect this arrangement of atoms that make up this thing we call a "human," and not this other arrangement that makes up this thing we call a "cow that is about to become lunch for a human?"

The answer is simple enough. The whole is greater than the sum of its parts. The correct unit of analysis is not the single atom or the single molecule. At least for our purposes. It is the whole human. But this idea that the sum is greater than its parts, that the correct level of analysis is not the individual molecules or atoms that make up a human, but the whole human itself must be asserted categorically. There is no utilitarian argument for that. Indeed, the premise of utilitarianism itself is based on a sort of categorical thinking that human happiness ought to matter.

Anyway, the bottom-line is this. You cannot escape the concept of dignity. You may think it is fuzzy and contentious. Not capable of precise definition. All I can say to this objection is this. So what? A lot of really important things in life, like love, happiness, human flourishing, and autonomy are not capable of precise definition. But, anyway, you cannot do without these things. They are just as important, no, I would say more important, than the things you can precisely measure and define. And anyway, that you can define something doesn't strike me as all that impressive anyway.

Pinker is not really arguing that the concept of dignity is useless or nearly so. In fact, he concedes that it is critical. He thinks that is what he is arguing, but I do not accept his premise that autonomy is a meaningful concept separate from dignity. I do not accept his premise that somehow the idea of autonomy itself is not to be classed in with the the group of things that we call dignity. To me, then, his argument can be reduced to the idea that this thing called autonomy is the only concept of dignity that matters. I find that statement to be entirely arbitrary. Why this concept of dignity and not others in addition?
11.20.2008 2:29am
David Welker (www):
David Warner,

I am fine with you buying an organ. But only if you can convince Bill Gates to sell you his.

Except for that case, I think someone who sells an organ for money (not gives you an organ because they have some attachment to you) is in some sort of desperate situation that you are exploiting.
11.20.2008 2:36am
David Welker (www):
BrianK,


what is your definition of dignity? what would violate someone's dignity?


I do not believe I need to come up with a precise definition. And I refuse to do so, because I do not want to be held to it later when it turns out to be inadequate in some way. I would not be willing to come up with a precise definition of "love" either. Yes, I know some people have precise definition fetishes, but, to me, it is not the be all and end all that you would make it.


and, yet again, what sets the sale of a kidney apart from everything else?


Look above. I answered this question already when I responded to Michelle.
11.20.2008 2:41am
David Welker (www):

Obviously, the calculation must be more than simply lives lost versus lives saved, or the relative quality of each life: there must be some moral value attached to non-interference in the functioning of the world. Human beings have a moral right to their own organs, their own bodily integrity, first and foremost.


This, I think, is an extremely insightful point. The idea of autonomy, like other concepts of dignity, is a moral one.
11.20.2008 2:46am
another anonVCfan:
I'd like to test the outer boundaries of this commitment to human dignity and find out how absolute it is. Which is more offensive to human dignity, being so poor that you have to sell your kidney to buy food, or starving to death because you're forbidden to sell your kidney?
11.20.2008 2:50am
David Welker (www):

I'd like to test the outer boundaries of this commitment to human dignity and find out how absolute it is. Which is more offensive to human dignity, being so poor that you have to sell your kidney to buy food, or starving to death because you're forbidden to sell your kidney?


Is it better to be first robbed, and then raped, and finally murdered or is it better to be first raped, then robbed, and finally murdered?

If you are getting the sense that neither alternative is acceptable, then you are on to something.
11.20.2008 2:56am
Ricardo (mail):

There's also simply the point that the burden of proof ought to be on those making categorical arguments.


This strikes me as an entirely arbitrary statement. I happen to think the burden of proof ought to be on those who make utilitarian arguments...

Actually, not. I think that both utilitarian and categorical arguments in this particular case lead to the same conclusion. Organ sales ought not be allowed.


Since I haven't made a utilitarian argument and don't practice utilitarian thinking without lots of qualifiers, I'm OK with this. But since you explicitly offered a utilitarian argument, are you prepared to back it up? How many lives need to be lost in order to outweigh your concerns about coercion and donor stupidity? If you can't answer that, your utilitarian argument is a dead end and you have to fall back on your categorical argument.

What I meant about the burden of proof claim is simple: if you want to consider certain kinds of conduct absolutely prohibited and back that prohibition up by sending people to prison, you should be willing to defend such a position with more than vague references to dignity. To do otherwise is to accept the logic of authoritarianism: government should prohibit anything without a convincing explanation of its morality or utility.

From a practical standpoint, "I find X repulsive and lots of other people do, too, therefore it should be illegal" isn't a very good argument. Views on what's reprehensible or "icky" can change radically over time -- look at what's happened to the status of gays in the U.S. As John Stuart Mill pointed out, those who make actual arguments with logic and evidence for their positions wind up with flaccid and weak ideas that won't stand the test of time. As the example of Singapore suggests, the taboo against paying organ donors may be on the way out.
11.20.2008 3:17am
Ricardo (mail):
Oops, that sentence about Mill should read, "those who don't make actual arguments with logic and evidence wind up with flaccid and weak ideas..."
11.20.2008 3:20am
another anonVCfan:
If you are getting the sense that neither alternative is acceptable, then you are on to something.
And yet we live in a world where people do starve to death, regardless of how morally unacceptable you might find it. If you're getting the sense that your idealized notions of dignity might not be too persuasive to someone who rationally believes that selling their kidney is their best chance at survival, and who takes cold comfort from your less-than-nourishing proclamation that their starving to death is morally unacceptable, then you are on to something.
11.20.2008 3:24am
theobromophile (www):
Brian K,

By "shamed," I mean "shamed." Trust me. As a long-haired woman, I've endured more than my share of harassment for having the audacity to keep the aforementioned mane attached to my own head. As a habitual blood donor (into my 3d gallon) and bone marrow registrant, I thoroughly dislike the idea of being called "selfish" for keeping some of my body to myself. I'm also sick of the Red Cross asking me to donate every eight weeks and treating me like a whack job when I point out that my body simply can't handle that.

Moving onwards....
in any case it is besides the point. the statements i quoted of yours apply to every single transaction we make. anyone can be coerced or pressured into buying and/or selling anything. yet you are not advocating shutting down our entire economy. what makes kidney donation unique from other sales? on what basis are you making the distinction? this shouldn't be hard for you to answer.

I'll answer, even though the question was not directed at me. If you're talking about non-regenerative organs, the distinction is that there is no fair market value - or market, even - for human dignity, and the transaction in question can never be functionally unwound. If a person is coerced into buying or selling goods on the market, he may, presumably, sell back those goods that he purchased or buy back those that he sold (or similar ones). However, one cannot buy another kidney and thus make the entire transaction a wash. First of all, the risks of surgery are a bit higher than of clicking a few buttons on Amazon.com. Second, and more importantly, the fact is that there is no substitute for your own kidney (or that of an identical twin): transplant recipients need to take immuno suppressant drugs to ensure that the organ will not be rejected.

Presumably, as well, there is some sort of fair market value for the goods or his labour (the latter being subject to various laws, which presume that while one may give away his goods for less than a fair deal, there is some floor below which people may not sell their time - time being, of course, a precious commodity for mortals). The same cannot be said for a human organ and the concurrent loss of dignity, wholeness, and the risk to one's future health and life.

Usually, we let the free market regulate transactions to ensure a just price for both buyer and seller. I'm not sure that free market principles really work, especially (as per above) when one is exchanging money for bodily integrity - the former is not an adequate exchange for the latter.
11.20.2008 3:36am
David Warner:
Foolsmate,

"Troll."

Tried that, but my body rejected it. Too far cross-species. Otherwise that would be a great idea, seeing as how trolls do not merit the benefit of your valiant defense of their human dignity, not being human.
11.20.2008 3:56am
David Welker (www):

you should be willing to defend such a position with more than vague references to dignity


Well, I don't agree with your premise that dignity arguments are weak. If you ask me, Martin Luther King's "I have a Dream Speech" was all about dignity. And that was quite powerful.

As far as your point about logic and evidence goes, I think that is a reasonable point. However, I think I have provided plenty of examples of those things.

Nonetheless, in any argument, there are premises that cannot be proven. For example, for utilitarian arguments, the premise that human happiness matters, and the happiness of everyone in the community should be considered typically goes unproven. I would say that my assertion that human dignity matters would be a premise of that sort. I clearly believe that a human being is much more than a particular arrangement of atoms and molecules that happen to exist in the universe. That this particular type of arrangement of atoms and molecules that we call "human" has something called "dignity" and therefor demands respect not owed to other arrangements of atoms and molecules in the universe. This appears to be a premise you disagree with. Fine. What are your reasons for disagreeing with that premise in light of my criticisms of Pinker's article? Do you believe that autonomy is a totally different sort of thing than dignity? Why?
11.20.2008 4:05am
David Warner:
David Welker,

I buy all of that, but to apply it to the integrity of the body and then to grant the state the right to protect that integrity, does it not therefore follow that all organ donation is right out?

If not, whence comes the moral distinction between violating that integrity with no compensation and violating it with?
11.20.2008 4:06am
David Welker (www):

If you're getting the sense that your idealized notions of dignity might not be too persuasive to someone who rationally believes that selling their kidney is their best chance at survival, and who takes cold comfort from your less-than-nourishing proclamation that their starving to death is morally unacceptable, then you are on to something.


Let's get real here. We don't even let people in North Korea starve if we can help it. And for good reason.

May I suggest that when people actually starve, the transaction costs (they are in some sort of war zone or their location is totally unknown) would prevent them from selling their organ anyway. If those transactions costs could be overcome, our obligation would be to ensure they do not starve. It would not be morally permissible to require their organs in exchange.

Let me put it this way. When I see a starving person, I see someone who needs to be fed, not an organ harvesting opportunity.
11.20.2008 4:14am
David Welker (www):

I buy all of that, but to apply it to the integrity of the body and then to grant the state the right to protect that integrity, does it not therefore follow that all organ donation is right out?

If not, whence comes the moral distinction between violating that integrity with no compensation and violating it with?


Let me start with a concrete example, and you can infer the general principle.

If you need to save your wife by donating your organ to her, you should be allowed to do so. Because there is a deep bond of love between her and you and you would do anything, including give up your own life if need be, for her. That, simply stated, is the difference.

You are allowed to give up your life freely to sacrifice for your country or defending someone you love. A suicide contract in which you gave up your life for money (perhaps some sicko wanted to make a profitable snuff video) would be illegal.

Even though you are able to volunteer your labor for the country and bind yourself to the military such that you cannot change your mind once committed, you are not allowed to sell yourself into slavery, or even indentured servitude, to a private individual.

The difference is the nature of the relationship that leads to the decision to give your organ.
11.20.2008 4:29am
Fedya (www):
What about compensating the estate of deceased organ donors instead? They're dead, so it's not as though the deceased are being coerced into doing something against their health.

David Welker wrote:

I do not agree that people "own" their kidney in the same way they own a car.


I own my kidneys. You, and the state, sure as hell don't.
11.20.2008 9:05am
Houston Lawyer:
If you can sell your body organs like any other property, then you can surely contract to do the same. So the next time you buy a home, you can grant a security interest in your left kidney to the bank. If you default, they can foreclose and sell it to the highest bidder. If there are any proceeds left, after payment of the hospital's and the bank's expenses, the remainder can be applied against the balance you owe the bank.

Since this is a secured transaction, it is not voidable in bankruptcy. Of course, the contract will contain a specific performance clause.
11.20.2008 9:49am
FoolsMate:

What about compensating the estate of deceased organ donors instead? They're dead, so it's not as though the deceased are being coerced into doing something against their health.


That is a common sense place to start. I don't think there's a rational argument against compensating for cadaverous organ donations, though there may be religious objections (not to imply those are not valid). I'd like to see what the compensation looks like and whether it's more than a couple hundred dollars plus coupons for a free soft drink at McDonalds.

I agree that your kidneys belong to you and not to David Welker; however, he makes a valid point. Even though you "own" your kidneys you cannot sell them.
11.20.2008 10:02am
PatHMV (mail) (www):
The proponents of self-mutilation for pay should establish what line will ultimately drawn to distinguish which compensated self-mutilation will be allowed and which won't, if any. (Eugene, apologies for the terminology, but I'm going to return in kind to a few of the commenters supporting your position here in the thread.)

For example, doctors not long ago performed a hand transplant. I've got two hands. If David Warner needs a hand, am I cruel and dictatorial to prohibit him paying someone else to chop off their own hand? After all, perhaps that other person has some job where they don't need 2 hands, and they'd be better off with the $100,000 fee. Can that person sell both hands, if he'd rather go around handless?

How about a face? Doctors in France recently performed a face transplant. There are a lot of social recluses in this country who live in seclusion, communicating primarily through the internet. They might consider themselves much better off to have a scarred-up remnant of a face and a million dollars worth of computer equipment.

How about fetuses? Can we pay a woman to conceive a child, then harvest the fetus for stem cells?

You know, there's also a real shortage of children available for adoption in this country. There's lot of couples wanting a child, with too few parents willing to put their unwanted children up for adoption. Should we have a market for children? There are undoubtedly plenty of crackheads who would sell their child for $100,000. Why not let them?

Once you start down that road, then, where do you draw the line? Can you sell a 5 year old? A 10 year old? 15?

Once you cross the line and treat a non-replaceable human body part as just another item of commerce, you've crossed a fundamental line. One can make some sort of distinction between renewable human parts (hair, blood, plasma, semen) and non-renewable ones (though, as Theobromophile notes, there are moral and practical issues even with that). But once you cross the line between renewable and non-renewable human body parts, there is no clear, easily defensible line between that and the selling of human beings themselves.
11.20.2008 10:07am
David M. Nieporent (www):
David Warner,

I am fine with you buying an organ. But only if you can convince Bill Gates to sell you his.

Except for that case, I think someone who sells an organ for money (not gives you an organ because they have some attachment to you) is in some sort of desperate situation that you are exploiting.
Yes, but who asked you? If you're not one of the people involved in the transaction, what business is it of yours?

The bottom line, though, is this: if this person is "in some sort of desperate situation" such that he needs to sell his kidney, then you're making him worse off by not letting him do so.

Your parenthetical underscores how irrational your argument is. If I don't need to sell my kidney, and give it to you out of some sort of emotional blackmail, then I'm not being exploited, but if I actually get something -- fair market value -- out of it, then I am?
11.20.2008 10:32am
Ken Arromdee:
Selling organs falls into the same category as prostitution and selling oneself into slavery; most people value them so highly that they would never sell them at any price even close to what the free market would bring.

The result is that the only people willing to sell them are either desperate, didn't think it through, or have mental health issues causing them to drastically undervalue the asset compared to an average person. This brings selling a kidney into the same category as being trapped in the desert and selling your diamond ring for a single glass of water because you need the glass of water to live; you must sell it for much less than it's worth to you because of desperation.

(Of course, this is a generalization. It's not literally only... it's just that that's the rule almost all of the time. Perhaps we should have "minimum wages" for organ selling and prostitution which approach what a non-desperate person would value them at. It's illegal to sell a kidney for, say, less than fifty million dollars. You can't pay less than a thousand dollars to a prostitute. And if you try paying for a diamond ring with a glass of water, you're "gouging", which is just a rephrasing of a minimum wage--charging too much is the same as not paying enough.)

The usual libertarian/utilitaritarian response to this is that if someone is willing to make the transaction, he obviously does value the money more than the kidney, so he's not being cheated. However, if you go this route, the values of things change depending on circumstances, and don't bear much resemblance to what we normally call value. More importantly, if you go this route, you've defined away the concept of a free market failure since by definition all transactions benefit both parties or they wouldn't have happened.

And the answer to the question of "why doesn't this apply to ordinary jobs? I wouldn't work if I didn't need a roof over my head" is that 1) desperation comes in degrees and the degree of desperation that would induce you to take a job you don't like is less than what it would take for you to sell your organ, and 2) if you think of it as a minimum wage, we actually do apply it to jobs of all types (although not very well; for instance, we have one minimum wage across the board).
11.20.2008 10:58am
PatHMV (mail) (www):
This thread is serving as a good reminder to me why I rarely let my self be sucked into arguments with libertarian ideologues. Little good comes of it, as you can't argue anything at all without having to tediously, time after time, shooting down their unswerving, fanatical believe in the glories of some Heinlein-esque fantasy world.

The answer to "what business is it of yours" is that humans are social creatures. We do not live lives of quiet isolation. My neighbors' actions regularly affect my life, and my actions theirs. As social creatures, individual decisions ARE shaped by societal incentives, pressures, mores. As a simple example, look at the fashion industry. People, on the whole, want to dress in the current style, so they don't stand out from the crowd in a bad way. If I like wide ties, but the current style is for thin ones, then there is pressure on me to wear the style I don't personally prefer. I must either go along with the group or face some level of social ostracism (mocking, giggling, not being considered attractive by women, whatever) as a consequence of my choice.

On a more serious example, consider the story related by Theobromophile. She's fairly strong-willed, and thus is willing to stand up to the thoughtless do-gooders who harangue her to chop off her hair for the benefit of others. Many people are not so self-assured. They succumb to this social pressure. When they do, it's not what can really be called "coercion." They get worn down. They desire to be seen as "good." They want to be invited to all the right parties.

The social costs of remaining a rugged individualist can be high. I am affected by the choices of others because that determines how much pressure is brought to bear on me, and thus how much my social costs are to maintain my independence in certain areas.

At any rate, I'm now going to return to my policy of avoiding the interminable debate with self-righteous, dogmatic libertarians who are convinced that human society can be governed by some one fundamental libertarian principle.
11.20.2008 11:08am
Elliot123 (mail):
We may be missing the elephant in the living room. The volunteer donor system has been a miserable failure. People don't care enough for their fellow man to willingly lay down under the knife for his benefit. They will for a close relative, but to hell with the stranger. They are not caring. They are not sensitive. They are not giving. They won't even do it after they're dead.

This is a slap in the face for the notion that we can successfully live in a communitarian society with common ownership, shared responsibility, and an acceptance that we are all our brothers keepers. Keep him? We won't even keep our brother alive.

The aternative is even worse. What if organ payment immediately wiped the waiting lists clean? What if all those folks shuffling around with walkers and oxygen bottles suddenly were playing tennis with bimbos because someone sold them a heart or kidney? What if some folks even had to face the fact the human race lacks the level of dignity they have defined for it?

What a great real world test that would be. It would be pretty great for that guy with the new tennis racket and bimbo, too.
11.20.2008 11:09am
David M. Nieporent (www):
The usual libertarian/utilitaritarian response to this is that if someone is willing to make the transaction, he obviously does value the money more than the kidney, so he's not being cheated. However, if you go this route, the values of things change depending on circumstances, and don't bear much resemblance to what we normally call value.
What do you mean "we," paleface? Things don't have inherent value; their value always changes based on circumstances. That's how I always use the term "value."
More importantly, if you go this route, you've defined away the concept of a free market failure since by definition all transactions benefit both parties or they wouldn't have happened.
That's not the definition of market failure in the first place. A market failure isn't a transaction that doesn't benefit both parties; it's a situation where the market is inefficient at allocating resources.
11.20.2008 11:48am
Ken Arromdee:
That's not the definition of market failure in the first place. A market failure isn't a transaction that doesn't benefit both parties; it's a situation where the market is inefficient at allocating resources.

Those are equivalent.

If the market is inefficient at allocating resources, there must be some transaction that a group of parties could make which would allocate the resources more efficiently (i.e. which would benefit the parties), but which they don't make.
11.20.2008 12:17pm
Fub:
PatHMV wrote at 11.20.2008 10:07am:
Once you start down that road, then, where do you draw the line? Can you sell a 5 year old? A 10 year old? 15?
Just as an informal and unscientific empirical observation, I'd say that most parents' asking price decreases monotonically with age until age 18, when it becomes zero by operation of law.

There are some exceptions though. Some parents use a potlatch approach effectively at younger ages, ie: "I ought to give you back to the Indians."
11.20.2008 1:52pm
David Welker (www):

Yes, but who asked you? If you're not one of the people involved in the transaction, what business is it of yours?


Of course it is my business. And yours too. This proposal would fundamentally shape who we are as a society.

You seem to think that there are only two people with an interest in this transaction, A and B. That is where we disagree.

Look, when A steals from B, I could also say, what business is it of mine? I am neither A nor B. But it is our business, because A stealing from B is morally wrong.

I don't understand why this is a difficult point for you. We as a society come to these moral decisions through the democratic process. You are free to advocate for a different position in that process.
11.20.2008 2:52pm
David Welker (www):

What about compensating the estate of deceased organ donors instead? They're dead, so it's not as though the deceased are being coerced into doing something against their health.


This sounds like a reasonable proposal to me. But only if the individual consents while they are still alive.
11.20.2008 2:55pm
Elliot123 (mail):
"Of course it is my business. And yours too. This proposal would fundamentally shape who we are as a society."

We as a society don't donate organs for free. That is demonstrated by the gwowing transplant list. That's who we are as a society. We are a society that doesn't donate and is content to let people die so others can feel good about themselves.
11.20.2008 4:36pm
PatHMV (mail) (www):
Elliot... you're not going to get many converts to your cause if you keep claiming that anybody who's not willing to sell one of their kidneys is selfish and "content to let people die." In short, screw you. It is not selfish to decide to keep all of one's own organs intact. Not only do I not owe you a part of my body, it is not in any way, shape, or form selfish of me to decide to keep my body intact.

Removing organs from the dead is another matter, and I'm open to reasonable debate on the issue. But screw you for suggesting that we as a society are selfish ("don't donate") for mostly deciding to keep our organs in our own bodies.

Eugene, this is the type of thinking that your suggestion brings about. If we allow the compensated maiming of individuals, if we treat human body parts from living people as just some other item of commerce, pretty soon people start thinking that they have some entitlement to having that, that there's nothing special about it. They will very rapidly shift from demanding the right to buy organs to demanding the right for the government to pay for it... and then they'll start wondering why all those comatose people really need their organs.

Once you decide that bodily integrity is something that can be bought and sold like this, once you acquiesce to a utilitarian philosophy rather than one which recognizes the uniqueness of the human being and the moral implications that entails, then soon those who do not have will be using the same "good of the many" utilitarian argument to take from those who do have.
11.20.2008 5:17pm
David Welker (www):

Not only do I not owe you a part of my body, it is not in any way, shape, or form selfish of me to decide to keep my body intact.


It is pretty crazy to argue otherwise, isn't it?

I guess you do get some pretty far out arguments here sometimes.
11.20.2008 6:24pm
Elliot123 (mail):
"Elliot... you're not going to get many converts to your cause if you keep claiming that anybody who's not willing to sell one of their kidneys is selfish and "content to let people die." In short, screw you. It is not selfish to decide to keep all of one's own organs intact. Not only do I not owe you a part of my body, it is not in any way, shape, or form selfish of me to decide to keep my body intact.

Removing organs from the dead is another matter, and I'm open to reasonable debate on the issue. But screw you for suggesting that we as a society are selfish ("don't donate") for mostly deciding to keep our organs in our own bodies.


What a wonderful way to get converts for your cause.

However, note I said nothing about anyone being selfish. That's your word. I said the organ donor system was a miserable failure because nobody cares enough about anybody else to donate an organ. Do you disagree? Is the system a success? Are the waiting lists cleared? How's it doing?

And why do we have such a system, one that does not allow the purchase of organs? It appears to be because people are concerned about "who we are as a society." They consider it beneath human dignity to trade in organs. They place their personal good feelings above another's life. They place their notion of what we are as a society above another's existence. So, yes, we are content to put folks on the waiting list and gently slide them into the grave waiting for that mysterious stranger to donate an organ.

But, since you are keenly atuned to selfishness, let's go there, too. Of course we are as a society are selfish with our organs. It's obvious. We keep them for ourselves when we could donate and save a life. When we have two kidneys, we cling to both for ourselves, even though we can donate one and have a very productive life. There is nothing wrong with selfishness.

The fact that we are selfish in no way implies anyone has a right to parts of another's body. It just means we are selfish.

So, let's have a show of hands here. Who has donated an organ to a stranger? Who has been selfish and kept all ther organs for themselves?

Truth in organs: I have been selfish and have kept all of mine. How about you, Pat?
11.20.2008 6:24pm
FoolsMate:
I wonder if anyone has donated a kidney to a complete stranger and then later watched helplessly when a loved one needed one. Assuming good matches, etc.
11.20.2008 6:53pm
Elliot123 (mail):
FoolsMate,

Let's try to make it better. I wonder if anyone has donated a kidney to a stranger, then come down with a malady in the remaining kidney. Prohibited from buying a kidney, they then die on the waiting list wondering who we are as a society.
11.20.2008 7:19pm
David Schwartz (mail):
If someone is so desperate that he'd rationally rather have $100,000 than his hand, how does it help him to take this option away from him?
11.20.2008 9:12pm
FoolsMate:
Reading through these comments again, society would be oh so much better off with brain instead of kidney transplants.
11.20.2008 9:28pm
David Warner:
Foolsmate,

"Reading through these comments again, society would be oh so much better off with brain instead of kidney transplants."

We'll see what we can find for you. We're a giving society.
11.20.2008 10:23pm
Elliot123 (mail):
Hey, how about a woman selling her egg? How does that fit with "who we are as a society?" Where does that register on the dignity scale?

I don't want to be sexist, so consider the same for sperm.

Ever wonder about the abortion debates where folks tell us a woman controls her own body? Interesting principle.
11.20.2008 11:11pm
theobromophile (www):
That's your word. I said the organ donor system was a miserable failure because nobody cares enough about anybody else to donate an organ. Do you disagree? Is the system a success? Are the waiting lists cleared? How's it doing?

Well, Elliot, putting the word "selfish" to your concept of "nobody cares enough about anyone else" seems to be pretty apt. Not sure why you're criticising it.

Personally, I don't I'm selfish (at least not in the pejorative sense) for keeping both my organs and my life. As per above, I could give my life to save about a dozen others, but I choose to remain alive and let them die. That does not make me selfish nor a murderer; it simply makes me someone with an unalienable right to her own body. It is a right that cannot be removed by the government, by society, or even by me. Personally, I think we live in a fantastic society, one which recognises the unalienable right to bodily integrity.

Death is not the worst thing in the world. I know that this is an odd thing for a pro-lifer to say, but, to me, the question is not if we will die, or when it is morally permissible to actively bring about the death of another, but about how we live and die. When nature ends the life of a human being - either in the womb or at age 80 - it's sad, but it's also natural. There is nothing wrong, morally, with natural death.

There is, however, something wrong with either killing someone prematurely, or artificially extending their life by violating the bodily integrity of another. Kidneys are not meant to be shared. They don't come in convenient zippered pouches for easy travel between one body and another. If anything is to be truly yours, it would be your body.

Death isn't the worst thing out there. In fact, it's gonna happen to all of us. The only questions are when, and with how much dignity - for ourselves and those around us.
11.21.2008 12:00am
Brian K (mail):
If you're talking about non-regenerative organs, the distinction is that there is no fair market value - or market, even - for human dignity, and the transaction in question can never be functionally unwound.

your falling back on the same canard that welker is. how does not selling an organ equate to "human dignity". the argument doesn't even make much sense. we sell our dignity all the time. our employers aren't paying us to stay at home and watch tv, they pay us for our body and/or our mind.


If a person is coerced into buying or selling goods on the market, he may, presumably, sell back those goods that he purchased or buy back those that he sold (or similar ones). However, one cannot buy another kidney and thus make the entire transaction a wash.

you can't buy back your own kidney? or void the sale in the first place as illegal? or how about just putting procedures in place to minimize coercion?


First of all, the risks of surgery are a bit higher than of clicking a few buttons on Amazon.com. Second, and more importantly, the fact is that there is no substitute for your own kidney (or that of an identical twin): transplant recipients need to take immuno suppressant drugs to ensure that the organ will not be rejected.

so why allow any organ transplant to take place? or for that matter any medical procedure. they all incur some risk. in what ways does the informed consent requirements currently in place fall short only in regards to the sale of organs?


Presumably, as well, there is some sort of fair market value for the goods or his labour (...). The same cannot be said for a human organ and the concurrent loss of dignity, wholeness, and the risk to one's future health and life.

this is a circuitous argument. essentially what you're saying is that the fact that there is no legal free market is a reason to keep free markets illegal.



Kidneys are not meant to be shared. They don't come in convenient zippered pouches for easy travel between one body and another.

your computer is made with plenty of metal and synthetic ingredients. none of that stuff can be easily picked up off the ground. none of it comes in convenient zippered pouches for installation into your computer. and yet you still own a computer, no?

regardless of the above, it all comes down to the same questions that you and welker have yet to answer. what definition of dignity are you using? how does the voluntary sale of organs violate it? what sets organ sales apart from the many similar markets that are legal? why should your desire to not give a kidney prevent me from selling mine?
11.21.2008 12:42am
PatHMV (mail) (www):
I am comforted by the fact that in my opinion, I stand together with Pope Benedict, who recently discussed this very subject at an international conference. (His remarks continue the teachings of Pope John Paul II on the subject.


Dear Brothers in the Episcopate,
Distinguished Ladies and Gentlemen,
Organ donation is a peculiar form of witness to charity. In a period like ours, often marked by various forms of selfishness, it is ever more urgent to understand how the logic of free giving is vital to a correct conception of life.
Indeed, a responsibility of love and charity exist that commits one to make of their own life a gift to others, if one truly wishes to fulfil oneself. As the Lord Jesus has taught us, only whoever gives his own life can save it (cf. Lk 9: 24).
In greeting all those present, with a particular thought for Senator Maurizio Sacconi, Minister of Labour, Health and Social Policies, I thanks Archbishop Rino Fisichella, President of the Pontifical Academy for Life, for the words he has addressed to me illustrating the profound meaning of this meeting and presenting the synthesis of the Congress' works.
Together with him I also thank the President of the International Federation of Catholic Medical Associations and the Director of the Centro Nazionale Trapianti, underlining my appreciation of the value of the collaboration of these Organizations in an area like that of organ transplants which, distinguished Ladies and Gentlemen, has been the object of your days of study and debate.
Medical history clearly shows the great progress that it has been possible to accomplish to ensure to each person who suffers an ever more worthy life.
Tissue and organ transplants represent a great victory for medical science and are certainly a sign of hope for many patients who are experiencing grave and sometimes extreme clinical situations.
If we broaden our gaze to the entire world it is easy to identify the many and complex cases in which, thanks to the technique of the transplantation of organs, many people have survived very critical phases and have been restored to the joy of life.
This could never have happened if the committed doctors and qualified researchers had not been able to count on the generosity and altruism of those who have donated their organs. The problem of the availability of vital organs to transplant, unfortunately, is not theoretic, but dramatically practical; it is shown by the long waiting lists of many sick people whose sole possibility for survival is linked to the meagre offers that do not correspond to the objective need.
It is helpful, above all in today's context, to return to reflect on this scientific breakthrough, to prevent the multiple requests for transplants from subverting the ethical principles that are at its base. As I said in my first Encyclical, the body can never be considered a mere object (cf. Deus Caritas Est, n. 5); otherwise the logic of the market would gain the upper hand.
The body of each person, together with the spirit that has been given to each one singly constitutes an inseparable unity in which the image of God himself is imprinted. Prescinding from this dimension leads to a perspective incapable of grasping the totality of the mystery present in each one.
Therefore, it is necessary to put respect for the dignity of the person and the protection of his/her personal identity in the first place.
As regards the practice of organ transplants, it means that someone can give only if he/she is not placing his/her own health and identity in serious danger, and only for a morally valid and proportional reason.
The possibility of organ sales, as well as the adoption of discriminatory and utilitarian criteria, would greatly clash with the underlying meaning of the gift that would place it out of consideration, qualifying it as a morally illicit act.
Transplant abuses and their trafficking, which often involve innocent people like babies, must find the scientific and medical community ready to unite in rejecting such unacceptable practices.
Therefore they are to be decisively condemned as abominable. The same ethical principle is to be repeated when one wishes to touch upon creation and destroy the human embryo destined for a therapeutic purpose. The simple idea of considering the embryo as "therapeutic material" contradicts the cultural, civil and ethical foundations upon which the dignity of the person rests.
It often happens that organ transplantation techniques take place with a totally free act on the part of the parents of patients in which death has been certified. In these cases, informed consent is the condition subject to freedom, for the transplant to have the characteristic of a gift and is not to be interpreted as an act of coercion or exploitation.
It is helpful to remember, however, that the individual vital organs cannot be extracted except ex cadavere, which, moreover, possesses its own dignity that must be respected.
In these years science has accomplished further progress in certifying the death of the patient. It is good, therefore, that the results attained receive the consent of the entire scientific community in order to further research for solutions that give certainty to all.
In an area such as this, in fact, there cannot be the slightest suspicion of arbitration and where certainty has not been attained the principle of precaution must prevail. This is why it is useful to promote research and interdisciplinary reflection to place public opinion before the most transparent truth on the anthropological, social, ethical and juridical implications of the practice of transplantation.
However, in these cases the principal criteria of respect for the life of the donator must always prevail so that the extraction of organs be performed only in the case of his/her true death (cf. Compendium of the Catechism of the Catholic Church, n. 476).
The act of love which is expressed with the gift on one's vital organs remains a genuine testimony of charity that is able to look beyond death so that life always wins. The recipient of this gesture must be well aware of its value. He is the receiver of a gift that goes far beyond the therapeutic benefit.
In fact, what he/she receives, before being an organ, is a witness of love that must raise an equally generous response, so as to increase the culture of gift and free giving.
The right road to follow, until science is able to discover other new forms and more advanced therapies, must be the formation and the spreading of a culture of solidarity that is open to all and does not exclude anyone.
A medical transplantation corresponds to an ethic of donation that demands on the part of all the commitment to invest every possible effort in formation and information, to make the conscience ever more sensitive to an issue that directly touches the life of many people.
Therefore it will be necessary to reject prejudices and misunderstandings, widespread indifference and fear to substitute them with certainty and guarantees in order to permit an ever more heightened and diffuse awareness of the great gift of life in everyone.
With these sentiments, while I wish each one to continue in his/her own commitment with the due competence and professionalism, I invoke the help of God on the Congress' works and I impart to all my warm Blessing.
11.21.2008 10:47am
Elliot123 (mail):
"As per above, I could give my life to save about a dozen others, but I choose to remain alive and let them die."

Actually, we don't have to give our life to save another. We can donate one kidney, live a full and active life, and save another.

I don't argue with an unalienable right to one's own body. I observe that the selfish among us exercise that right by refusing to donate a kidney. One can certainly be exercising a right while still being selfish. Hiding behind a right doesn't change selfishness to virtue.

"If anything is to be truly yours, it would be your body."

I completely agree. So, the selfish among us are free to hold on to our kidneys, while those of us with a less selfish nature are free to give a kidney to another who needs one.

But, let's test that idea of dignity. We now have thousands who have unselfishly given a kidney to another. Likewise, we have thousands who have received a kidney. How have these people reduced the dignity of humanity? How have the donors reduced human dignity? How have the receivers reduced human dignity? How have they reduced dignity - for ourselves and those around us?

Virginia Postrel gave a kidney to a stranger earlier this year. Can you tell us specifically how she damaged the dignity of the human race? What was the state of that dignity when she had two kidneys. What is the state now that she has only one?
11.21.2008 11:06am
theobromophile (www):
Elliot,

Enough with the straw men. Use them as Thanksgiving decorations instead, if they are left over from Halloween.

None of us are arguing against organ donation, which, as a donation and not as a sale, is a gift of life to another human. What we are arguing against is selling organs to another, or this total b.s. about it being selfish to retain your own organs in your body. Capiche?
11.21.2008 12:02pm
David M. Nieporent (www):
Yes, but who asked you? If you're not one of the people involved in the transaction, what business is it of yours?

Of course it is my business. And yours too. This proposal would fundamentally shape who we are as a society.
"We" aren't anybody "as a society." You're talking about the Borg. We are individuals. I am an individual. And true "dignity" involves respecting that, not treating me as merely a cog in "society."
You seem to think that there are only two people with an interest in this transaction, A and B. That is where we disagree.
Indeed it is.
Look, when A steals from B, I could also say, what business is it of mine? I am neither A nor B. But it is our business, because A stealing from B is morally wrong.
In fact, that's wrong, and it underscores why your position is mistaken: it's only your business if B says it is. If B says, "That's okay; A can have the item/money. I'm okay with that," you don't get to interfere and say, "No; I want to prosecute A for stealing anyway."
I don't understand why this is a difficult point for you. We as a society come to these moral decisions through the democratic process. You are free to advocate for a different position in that process.
I don't understand why you think that "we" can "democratically" tell other people what to do any more than you can do so individually.
11.21.2008 1:01pm
Elliot123 (mail):
"None of us are arguing against organ donation, which, as a donation and not as a sale, is a gift of life to another human. What we are arguing against is selling organs to another, or this total b.s. about it being selfish to retain your own organs in your body. Capiche?"


However, this is what you told us:

Kidneys are not meant to be shared. They don't come in convenient zippered pouches for easy travel between one body and another. If anything is to be truly yours, it would be your body.

Do kidneys come in zipperd bags when they are donated and not shared?
11.21.2008 1:37pm
theobromophile (www):
Sorry that you missed this thing we like to call "the point." If, as you claim, it is "selfish" to not give one's kidneys away, they would be easily alienable from the body. They aren't. That makes a donation of a kidney an incredible gift, rather than an act which merely prevents one from being selfish.
11.21.2008 2:08pm
Elliot123 (mail):
Nonsense. We can donate kidneys and we don't. We can save a life and we don't. We pretend to care by having a donation program, then watch participants die. Kidneys are easily taken from the body and transplanted; that has been proven thousands of times.

Remember, your policy for all of us is, "Kidneys are not meant to be shared."
11.21.2008 6:57pm
David Welker (www):

In fact, that's wrong, and it underscores why your position is mistaken: it's only your business if B says it is. If B says, "That's okay; A can have the item/money. I'm okay with that," you don't get to interfere and say, "No; I want to prosecute A for stealing anyway."


First, the decision to prosecute for a crime or not is not typically up the victim. If A says B committed a crime against A, but A does not wish B to be prosecuted, at the end of the day it is up to the prosecution whether to follow the wishes of A or not.

Here is a question for you.

If A wants to make a snuff film and kill B, and B agrees in exchange for a large amount of compensation for B's heirs, do you think this is no one else's business? That no one else has an interest in the matter?
11.22.2008 12:39am
David Welker (www):
Elliot123,

I think your definition of selfish is incredibly broad. One that makes the concept rather meaningless. The problem with your definition of selfishness is that it actually excuses actual selfishness that should be the subject of criticism, because it gets lumped in with all these things that are perfectly socially acceptable.
11.22.2008 12:44am
Elliot123 (mail):
I think your definition of selfish is incredibly broad. One that makes the concept rather meaningless. The problem with your definition of selfishness is that it actually excuses actual selfishness that should be the subject of criticism, because it gets lumped in with all these things that are perfectly socially acceptable.

I haven't defined selfish. I have written about a particular practice and classed it as selfish. Something can be extremely selfish and still be socially acceptable. Do you consider socially acceptable and selfish to be mutually exclusive? If we all do it, it can't be selfish? All a selfish lout has to do is get enough people to accept his behavior, and it's no longer selfish?

Is there something wrong with being selfish?
11.22.2008 1:06am
David Schwartz (mail):
If A wants to make a snuff film and kill B, and B agrees in exchange for a large amount of compensation for B's heirs, do you think this is no one else's business? That no one else has an interest in the matter?
The hypothetical is vague, but I think it could be fleshed out so that no one else had an interest in the matter and it was no one else's business. However, those cases might be so rare that for a society like ours, it's simpler and wiser to simply prohibit such transactions, since the potential benefit is so small.
11.22.2008 6:59am
David Welker (www):

Is there something wrong with being selfish?


Yes, when selfish is properly and narrowly defined, there is something wrong with being selfish. Now, if you define selfish very broadly, the word loses all meaning and at the same time any and all normative power.
11.22.2008 5:06pm
David Welker (www):

The hypothetical is vague, but I think it could be fleshed out so that no one else had an interest in the matter and it was no one else's business.


Okay. In what case do you think the making of a snuff film would be no one's business besides A and B?
11.22.2008 5:09pm
Elliot123 (mail):
"Yes, when selfish is properly and narrowly defined, there is something wrong with being selfish. Now, if you define selfish very broadly, the word loses all meaning and at the same time any and all normative power."

OK. Here's a nerrow case. I have two healthy kidneys. I need only one for the rest of my life. You have diseased kidneys that will not last more than a month. You will die in a month. I choose to keep my kidneys and let you die. I am selfish.

Further, while keeping my kidney, I want to keep you from purchasing a kidney from a willing, informed, and healthy individual, thereby ensuring you die. I do this because I think your purchase would be undignified and would reflect badly on who we are as a society. Again I am selfish for insisting you should die to make me feel good.

Then as you are lowered into the ground, I insist I am not selfish, nor are any others who keep their extra kidney selfish. I also insist I am actually noble in preventing you purchasing that kidney and watching you die because we as a society are better off with you dead and my personal dignity intact.

On your deathbed I instruct you on the unalienable right to one's own body, the unalienable right to bodily integrity, who we are as a society, and what a kind, generous, unselfish, and giving person I am.
11.22.2008 6:10pm
David Welker (www):
Elliot123,

We can infer that your definition of selfish, based on its inclusion of not donating one's kidney's, is obviously way too broad. Obviously, we should factor the well-being of others in our decisions. But that does not mean there are no limits to our obligations.

Maybe you are an Ayn Rand fan and buy her ridiculous argument that selfishness is acceptable or even a virtue. I don't. For that reason, I do not define selfishness so broadly such that it loses its sting.

I think one possible refuge of those who are selfish but wish to avoid criticism would be to define selfishness so broadly as to encompass every person. (I am not saying that is you.) After all, if everyone is selfish, what sting could the assertion have with respect to the behavior of a particular individual? At the end of the day, this ploy is not persuasive.

Anyway, I am not sure why you decided to turn the conversation in this direction. It certainly seems only tangentially related, at best, to the question at hand. I am not sure if you seriously intend for this point to have any weight. You are not going to persuade anyone that takes the concept of selfishness seriously and views it as a negative quality for someone to have that failure to donate one's organs is selfish. Under that definition, everyone (or nearly everyone) is selfish and the term has no meaning. Deploying a term you have rendered meaningless will not assist you in making any larger points.

Once again, selfishness, when narrowly defined, rightly has a pejorative meaning. In a civilized society, people should consider the effects of their actions on others. But there are and must be limits.
11.22.2008 6:55pm
Elliot123 (mail):
"Once again, selfishness, when narrowly defined, rightly has a pejorative meaning. In a civilized society, people should consider the effects of their actions on others. But there are and must be limits."

Limits to what? Limits to considering the effects of ones actions on others? Why must there be limits to such consideration?
11.22.2008 9:32pm
David Welker (www):

Limits to what? Limits to considering the effects of ones actions on others? Why must there be limits to such consideration?


Because, along with the effects of your actions on others, you must also consider the effects of your actions on yourself.

Stop with the simple binaries already. "Either you consider other peoples' interests exclusively, or you are selfish."

That is surely one possible way to look at the world. Just not a very useful one.
11.22.2008 10:38pm
Elliot123 (mail):
Who said others' intrests are exclusive? That's your notion. I'm saying it's selfish to preach against selling a kidney to a dying man, while at the same time refusing to donate one. All that does is make sure he dies.

Our current system is a failure, and its apologists want to keep staging people on lists knowing they'll die on the list. And it's all for dignity, the unalienable right to one's own body, the unalienable right to bodily integrity, and who we are as a society. And let's not forget the kicker: "Kidneys are not meant to be shared."

The guardians of "who we are as a society" are certainly entitled to refrain from saving people. But, it's curious they want to make sure nobody else does.
11.22.2008 11:06pm
David Welker (www):

But, it's curious they want to make sure nobody else does.


Nobody said that kidney donations should not be allowed. Therefore, attributing to anyone a desire to make sure no one else provides someone who needs one a kidney seems a bit inaccurate.
11.23.2008 12:06am
Elliot123 (mail):
"Nobody said that kidney donations should not be allowed. Therefore, attributing to anyone a desire to make sure no one else provides someone who needs one a kidney seems a bit inaccurate."


theobromophile:"Kidneys are not meant to be shared."

The guardians of "who we are as a society" are determined to prevent any purchase of kidneys, and therefore ensure a continued continued stream of folks from the waiting list to the obits. The guadians get to feel good about themselves and "who we are as a society." The sick get to die.

I notice everyone in a transplant gets paid... doctor, nurse, orderly, hospital, organ transporter, organ broker. And the recipient gets a kidney. All that oozing cash is apparently within the bounds of the guardians' dignity and "who we are as a society." Hundreds of thousands are shoveled out by the recipient. So, it must be dignified for the recipient to pay, it's just undignified for the donor with the big hole in his back to get any of it. Everyone gets something except that guy on the other table.
11.23.2008 1:46am
David Welker (www):
I agree with theobromophile that kidney's are not meant to be shared. Nonetheless, I do not object to voluntary donations where no money changes hands. I am sure she does not object to such donations either.

Again, I do not think your statement that anyone has a desire to ensure that someone who needs a kidney doesn't get one is accurate.

As for the rest of your argument, you seem to think that it is somehow strange that, for example, the transplant surgeon gets paid for his services, just as a heart surgeon gets paid for his services. Obviously the transplant surgeon is not getting paid to donate his organ, he is being paid to perform a surgery. Just as a heart surgeon is.

Overall, even though we continue to disagree, I am glad that you have moved away from charged (and I think a bit bizarre) accusations of "selfishness" to more civilized discourse.
11.23.2008 4:44pm
Elliot123 (mail):
Don't jump to conclusions. As a society we are selfish because we insist on letting people die when we can donate unnecessary kidneys. Each individual who keeps their extra kidney is selfish.

Consider the guardians of "who we are as a society," watching death all around them, but feeling good about "who we are as a society." They are the most selfish since 1) they keep their unnecessary kidney that could save another, 2) they value their feelings of "who we are as a society" more then the life of another.

Now, ask the guardians of "who we are as a society" what dignity means, and you will get no answer. Ask how selling a kidney reduces human dignity, and you will get no answer. Ask how human dignity in Singapore differs from the US, and you will get no answer. Ask what "who we are as a society" means, and you will get no answer.

But, ask if people should be willing to endure a lingering death for these undefined terms, and they will say "Yes, Yes, Yes. Die for me."
11.23.2008 6:29pm
David Welker (www):
Elliot,

First, you may still insist that people who do not donate their kidney's are selfish. Fine. But, your definition of selfish is so broad that all I can say is "so what." There is nothing wrong with being selfish under your definition of the term, because your definition of the term is too broad.

Second, I have already addressed the definitional issues around the the term dignity. And I think I have established that we cannot do without the concept. Even the idea that we should respect the autonomy of others originates from a concept of dignity. You seem to want a top-down definitions where the boundaries of dignity are precisely delineated. Some people might be willing to do that. I am not, simply because it seems to me a major commitment to the extent that all behavior that falls outside of that definition is, in some sense, licensed. Now, given the huge variety of behavior that could exist in the universe, I prefer a more case-by-case examination. This appears to make you feel uncomfortable, simply because you prefer precise definitions. While I understand that preference on some level, I do not consider this preference to be of overriding importance.

Third, if you don't believe in the concept of dignity, why don't you explain how we can get by without it? So far, you have stood as a critic without making many affirmative points yourself. If there is no such thing as dignity, why not just steal, rape, or murder? I would be interested in how one moves from total chaos to order without some sort of concept of dignity.
11.24.2008 1:35am
Elliot123 (mail):
Like I said:
"Now, ask the guardians of "who we are as a society" what dignity means, and you will get no answer."

"Third, if you don't believe in the concept of dignity, why don't you explain how we can get by without it?"

I haven't made any arguments that are based on dignity. You have, but can't tell us what it means. Go ahead. Tell us what dignity is.
11.24.2008 11:11am
David Welker (www):
Elliot,

You seem to making arguments based on the idea that we can do without the concept of dignity. So, why don't you explain how our society can function without it? How do we move from chaos to order without a concept of dignity?

And contrary to what you have said, I have provided a general definition of dignity. I just have declined to give a precise definition for the reasons I stated.

You keep on insisting that I should "tell you what dignity means" without either (1) acknowledging that I have already answered that question in a general way and (2) without addressing my reasons for not giving a more precise definition and convincing me that a more precise definition is appropriate. You can't just repeat a demand without addressing the reason why that demand is initially declined and expect a response. Obviously.

So, at this point, all you are doing is repeating yourself, failing to acknowledge the points that have been made. All I know for sure is that you disagree. But you have failed to adequately defend your disagreement. You are skeptical of the concept of dignity. You seem to assume without explanation that the burden is on me to prove that this concept matters. But, given the conversation up to this point, I think the burden is on you to explain how we can function as a society without that concept. What makes humans more than a temporary collection of atoms and molecules bound together if not some sort of concept of dignity?

Anyway, if in your response to this comment you are merely going to repeat yourself (make another demand for a precise definition of dignity without addressing the reasons I have already given for not providing such a precise definition) you might as well not bother. Because I am not going to respond to someone who does not address the points that I have already made that is relevant to their inquiries.
11.24.2008 12:20pm
Elliot123 (mail):
"And contrary to what you have said, I have provided a general definition of dignity. I just have declined to give a precise definition for the reasons I stated."

Can you help us out by just cutting and pasting it?
11.24.2008 3:10pm