The Analysis Of “The Moral Limits Of Markets: The Case Of Human Kidneys,” By Satz

How does a modern society resolve the tension between market forces and moral priorities? Can this tension be resolved when issues of bodily integrity are involved? These are questions raised by those who advocate for a legal market in human kidneys. Markets have been used since the beginning of human time as a means of exchanging what an individual has for what they want. However, where is the line drawn about what can and cannot be exchanged for a profit?

In “The Moral Limits of Markets: The Case of Human Kidneys,” Satz addresses the question of whether a market should exist for human organs, specifically kidneys. When human organs become an object to be traded, we are challenged with religious, ethical and social justice concerns. A market in kidneys should not exist because the human body should not be an article to be sold, it would create a disadvantage for low income people, and a market would take away from the charitable relationship between the donor and receiver. The sale of kidneys is currently illegal in all developed countries (Satz 270). However, because of developments in medical technology and the growing acceptance of individual freedom, there has been discussion about the ethical acceptability of compensation for kidney donors.

Currently, individuals in need of a kidney must solely rely on voluntary donations. Because of this, kidney donation frequently occurs between relatives. Kidney donation involves invasive surgery and potential health risks for the donor. For these reasons, an extreme shortage exists in the market for kidneys (Satz 271). Many would argue that introducing a market for kidneys would increase the supply of kidneys and decrease the shortage. However, selling a human kidney goes against the dignity of humankind by placing a price tag on the human body, and alternative solutions such as a public information campaign to increase knowledge of organ donation opportunities should be considered.

Many religions strongly oppose a market for selling human organs because it is considered morally wrong to make body parts into a financial commodity. For example, in Roman Catholicism, it is believed that no one owns their body because everyone was created by God, therefore each body belongs to God and is not something you can choose to sell (Stempsey). This creates a cultural and political obstacle to setting up a legal market in kidneys because religious voters would oppose any effort to create a financial market for kidney donation. This may result in fewer kidneys actually being available. Permitting the sale of kidneys also creates a “slippery slope” of moral questions. Where is the line drawn? If kidney sales are permitted, will babies placed for adoption also go to the highest bidder in a supply and demand market? Should an elderly person be permitted to sell an eye, or a lung, knowing that they only have a few years to live and bills to pay?

These moral concerns outweighs the risk of continued shortage of donor kidneys. Another major reason a market for kidneys should not exist is because it highlights the underlying inequalities in our social world (Satz, 280). When you introduce a financial incentive to the idea of donating kidneys, a moral inequality arises between the haves and have nots. People with low income will be tempted to go to extreme ends to make money. Therefore, if undergoing surgery to donate a kidney has a price tag attached to it, people with little money may be more inclined to take the risk and sell their kidney. On the opposite side of the socio-economic spectrum, people with a large income and stable financial situation will be inclined to buy kidneys no matter the price, if it will allow them to preserve their life or someone they are close to. It can be unsettling to think of the poor providing the rich with a vital organ as a desperate way to make financial ends meet. However, when the poor are in need, the rich will not supply the poor with this vital organ because the poor can't afford to pay for it. In this vision of the healthcare future, patients may survive not due to the generosity of their fellow citizen, but because of their personal wealth.

A kidney market increases the range of markets by introducing organs as an object that people with money have access to (Santz 280). For this reason, a legal kidney market will worsen the effect of income inequality. Without money as a factor, a person receives a kidney for reasons independent of financial status (Santz 280). Why should someone who has been waiting for years and on their deathbed be lower on the kidney waiting list compared to a person who just found out he or she needs a transplant, simply because the second person has unlimited funds to pay for a kidney? That seems morally unfair because a price is being put on life. It is not ethical for a hierarchy of kidney needs to be created by how much money a person is willing to spend. In a just society, kidney access should be based on need, not want or ability to pay.

The last argument to make about why a market for kidneys should not exist is that a market removes the acts of charitable donations. Without the variable of price, each kidney is donated to a needy person as an entirely altruistic act. The variable of price removes the pro-social reasons people would donate their body part. As of now kidneys, are given to people as an act of goodwill. If a price tag is added, it would most likely crowdout altruistically motivated people and increase extrinsically motivated donors, who would transform an act of giving into a for profit business transaction. A legal kidney market may increase the supply of kidneys, however, they are being supplied for the wrong reasons. Instead, becoming an organ donor should be more publicized as well as the need for kidneys today. If the public was more aware of the need and simplicity of becoming an organ donor, especially after death, it would allow for an increase in kidneys. German philosopher Immanuel Kant said, “Act always in a way that expresses respect for the value of humanity” (Ireland). Allowing a financial market for organs is allowing human dignity to be exploited. A market for kidneys would result in the poor being taken advantage of, altruistic motives to be lost, and the human body to be viewed as a commodity with a price. Basic human dignity demands that we keep higher ideals than these.