Rev. Phil Pinckard reviews the book

Kidney for Sale by Owner

First, a disclaimer: I am a donor’s dad. Our only son, Mark 18, donated his liver, kidneys, corneas and heart valves at his death resulting from injuries sustained in a vehicle accident on 20 May 2002. We have intimate personal experience with the emotional and spiritual benefits of the humanitarian “gift of life.”

Mark J. Cherry, associate professor in the department of Philosophy at Saint Edward’s University in Austin, TX, has written a detailed analysis addressing the complex issues that surround the sale of organs. He raises important moral questions about how we understand the body and moral authority in our society. “Is a global consensus and its promotion of a worldwide legal prohibition [of a market for human organs and tissues] morally justified?”[1] In 2002, the American Medical Association voted to promote studies to assess whether financial incentives would likely increase the pool of cadaver organ donors.

The text is organized in five major sections. Chapter 1 outlines the moral debate within the medical practice of transplantation and the attendant public health care crisis. Cherry considers ‘global consensus’ then critically assesses the claims that financial incentives would undermine free and informed consent, coercing the poor to offer their organs for sale; possible exploitation of the poor; corrosion of ‘gift of life’ sentiment and moral repugnance of creating a free market economy for organ donation and transplantation.

In the second chapter Cherry assesses conditions necessary and sufficient to create a market in human organs. His analysis explores foundational issues including the relationship between persons and their bodies; human organs as property; the distinction between justified and unjustified moral repugnance; and the moral limits of society or government when it interferes [his word] in consensual exchange of body parts. Does such logic lead to moral acceptance of legalized prostitution [consensual sex for hire] or ‘multiple marriage’ of teen-aged girls among members of the FLDS? Without intervention on moral grounds, would not slavery yet co-exist with free-enterprise in our nation?

Chapter 3 seeks to evaluate the costs and benefits of a free-enterprise organ market. Cherry evaluates the advantages and/or disadvantages of the market’s impact on healthcare, allocation of resources, and whether such a market would lead to greater liberty, equality, and altruism. What prevents an individual from offering his/her healthy kidney for sale for a price? Like the landowner [see Matthew 20:1:15] “Don’t I have the right to do what I want with my own money [body]?”

The fourth chapter considers the historical and philosophical roots of crucial moral institutions, ontological considerations, and political theoretical premises, as well as understandings of moral concerns. What are permissible uses of the body and its parts which frames the so-called ‘global consensus’ that prohibits a market in human organ exchange?
Chapter 5 brings these diverse analyses together to show why the apparently strong consensus against the selling of human organs is misguided. Each chapter includes a summary which I found helpful to the reader.

In his introduction, Cherry notes that “The Transplantation Society, the World Health Organization, the Nuffield Council on Bioethics and the U. S. Task Force on Organ Transplantation each has issued pronouncements condemning the creation of a for-profit market in human organs.”[2] He further notes that “The U. S. Congress, the National Kidney Foundation, the United Network for Organ Sharing [UNOS], the American Medical Association, the American Society of Transplant Surgeons, and the World Medical Association have similarly denounced proposals to broker human organs for transplantation.”[3]

Despite his intelligent presentation and detailed arguments, I remain unconvinced. Professor Cherry is cogent and persuasive. A time may come when a market in human organs and tissues becomes acceptable, even preferable to our current system. Until then, much work remains. Since 2003, the number of organs from deceased donors, both from brain death and cardiac death [DCD] has significantly increased. Consent rates have risen, but there remains a disparity between donors and potential recipients. I encourage you to read this book and draw your own conclusions

Footnotes:

[1] p. x.
[2] p. ix.
[3] Ibid.

Kidney for Sale by Owner, Cherry, Mark J., Washington DC: Georgetown University Press, 2005, 276 pp.

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