Pennsylvania plans to begin paying the relatives of organ donors $300 toward funeral expenses. It would be the first jurisdiction in the country to reward organ donation. Indeed, it might even be violating a 1984 federal law that declares organs a national resource not subject to compensation. Already there are voices opposing the very idea of pricing a kidney.
It is odd that with 62,000 Americans desperately awaiting organ transplantation to save their life, no authority had yet dared offer money for the organs of the dead in order to increase the supply for the living. If we can do anything to alleviate the catastrophic shortage of donated organs, should we not?
One objection is that Pennsylvania's idea will disproportionately affect the poor. The rich, it is argued, will not be moved by a $300 reward; it will be the poor who will succumb to the incentive and provide organs.
So what? Where is the harm? What is wrong with rewarding people, poor or not, for a dead relative's organ? True, auctioning off organs in the market so that the poor could not afford to get them would be offensive. But this program does not restrict supply to the rich. It seeks to increase supply for all.
Moreover, everything in life that is dangerous, risky or bad disproportionately affects the poor: slum housing, street crime, small cars, hazardous jobs. By this logic, coal mining should be outlawed because the misery and risk and diseases of coal mining disproportionately fall on people who need the money. The sons of investment bankers do not go to West Virginia to mine. (They go there to run for the Senate.)
No, the real objection to the Pennsylvania program is this: it crosses a fateful ethical line regarding human beings and their parts. Until now we have upheld the principle that one must not pay for human organs because doing so turns the human body--and human life--into a commodity. Violating this principle, it is said, puts us on the slippery slope to establishing a market for body parts. Auto parts, yes. Body parts, no. Start by paying people for their dead parents' kidneys, and soon we will be paying people for the spare kidneys of the living.
Well, what's wrong with that? the libertarians ask. Why should a destitute person not be allowed to give away a kidney that he may never need so he can live a better life? Why can't a struggling mother give her kidney so her kids can go to college?
The answer is that little thing called human dignity. According to the libertarians' markets-for-everything logic, a poor mother ought equally to be allowed to sell herself into slavery--or any other kind of degradation--to send her kids through college. Our society, however, draws the line and says no. We have a free society, but freedom stops at the point where you violate the very integrity of the self (which is why prostitution is illegal).
We cannot allow live kidneys to be sold at market. It would produce a society in which the lower orders are literally cut up to serve as spare parts for the upper. No decent society can permit that.