Wednesday, March 7, 2007
A recent New York Times book review by Amitai Etzioni, who advocates against selling organs for a variety of reasons, has provoked a bit of a debate. Kieran Healy, author of Last Best Gifts, writes here about his support for some organ market. He states,
At bottom, I think, monetary payments and financial incentives are simply not incompatible with the kind of moral obligations that Etzioni has in mind. We might want to idealize the distinction between morally virtuous gift-exchange and selfishly-motivated market transactions, but this boundary is crossed too often in practice for us to draw a bright line. Moreover, it is crossed in both directions: gift-exchange is often made a vehicle for self-interest; market transactions routinely have strongly moralized or normative aspects. Empirically, I would have two expectations for a viable market for kidneys. First, it would immediately incorporate a great deal of the gift form in order to legitimate itself, with market-matching between donors and recipients working largely at the back-end. Second, it would probably stratify itself in a way that reflected the structure of the U.S. health care system in general, with all that implies about the bottom-end of the market. In that sense Etzioni’s concerns are valid. But those inequities apply also to the communitarian alternative. Why should people feel any moral obligation to participate in a system that does not serve them well in other respects? To think otherwise is a kind of gift fetishism – the belief that we can guarantee the fairness of an exchange simply by insisting that it take the form of a morally obligatory gift.
For more on Etzioni's views on handling the lack of organs, see here.