Kantian Condemnation of Commerce in Organs

1. Kantian Condemnation

2. Small Group Discussion: 10-12 minutes
1. What is transplant tourism? What do you know about the current issue?
2. What is your opinion about creating a regulated market? Is it ethical to pay
someone for their organs?
3. What are the potential dangers of transplant tourism?
4. WWKD (What would Kant do?) Why do many critics of the practice
maintain that this practice violates a categorical imperative?
5. Would this practice likely be acceptable through a utilitarian lens? Why?
One person in the group should record responses and names.

6. Small Group Discussion: 3-5 minutes
1. What stood out to you in the videos?
2. Did any of your opinions change, or were any reinforced
by what you saw?
One person in the group should record responses and
names.

7. Transplant Tourism
Problem: Growing, unregulated market
1. Some want a regulated market.
2. Opponents make Kantian arguments on formula for humanity
Kant implies selling off your organs wrong…

8. Can choosing to sell one’s kidney be
morally permissible?
Kant would say, “No.”
There are limitations on what a person can
permissibly do to her body and on how she
may allow others to use her for their
purposes.

9. Humanity, whether in one’s own person or that
of any other, must never be treated merely as a
means, but always at the same time as an end,
is Kant’s instruction.
He thought that organ sale violates this
imperative:
“To deprive oneself of an integral part or organ (to
maim oneself); for example, to give away or sell a
tooth to be transplanted to another’s mouth …
are ways of partially murdering oneself.”

10. 1. “A man is not entitled to sell his limbs for money…. One may dispose of things
that have no freedom, but not of a being that itself has free choice. If a man
does that, he turns himself into a thing, and then anyone may treat him as
they please, because he has thrown his person away; as with sexual
inclination, where people make themselves an object of enjoyment and
hence into a thing.”
2. … man is not his own property, and cannot do as he pleases with his body; for
since the body belongs to the self, it constitutes, in conjunction with that, a
person; but now one cannot make one’s person a thing…. Now, it is evident
that if someone concedes a part of himself to the other, he concedes himself
entirely. It is not possible to dispose over a part of oneself, for such a part
belongs to the whole.
3. “Man cannot dispose over himself, because he is not a thing. He is not his own
property—that would be a contradiction; for so far as, he is a person, he is a
subject, who can have ownership of other things. But now were he something
owned by himself, he would be a thing over which he can have ownership.
He is, however, a person, who is not property, so he cannot be a thing such as
he might own; for it is impossible, of course, to be at once a thing and a
person, a proprietor and a property at the same time.”

11. Problems with the Interpretation
Opponents don’t specify what dignity is, what ends are, what are permissible
means, etc.
For example, the author asks whether the person is being used as a means if
permission is given, if both parties are treated with respect, etc.
Thus, the Kantian argument needs interpretation:
Examples to work with:
1. Entrepreneur: Two well-off people in rich country, both fully informed.
2. Transplant tourist: The broker is a good one, and pays for the surgery and
recovery.
3. Regulated Market: The government market in a developing country; the guy
does the surgery and gets cash and insurance for life.

12. Entrepreneur
A 30-year-old man who is in good health sells one of his kidneys
for $50,000 in order to finance a new business. He has a secure
job, but not enough savings to get his venture off the ground.
The buyer is a 45-yearold woman in end-stage kidney failure
whose health is deteriorating to the point that her doctors soon
will deem her too sick to remain on the national waitlist for an
organ. Both buyer and seller have a thorough understanding of
the health risks each will incur. The buyer pays for the organ with
her own funds, without giving up her financial well-being or that
of her family. She has excellent insurance, which covers all the
rest of her medical expenses. She pays the medical expenses
that the seller incurs, and guarantees him health insurance for
the rest of his life. Both are cared for by first-rate physicians in a
state-of-the-art facility.

13. Transplant Tourism
A 25-year-old, married man in a developing country has struggled as a
laborer to make ends meet. Expenses for food, housing, and,
especially, medical care for his wife have landed him in debt. His
creditors are harassing him to pay what he owes. He agrees to sell one
of his kidneys to a broker for $2,500. As the seller is aware, the broker is
an agent of a nearby clinic, one that provides services to transplant
tourists from wealthy countries. The broker tells the seller that it is easy
to explain the risks he will face: the surgery necessary to harvest the
kidney poses little threat to his well-being; in all likelihood, he will be
fine in a few weeks. In addition to giving the laborer the cash, the
broker pays for the surgery, as well as for the medical expenses
incurred during the seller’s recovery. The surgeon is experienced and
competent, and the facilities for surgery and recovery are adequate.

14. Regulated Market
A 25-year-old, married man in a developing country has
struggled as a laborer to make ends meet. Expenses for
food, housing, and, especially, medical care for his wife
have landed him in debt. His creditors are harassing him to
pay what he owes. But in his country, the government has
established a regulated market in organs. A government
employee gives the man a thorough and comprehensible
description of the short- and long-term health risks posed
by kidney extraction as well as of the benefits he will
receive if he sells an organ, including $2,500 and health
insurance for life. The man goes ahead with the procedure
and indeed receives the cash and insurance coverage.

15. Value-Based Account
Two accounts– Possible Consent and Value-Based
Possible Consent– specifies a sufficient condition for an agent’s violating
the Mere Means Principle.
Value-Based— Expressing Respect for the worth of humanity
Means that something is an end in itself:
1. It’s an objective end (as opposed to subjective): would count as an end
for all rational agents.
2. Has absolute, unconditional worth – no matter what context it’s in, how it
emerged, or what its effects may be
3. Has dignity (Kant contrasts with “price”)
a) Means it has incomparable worth – something with dignity can never be
equivalently traded for something with price
b) And you can’t sacrifice/trade something with dignity for something else with
dignity

16. Value-Based Account: Expressing Respect for the worth of humanity
Thus an action needs to “express respect for the worth of humanity.”
(157)
Kant’s example: wrong to sell a tooth
1. Rich people in late 18th century Europe would sometimes purchase
teeth from the poor.
 High fees
 Mostly aesthetic for the buyer – nice, white teeth were in fashion
 Potentially dangerous to the seller

17. Value-Based Account: Expressing Respect for the
worth of humanity
2. Assuming that it was consensual, Kant would still condemn it. Possible justifications:
a) Involves putting self/health at considerable risk for somebody’s beauty--
(1) Therefore not respecting your own humanity
(2) Answer: It's no health risk for us today. (What if the risks aren’t great?)
b) Teeth are important--
(1) They occupy an intimate part of your body.
(2) So the act signals you’re willing to sell even an intimate part of yourself (160)
(3) Answer: this conflates tooth and personhood. Can you really compare a tooth to a kidney?
c) This sort of action tends to promote others of its type—
(1) Thus would presumably be true even if a given act of selling a tooth doesn't actually cause
anybody else to do so
(2) But it needs to be empirically plausible
(3) So it's empirical, but plausible, to say that in K’s time this reinforced the notion that the poor
were tools for the rich, and could make themselves available as such
(4) Comparable to organ transplants- For the author, this is the best argument.

18. Do Organ Transactions Express Respect
for the Worth of Humanity?
Following the third argument:
1. The key premise is that “at least in a certain historical context, actions of the
type-- ‘selling a tooth to increase comfort’ -- tend to promote a notion that
is inconsistent with the idea that humanity has dignity, namely the notion
that a person is available for the right price for others to use as they will”
(162).
2. “The question is whether the types of actions performed by the buyers and
sellers in the examples of organ sales would tend to promote this notion”
(162).
 Consider any problems with the three scenarios.
3. If so, then there'd be a Kantian problem. It is the author’s position that a
Kantian problem does exist.

19. Do Organ Transactions Express Respect for
the Worth of Humanity?
Organ Buyers:
1. They’re buying from somebody who’s very poor.
2. They’re unlikely to see that person as their moral equal.
3. It does not seem a stretch to maintain that “actions of this type tend to encourage the
notion that such laborers themselves, and not merely parts of their body, can be had
for price and so lack Kantian dignity” (162).
4. Whether that slide happens would be context-dependent.

20. Do Organ Transactions Express Respect for
the Worth of Humanity?
The government:
1. Might also violate – Still poses the issue that only poor people would do this. The
wealthy would have no reason to.
2. And so government policy sanctions the idea that poor people themselves are to be
for sale for the comfort of others.
The entrepreneur situation:
1. Unclear what encouragement that would get (163)
2. Since he is socially privileged, it might not necessarily encourage others to see him as
mere means.
3. However, he is still selling an intimate part of himself for profit.
Organ sellers--- This would be like the tooth selling??? How might it be different?

21. Final Points
1. This is empirical – It’s hard to get data in this area.
2. Just because, say, the laborer does something wrong does not imply we
have to blame him for it – he may not know.
3. Even with possible gray area and variant circumstances, there are still huge
problems within Kantianism for accepting this practice as ethically
permissible--
1. Encourages a general rule that some can be treated as a means for betterment
of others
2. Encourages poor treatment and opinions about the sellers
3. Even in a government-regulated market, it could encourage government abuse.
 What if the government is responsible for the economic circumstances that create a
need to sell organs for profit in the first place.
4. Just because this is mostly condemned by Kantianism, does not mean that
you could not argue it’s ethical permissibility through your own
interpretation or by using an opposing theory.