This paper takes the view that compensated donation and altruism are not incompatible. In particular, it holds that the arguments against giving compensation stand on weak rational grounds: the charge that compensation fosters “commodification” has neither been specific enough to account for different types of monetary transactions nor sufficiently grounded in reality to be rationally convincing; although altruism is commendable, organ donors should not be compelled to act purely on the basis of altruistic motivations, especially if there are good reasons (...) to believe that significantly more lives can be saved and enhanced if incentives are put in place, and offering compensation for organs does not necessarily lead to exploitation—on the contrary, it may be regarded as a necessity in efforts to minimise the level of exploitation that already exists in current organ procurement systems. (shrink)

Abstract: Human rights developed in response to specific violations of human dignity, and can therefore be conceived as specifications of human dignity, their moral source. This internal relationship explains the moral content and moreover the distinguishing feature of human rights: they are designed for an effective implementation of the core moral values of an egalitarian universalism in terms of coercive law. This essay is an attempt to explain this moral-legal Janus face of human rights through the mediating role of the (...) concept of human dignity. This concept is due to a remarkable generalization of the particularistic meanings of those "dignities" that once were attached to specific honorific functions and memberships. In spite of its abstract meaning, "human dignity" still retains from its particularistic precursor concepts the connotation of depending on the social recognition of a status—in this case, the status of democratic citizenship. Only membership in a constitutional political community can protect, by granting equal rights, the equal human dignity of everybody. (shrink)

This paper defends an in principle understanding of the authority of persons over themselves and, in consequence, argues for significant limits on morally permissible state authority. It also defends an account of the limits of permissible state action that distinguishes between the ability of persons to convey authority to common projects and what may be judged virtuous, good, safe, or proper to do. In terms of organ transplantation policy, it concludes that it is morally acceptable, and should be legally permissible, (...) for individuals to sell one of their kidneys while living, pocketing the cash to use as that person sees fit to advance their own understanding of their own best interests. Morally objectionable policy proposals, I argue, are not those that encourage individuals to sell a redundant kidney while living or families to sell the organs of a recently deceased loved one, but those that seek coercively to confiscate the organs of the recently deceased. Recognizing the authority of persons over themselves, and their ability to convey moral authority to common projects, including the sale of human organs for transplantation, would shed light on the medical marketplace and clarify public policy, while increasing the efficiency and effectiveness of procuring human organs for transplantation. (shrink)

Many people are vaguely disquieted by developments (real or imagined) that could alter minds and bodies in novel ways. Romantics and Greens tend to idealize the natural and demonize technology. Traditionalists and conservatives by temperament distrust radical change. Egalitarians worry about an arms race in enhancement techniques. And anyone is likely to have a "yuck" response when contemplating unprecedented manipulations of our biology. The President's Council has become a forum for the airing of this disquiet, and the concept of "dignity" (...) a rubric for expounding on it. This collection of essays is the culmination of a long effort by the Council to place dignity at the center of bioethics. The general feeling is that, even if a new technology would improve life and health and decrease suffering and waste, it might have to be rejected, or even outlawed, if it affronted human dignity. (shrink)

The dark side of body part trading operates in a dynamic fashion, full of mystery, intrigue, and ambition. On the one hand, black and gray markets are illegal, but also pioneering and inventive; and although this type of criminal activity requires a level of dexterity and innovation, the point should not be lost that these markets thrive and flourish, sometimes in view of law. On the other hand, altruistic body part procurement is mired by low participation, which encourages black market (...) transactions. Thousands of sick patients die each year without the hope of receiving an organ or bone marrow donation through the altruistic procurement system, so they turn to the dark side. This book offers a frank conversation about altruism in the global body market. It exposes how researchers exploit their patients' ignorance to harvest tissue samples, blood, and other biologics without consent for research and patent development. The book chronicles exploitation in the name of altruism, including the nonconsensual use of children in dangerous clinical trials, and analyzes social and legal commitments to the value of altruism - offering an important critique of the vulnerability of altruism to corruption, coercion, pressure, and other negative externalities. (shrink)

Book reviewed in this article: The Most Useful Gift: Altruism and the Public Policy of Organ Transplants. By Jeffrey Prottas.

This volume collects two lectures by Jeremy Waldron that were originally given as Berkeley Tanner Lectures along with responses to the lectures from Wai Chee Dimock, Don Herzog, and Michael Rosen; a reply to the responses by Waldron; and an introduction by Meir Dan-Cohen.

Reproductive medicine, a sector of a health care system increasingly captured by the demands of the marketplace, is enmeshed in a drive to sell certain human bits and pieces, such as gametes, cells, fetal eggs, and fetal ovaries, for reproductive purposes. The ethical objection raised by Kant and Radin to the sale of human organs -that this is incompatible with human dignity and worth - also applies to these sales. Moreover, such sales nullify the reproductive paradigm, irretrievably replacing it with (...) a ma nufacturing paradigm. This represents a change in kind, not just of degree, in the way that we view our capacity to generate children and destroys our concept of reproduction as an essentially human activity. In the face of a struggle to retain those common ethical values at the foundation of reproductive medicine, this form of commodification of the human body should be viewed as ethically unacceptable. (shrink)

The country's leading libertarian scholar sets forth the essential principles for a legal system that best balances individual liberty versus the common good.

In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective—and morally justified—means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions (...) that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where “market-place morality” is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves. (shrink)

st of these lectures, I present a conception of dignity that preserves its ancient association with rank and station, and a conception of human dignity that amounts to a generalization of high status across all human beings. The lectures argue that this provides a better understanding of human dignity and of the work it does in theories of rights than the better-known Kantian conception. The second lecture focuses particularly on the importance of dignity - understood in this way - as (...) a status defining a person's relation to law: their presentation as persons capable of self-applying the law, capable of presenting and arguing a point of view, and capable of responding to law's demands without brute coercion. Together the two lectures also illuminate the relation between dignity conceived as the ground of rights and dignity conceived as the content of rights; they also illuminate important ideas about dignity as noble bearing and dignity as the subject of a right against degrading treatment; and they help us understand the sense in which dignity is better conceived as a status than as a kind of value. (shrink)

On the occasion of the 50th anniversary of C. S. Lewis’s death, a special annotated edition of his Christian classic, The Screwtape Letters, with notes and excerpts from his other works that help illuminate this diabolical masterpiece. Since its publication in 1942, The Screwtape Letters has sold millions of copies worldwide and is recognized as a milestone in the history of popular theology. A masterpiece of satire, it offers a sly and ironic portrayal of human life and foibles from the (...) vantage point of Screwtape, a highly placed assistant to “Our Father Below.” At once wildly comic, deadly serious, and strikingly original, The Screwtape Letters comprises the correspondence of the worldly-wise devil Screwtape and his nephew Wormwood, a novice demon in charge of securing the damnation of an ordinary young man. For the first time, The Screwtape Letters will be presented in full-text accompanied by helpful annotations in a striking two-color format. These annotations will give fans a deeper, more nuanced understanding of the popular book, providing background information, explanations of terms, historical significance, and excerpts from Lewis’s other works that more fully explain the ideas in this volume. For both expert Lewis fans and casual readers, The Screwtape Letters: Annotated Edition will be a beautiful and insightful guide to a beloved classic. (shrink)

Recent work in behavioral economics and psychology provides valuable resources for religious ethicists. This book discussion examines contributions by Cass Sunstein, Daniel Kahneman, George Akerlof and Rachel Kranton, Uri Gneezy and John A. List, and Douglas Hough. This literature raises important questions about ethical decision-making, moral agency and responsibility, and the ethics of life in global capitalism. It also opens up promising areas for interdisciplinary dialogue between economics and religious studies. This book discussion concludes that religious ethicists have much to (...) contribute to the conversations about moral anthropology that are now being held in behavioral economic research, and to the broader political economic debates in which this research participates. (shrink)

for the Bioethics Commission, August 16, 2006.