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- <text id=89TT0681>
- <title>
- Mar. 13, 1989: Take My Kidney, Please
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1989
- Mar. 13, 1989 Between Two Worlds:Middle-Class Blacks
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- ESSAY, Page 88
- Take My Kidney, Please
- </hdr><body>
- <p>By Michael Kinsley
- </p>
- <p> Even Margaret Thatcher's devotion to the free market has
- some limits, it seems. Reacting to newspaper reports that poor
- Turkish peasants are being paid to go to London and give up a
- kidney for transplant, the British Prime Minister said that
- "the sale of kidneys or any organs of the body is utterly
- repugnant." Emergency legislation is now being prepared for
- swift approval by Parliament to make sure that capitalism does
- not perform its celebrated magic in the market for human organs.
- </p>
- <p> Commercial trade in human kidneys does seem grotesque. But
- it's a bit hard to say why. After all, the moral logic of
- capitalism does not stop at the epidermis. That logic holds, in a
- nutshell, that if an exchange is voluntary, it leaves both
- parties better off. In one case, a Turk sold a kidney for
- (pounds)2,500 ($4,400) because he needed money for an operation
- for his daughter. Capitalism in action: one person had $4,400
- and wanted a kidney, another person had a spare kidney and
- wanted $4,400, so they did a deal. What's more, it seems like an
- advantageous deal all around. The buyer avoided a lifetime of
- dialysis. The seller provided crucial help to his child, at
- minimum risk to himself. (According to the Economist, the
- chance of a kidney donor's dying as a result of the loss is 1
- in 5,000.)
- </p>
- <p> Nevertheless, the conclusion that such trade is abhorrent is
- not even controversial. Almost everyone agrees. Is almost
- everyone right? This question of how far we are willing to push
- the logic of capitalism will be thrust in our faces
- increasingly in coming years. Medical advances are making it
- possible to buy things that were previously unobtainable at any
- price. (The Baby M. "womb renting" case is another example.)
- Meanwhile, the communications and transportation revolutions are
- breaking down international borders, making new commercial
- relations possible between the comfortably rich and the
- desperately poor. On what basis do we say to a would-be kidney
- seller, "Sorry, this is one deal you just can't make?"
- </p>
- <p> One widely accepted category of forbidden deals involves
- health and safety regulations: automobile standards, bans on
- food additives, etc. Although we quarrel about particular
- instances, only libertarian cranks reject in principle the idea
- that government sometimes should protect people from
- themselves. But it is no more dangerous to sell one of your
- kidneys than it is to give one away to a close relative -- a
- transaction we not only allow but admire. On health grounds
- alone, you can't ban the sale without banning the gift as well.
- Furthermore, the sale of a kidney is not necessarily a foolish
- decision that society ought to protect you from. To pay for a
- daughter's operation, it seems the opposite.
- </p>
- <p> But maybe there are some things money just shouldn't be
- allowed to buy, sensibly or otherwise. Socialist philosopher
- Michael Walzer added flesh to this ancient skeleton of
- sentiment in his 1983 book, Spheres of Justice. Walzer argued
- that a just society is not necessarily one with complete
- financial equality -- a hopeless and even destructive goal --
- but one in which the influence of money is not allowed to
- dominate all aspects of life. By outlawing organ sales, you are
- indeed keeping the insidious influence of money from leaching
- into a new sphere and are thereby reducing the power of the
- rich. Trouble is, you are also reducing opportunity for the
- poor.
- </p>
- <p> The grim trade in living people's kidneys would not be
- necessary if more people would voluntarily offer their kidneys
- (and other organs) when they die. Another socialist
- philosopher, Richard Titmuss, wrote a famous book two decades
- ago called The Gift Relationship, extolling the virtues of
- donated blood over purchased blood and, by extension, the
- superiority of sharing over commerce. Whatever you may think of
- Titmuss's larger point, the appeal of the blood-donor system as
- a small testament to our shared humanity is undeniable. Perhaps
- we should do more to encourage organ donation at death for the
- same reason. On the other hand, however cozy and egalitarian it
- might seem, a system that supplied all the kidneys we need
- through voluntary donation would be no special favor to our
- Turkish friend, who would be left with no sale and no $4,400.
- Why not at least let his heirs sell his kidneys when he dies?
- A commercial market in cadaver organs would wipe out the sale
- of live people's parts a lot more expeditiously than trying to
- encourage donations.
- </p>
- <p> The logic of capitalism assumes knowledgeable, reasonably
- intelligent people on both sides of the transaction. Is this
- where the kidney trade falls short? At $4,400, the poor Turk
- was probably underpaid for his kidney. But in an open, legal
- market with protections against exploitation, he might have got
- more. At some price, the deal would make sense for almost
- anyone. I have no sentimental attachment to my kidneys. Out of
- prudence, I'd like to hang on to one of them, but the other is
- available. My price is $2 million.
- </p>
- <p> Of course, I make this offer safe in the knowledge that
- there will always be some poor Turk ready to undercut me. So
- maybe, because of who the sellers inevitably will be, the sale
- of kidneys is by its very nature exploitation. A father
- shouldn't have to sacrifice a kidney to get a necessary
- operation for his daughter. Unfortunately, banning the kidney
- sale won't solve the problem of paying for the operation. Nor
- can the world yet afford expensive operations for everyone who
- needs one. And leaving aside the melodrama of the daughter's
- operation, we don't stop people from doing things to support
- their families -- working in coal mines, for example -- that
- reduce their life expectancies more than would the loss of a
- kidney. In fact, there are places in the Third World where even
- $4,400 can do more for a person's own life expectancy than a
- spare kidney.
- </p>
- <p> The horror of kidney sales, in short, is a sentimental
- reaction to the injustice of life -- injustice that the
- transaction highlights but does not increase. This is not a
- complaint. In fact, it may even be the best reason for a ban on
- such transactions. That kind of sentiment ought to be
- encouraged.
- </p>
-
- </body></article>
- </text>
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