As a rule, I like Jeff Jacoby’s columns, and even agree with him as often as not, but every now and then he comes out with something I find downright unconscionable. His July 5th Boston Globe op-ed promoting the marketing of human organs is an unfortunate example of the latter. With the recent liver transplant of celebrity tech guru Steve Jobs having again roiled the waters of the debate over the “fairness” of our current organ donation system, Jacoby has added his voice to the rising tide of liberal, utilitarian opinion promising free market “solutions” to the “problem” of death.
I’ve read a number of these proposals over the years, and they all seem to succumb to the same three basic errors. As can be surmised from the title of this piece, I see these errors as involving misunderstandings of the man’s nature as a being both physical and spiritual, in ontological unity; the fundamental and unique character of human subjectivity in differentiation from other material objects (or ‘what are people for?’ – to steal a phrase from Wendell Berry); and the inability of mankind to cheat death (or “what is not given to man” – to steal a phrase from Leo Tolstoy).
The premise of these proposals is that there are currently many people dying from organ failure who could be spared death if more organs were available for transplant, and that the economy of transplant organs would produce at least part of the requisite supply if it were freed from legal constraint, to function more or less unimpeded in the liberal model of supply and demand, therein saving lives. The thinking is that everything else is for sale, after all, including all the other products and services involved in actually transplanting an organ – the organ donor is the only non-compensated person in the entire chain, and that not only introduces market inefficiencies, but may even be unjust.
The most fundamental moral or ethical dilemma that arises from these proposals stems from the fuzzy — and yet now widely appealed-to — notion of human dignity, which itself has its origins in the recognition of the sacredness of human life. Meanwhile, sacrality is a concept that is all but alien to modernity (my spell-checker didn’t even recognize it as an English word when I typed it!). Jacoby, like most any writer promoting blasphemy, marginalizes the matter of sacrality, conflating the transmission of human organs with the broad vista of “medical care” ( a concept which does not share with organ transmission the very characteristic at issue), and substituting utilitarian arguments about “needless” deaths.
Ethical concerns also arise around the prospect of the rich and powerful exploiting the poor under such a system. Jacoby, ironically, writes these off as resulting from misguided altruism (but see, for example, this column from University of Minnesota Bioethicist Jeffrey P. Kahn, discussing a JAMA article on organ sales in India, where it is legal). Though I am convinced that Jacoby is actually the one suffering here from a misguided altruism (and am not in the least surprised by the realities come to light in India, as per the linked article), I am not particularly interested in this angle of the argument, as it is clearly a secondary issue: the unjust character of any specific policy implementation is wholly subordinate to (and inevitably predicated upon) the immoral nature of the proposal in and of itself (in other words, it is secondary because there is simply no right way to do a wrong thing, so there’s not a lot of point in harping on method, or even consequences).
Both of these areas of ethical concern refer directly to the second area of error I am pointing out: the commodification of man; the failure to adequately distinguish between the human being himself, and those things which are produced by man. When the term “human dignity” is used properly, it refers precisely to the ontological distinction between the human person (a subject) and an objective reality that lacks subjectivity, or personhood, or a spiritual soul. The dignity that humans distinctly possess within the material world derives from our unique spiritual character, which is the capacity to love rationally – or to choose love. The violation of humanity consists in asserting that that subject can be objectified, and treated as a thing.
The idea of the wrongness of treating people as things is widely acknowledged, even among people who don’t put a lot of thought into moral issues. That does not mean that it can’t be (and isn’t often) trumped by utilitarian arguments, but at least the notion is readily available to most people. So when folks like Jacoby argue that the human being (or human parts) should be a commodity, because everything else is for sale, the argument runs against the grain of an intuitive sense that it is wrong to treat people as things. Or, to be more concise: even if were to allow that everything should be for sale (a dubious proposition in and of itself), people are not things.
This is the moral or ethical problem with the human parts market proposal, but it is not the root of the problem, because the moral error is itself grounded upon an inadequate understanding of human nature, or what it means to be a human being. It is furthermore, in this case, driven by a culturally pervasive but irrational view of death, but that is a point to be taken up later. It can be clearly demonstrated by example how the “commodification of man” proposal fails the moral test by noticing how the “everything else is for sale” argument not only meets intuitive resistance to treating people as things, it also runs smack into the fact that, no, not everything is for sale – or at least it shouldn’t be.
For examples, we have only to look at slavery and prostitution to see that society does not accept as morally licit the notion that anything can be bought and sold: people cannot morally be bought and sold. Sure, there are those who will argue that prostitution should be legal, just as there have been many who never flinched at legal slavery, and we have our chorus today calling for the buying and selling of human body parts, but civilization has come to see that people cannot morally be themselves reduced to commodities, and this insight is the genius behind the modern ideas of human dignity and human rights, being long anticipated in the ancient idea of tsedaqah (righteousness), or what we owe one another as fellow beings created in the image of God.
If someone who despises slavery promotes the marketing of body parts (whether for medical purposes or sexual purposes), he most likely has fallen into one of the two popular errors concerning the nature of man: naturalism, or (much more commonly) dualism. In a follow-up post, I will explore how slavery, prostitution, and organ sales share a common mode of unrighteousness in the degradation of the self, properly understood. This is no trivial matter, as it is the unrighteousness itself, not this it that particular expression of it, that is a growing menace to a human civilization that has largely succeeded in forgetting that righteousness comes from God, and is rooted in right relationship with Him. We must not allow our “misguided altruism ” to feed the beast of unrighteousness.