Monday, 23 May 2011

Ethics versus ethicists

Only an ethicist could find a way of deeming this nonsense to be ethically required.

TVNZ reports on an infertile couple who had to leave New Zealand to find donor eggs; prohibitions on sale for money led to drying up of the New Zealand supply of willing donors. Those who've made the expensive trips abroad recommend that New Zealand allow donor compensation. But that riles the ethicists:
Professor Gareth Jones, a bioethicist at Otago University of Otago says the situation should be looked at.

"The present reality is that commercialisation of any human tissue is prohibited in this country," Jones told Sunday.

But he said to pay donors changes the whole ethical framework.

"Do we want to have markets of buying and selling for not only human tissue but also children, or babies? I think there are issues involved here ethically."

Professor Jones regards paying for eggs as the start of a slippery slope leading to buying and selling live organs such as livers and kidneys.
Organ sales would save many lives and dramatically improve others, allowing those suffering from kidney disease to get off dialysis. But the ethicists would feel bad because a voluntary trade between a willing donor and a willing recipient somehow becomes unethical if money changes hands. And so anything that brings compensation into the transaction has to be banned, as must anything that might lead to it anywhere down the line. So folks needing donor eggs have to be forced to go abroad, or to go childless if they can't afford it.

Perhaps the ethicists ought to start by insisting that the doctors work free, spending their nights begging for alms by the side of the road. If cash is evil, then the first ones that need be spared its taint ought to be the doctors. If the bioethicists can't convince their medical colleagues to work for free, why should we let them legislate that others have to?




  1. I hope the ethicists don't get paid for their advice. If they did, it would somehow feel ...tainted.

  2. Slavery would save many lives and dramatically improve others, allowing those suffering from unemployment to get out of the cycle of welfare and crime. But the ethicists would feel bad because a voluntary trade between a willing slave and a willing master somehow becomes unethical...

  3. Selling a kidney is hardly selling oneself into bondage. And recall that the ethicists also favour bans on cadaveric markets.

  4. The only downside to an organ market is that there is a possibility that unscrupulous individuals may choose to sell organs of terminal dependents on life support, or that very occasionally someone may be abducted only to wake up in an icy bath with one of their kidneys missing. However I think these are stories more likely to appear in horror stories and tv police shows than in real life. Ultimately a market for organs would be vastly more likely to benefit rather than cause harm in my opinion.

    I suspect that the same people who rail against organ markets also feel we ought to ban anything else that doesn't fall neatly in line with their moral compass. E.g. double down burgers, recreational drugs, salty food, cars that can travel faster than 50 kph, alcohol (but only for young people), etc.

  5. Hypothetical perfect organ markets are one thing. But it's easy to imagine imbalances in power/wealth causing problems with 'consent' in organ markets which would be similar to the problems in eg. unsafe 19th century factories (or allowing people to sell themselves into slavery for an extreme case).

    Allowing money to influence the distribution of donor organs also conflicts with the current system of trying to assign organs to those most in need who will get the most benefit from them. I guess this line of reasoning boils down to the same old arguments as public vs. private healthcare.

    For me (as a non-ethicist) it's not about being a moral policeman, it's about wanting a guarantee that the system will work in a fair way.

  6. @Anon: We don't need perfect ones, just ones with smaller losses than those experienced in the current system. And allowing money into the system increases the total supply - it doesn't just reallocate an existing stock from some meritocratic ordering to a money ordering. Could buy the objection in that latter case, but supply increase effects would dominate.

    The current system doesn't work in a "fair" way. If you're a famous rugby player, you get a new kidney quickly. If you're Joe Nobody, you're condemned to rather bad outcomes. And you want an alternative system to be perfect? Why can't it just be better than the awful system we have now?