As a graduate student, James Stacey Taylor stumbled upon one philosophy article that opened his mind to a widely controversial academic challenge. The article, authored by Paul M. Hughes, argued that respect for individual autonomy required that human organ markets be strictly prohibited.
“This struck me as very odd, since it’s usually thought that respect for autonomy requires that persons be allowed to have more options, not less,” Taylor said. Currently an associate professor of philosophy and religion at TCNJ, Taylor has researched the issue for 10 years and become an informed voice in the debate.
In August, the professor discussed the issue with 89.3 KPCC’s Larry Mantle. In September, he addressed TCNJ students and answered their questions on the issue as part of the School of Culture and Society’s Politics Forum series. His lecture was straightforwardly titled, “Why markets in human transplant organs should be legalized.”
Concerned with chronic shortages in the availability of transplant organs, particularly kidneys, Taylor has assembled a point-by-point argument advocating a legal market in human organs as an alternative to the altruistic system.
Kidneys are a prime focus in the organ market debate: first, because they are in especially high demand, and second, because human beings only require one of their two kidneys for survival. In a legal kidney market, a person in need—of money, education, or some other incentive—might sell one of his or her kidneys without consequence.
During the lecture, Taylor noted that both the American Medical Association and British Medical Association favor a pilot program that incentivizes for kidneys. He also cited the situation in Iran, where the selling of kidneys is legal, as proof of the potential of organ markets. Iran has eliminated waiting lists for those in need of transplant kidneys.
Instead, Taylor said, there is a different kind of waiting list: Iranians wait in line to sell their spare organs away.
Taylor foresees some movement to legalize incentives in the United States within the next five to ten years. “It’s likely that more indirect forms of compensation will be allowed, such as the provision of long-term health insurance for the vendor and his or her family members, or education credits,” he said.
Arguments against the legalization of kidney-selling focus on three points: the risks of living-patient removal procedures, the pressure that impoverished people may feel to sell their organs, and the prospect of dishonest selling. Taylor rebutted: the risk of death from kidney-removal procedures is lower than other cash-motivated activities that are common practice, he said. For example, the lowest statistical range of death rates in high steel construction is 0.01-0.03%. The highest rates of death due to kidney removal are 0.00-0.02%.
Responding to the poverty issue, the professor acknowledged that the majority of organ sales would come from the poor, but argued that giving them the option to sell their organs was better than giving them no option. Taylor used a metaphor to argue his point: a ship captain threatened by a storm might dump his cargo to keep from going under. Restricting the sale of organs, Taylor said, is like telling the endangered captain that he can’t abandon his own goods.
Regarding selling practices, Taylor said that the practices of an open, legalized commercial system would mark a significant improvement over those of black-market systems already in operation.
He expects that the government would play a role in regulating organ sales the way it does under the current altruistic system. “Moreover,” he said, “I think that it’s useful to note that the government could also play an indirect role in ensuring the quality of organs…providing a legal framework in which people could seek legal redress for any contract violations that might occur in such a market.”
These aren’t the only arguments that fall under Taylor’s purview. There are also issues related to taxation, the problem of ethnic compatibilities, and the concept of personal autonomy that he’s written about for years.
The topic remains contentious. However, Taylor said that since he first encountered Hughes’ argument years ago, he and his opponent have developed a positive scholarly relationship. “Incidentally, Paul was good enough to comment on my initial criticisms, and we’ve since become good friends,” the professor said, then laughingly added, “although he still mistakenly thinks that markets in human organs are immoral!”