The proposal is not new. In 2006, in an interview in the San Francisco Chronicle subsequently picked up by the New York Times and The Wall Street Journal, Nobel Prize winning economist, Gary Becker, called for the opening of a legal market for the sale of human organs.
The call was born out of the growing diffusion of transplant tourism and the now socially accepted act of desperation that was once considered shameful: the clandestine acquisition of a kidney or a liver for fear of not surviving the long waiting list in America. Recently, Jessica Pauline Ogilvie in the pages of the Los Angeles Times expressed the hope that the market for kidneys would be legalized: if it were legal to buy and sell organs, many poor people would make money and many ill people would resolve their problems.
The debate is heated. Many, some doctors included, maintain that the buying and selling of kidneys should be legalized under conditions of full and informed consensus, with medical assistance both before and especially after the extraction of the organ and in light of the incontrovertible data which, like it or not, shows that the phenomenon is already a reality.
Besides, the more Western democracies move toward individual auto-determination in choices of health and life, the more it is likely that juridical obstacles on the level of principle will be quickly overcome.
Those against the proposal object that such a market would only benefit the rich; that it would create a form of modern slavery; that it is a juridical lie to speak of full and free consensus given the desperation that induces one to sell a part of oneself; that a legalized commercial donation would have a negative impact on the voluntary organ donations of corpses, which instead represent the main source of donations in many countries. Giuseppe Remuzzi, an Italian doctor specialized in transplants, while recognizing the desperation of many, wrote in Italian daily, Corriere della Sera, “We cannot accept the buying and selling of organs, not even if regulated by law.”
Fully sharing in the opposition to such commerce, the moral problem is not primarily that of the seller. In human history, desperate persons have resorted to desperate measures in order to save themselves or someone they love. If medical science today allows every conceivable line to be crossed, the hidden rationale becomes this: crazy desperation induced by poverty. And societies that “legitimize” this desperation are societies that are incapable of defending their citizens. The most serious problem, however, resides with the buyer. Outside of any other consideration, the heart of the problem lies here: are we willing to accept that a person buys his health, or saves his life, by buying replacement pieces from someone else’s body?
The suspicion that societies open to this market are in fact cannibalistic, is real and dramatic.