Autonomy, inducements and organ sales

Philosophical Reflections on Medical Ethics

Volumn , Issue , 2005, Pages 135-159

  Taylor, James Stacey ^a  

^a Department of Health and Exercise Science   (United States)

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EID: 85015054294     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1057/9780230273931     Document Type: Chapter

References (59)

1. Janet Radcliffe Richards (1996) 'Nepharious Goings On: Kidney Sales and Moral Arguments', The Journal of Medicine and Philosophy, 21, p. 375.
2. Leon Kass (2002) Life, Liberty and the Defense of Dignity (San Francisco:Encounter Books), pp. 177-98;
3. Nancy Scheper-Hughes (2003) 'Keeping an Eye on the Global Traffic in Human Organs', The Lancet, 361 (10 May), pp. 1645-8;
4. Lawrence Cohen (1999) 'Where it Hurts: Indian Material for an Ethics of Organ Transplantation', Daedalus, 128(4), pp. 135-65.
5. See, for example, Mario Morelli (1999) 'Commerce in Organs: A Kantian Critique', Journal of Social Philosophy, 30(2), pp. 315-24;
6. T. L. Zutlevics (2001) 'Markets and the Needy: Organ Sales or Aid?, Journal of Applied Philosophy, 18(3), pp. 297-302.
7. See Janet Smith (1997) 'The Pre-Eminence of Autonomy in Bioethics', in David S. Oderberg and Jacqueline A. Laing (eds.) Human Lives: Critical Essays on Consequentialist Bioethics (New York: St. Martin's Press), pp. 182-95.
8. This autonomy-based pro-market argument is offered by Gerald Dworkin (1994) 'Markets and Morals: The Case for Organ Sales', in Gerald Dworkin (ed.), Morality, Harm, and the Law (Boulder, CO: Westview Press), pp. 155-61.
9. See James Stacey Taylor (2002) 'Autonomy, Constraining Options, and Organ Sales', Journal of Applied Philosophy, 19(3), pp. 273-85;
10. (2004) Stakes and Kidneys: Why Markets in Human Body Parts are Morally Imperative (Aldershot: Ashgate Press), chapter 4.
11. The two most prominent proponents of the view that the sale of an organ is an autonomy-compromising constraining option are Paul Hughes (1998) 'Exploitation, Autonomy, and the Case for Organ Sales', International Journal of Applied Philosophy, 12.1, pp. 89-95
12. Zutlevics, 'Markets and the Needy'.
13. I have previously defended the first of these premises in Stakes and Kidneys, chapters 2 and 3.
14. Dworkin G. views on coercion as expressed in Gerald Dworkin (1970) 'Acting Freely', Nous, 4(4), pp. 367-85
15. Noted by Radcliffe Richards, 'Nepharious Goings On', p. 376.
16. See Charles A. Erin and John Harris (2003) 'An Ethical Market in Human Organs', Journal of Medical Ethics, 29(3), pp. 137-8.
17. I argue against this proposal and in favour of a regulated market for the distribution of in human organs in Stakes and Kidneys, chapters 5 and 9.
18. Harry G. Frankfurt (1988) 'Freedom of the Will and the Concept of a Person', in Harry G. Frankfurt (ed.), The Importance of What We Care About (Cambridge: Cambridge University Press), p. 11.
19. Frankfurt, 'Freedom of the Will', p. 12.
20. Frankfurt, 'Freedom of the Will', p. 19.
21. Frankfurt, 'Freedom of the Will', p. 20.
22. For Hobbes, 'the last appetite, or aversion, immediately adhering to the action, or to the omission thereof, is that we call the will'.
23. Thomas Hobbes (1994) Leviathan, ed. Edwin Curley (Indianapolis, IN: Hackett Publishing), Part 1, chapter 6, para. 21.
24. See Frankfurt, 'Freedom of the Will', p. 14.
25. Frankfurt, 'Freedom of the Will', p. 20.
26. For an outline of such criticisms see my Introduction to James Stacey Taylor (ed.) (2005) Personal Autonomy: New Essays in Personal Autonomy and its Role in Contemporary Moral Philosophy (Cambridge: Cambridge University Press), pp. 4-10.
27. The most recent of these modifications and clarifications can be found in Frankfurt's replies to his critics, in Sarah Buss and Lee Overton (eds.) (2002) The Contours of Agency: Essays on Themes from Harry Frankfurt (Cambridge, MA: MIT Press).
28. See, for example, John Christman, Introduction to John Christman (ed.) (1988) The Inner Citadel: Essays on Individual Autonomy (Oxford: Oxford University Press), pp. 8-9.
29. See also James Stacey Taylor, Introduction," in Taylor (ed.), Personal Autonomy, p. 4.
30. Frankfurt (ed.), The Importance of What We Care About, p. 43.
31. James Stacey Taylor (2003) 'Autonomy, Duress, and Coercion', Social Philosophy & Policy, 20(2), pp. 127-55
32. Ann Cunningham (2003) 'Autonomous Consumption: Buying into the Ideology of Capitalism', Journal of Business Ethics, 48(3), pp. 229-36.
33. See Robert Noggle (1995) 'Autonomy, Value and Conditioned Desire', American Philosophical Quarterly, 32(1), pp. 57-69.
34. The second of these mistakes is made by Nomy Arpaly, 'Responsibility, Applied Ethics, and Complex Autonomy Theories'," in Taylor (ed.), Personal Autonomy, pp. 173-5.
35. Versions of this argument have been offered by Pranlal Manga (1987) 'A Commercial Market for Organs? Why Not', Bioethics, 1(4), p. 327;
36. John B. Dossetor and V. Manickavel (1992) 'Commercialization: The Buying and Selling of Kidneys', in C. M. Kjellstrand and J. B. Dossetor (eds.), Ethical Problems in Dialysis and Transplantation (Dordrecht: Kluwer Academic Publishers), p. 63;
37. Patricia A. Marshall, David C. Thomasma and A. S. Daar (1996) 'Marketing Human Organs: The Autonomy Paradox', Theoretical Medicine, 17, p. 13. I have addressed this argument at length in Stakes and Kidneys, chapter 3.
38. All parties to this debate accept that the typical vendor will be poor.
39. Zutlevics, 'Markets and the Needy', pp. 297-302.
40. Sells writes that since 'the financial benefits [of selling a kidney] [would] have such an impact on the life of the donor ... as to be irresistible: the element of voluntariness ... must be ... in extreme cases, abolished'.
41. R. A. Sells (1991) 'Voluntarism of Consent', in W. Land and J. Dossestor (eds.), Organ Replacement Therapy: Ethics, Justice, Commerce (New York:Springer-Verlag), p. 20.
42. I address Sells' argument more fully and directly in Stakes and Kidneys, 67-9.
43. I thank Thomas Magnell for bringing this objection to my attention.
44. See Paul Hughes, 'Autonomy, Ambivalence, and Organ Sales', unpublished MS.
45. A version of this argument is also developed in Ruth Grant and Jeremy Sugarman (2004) 'Ethics in Human Subjects Research: Do Incentives Matter?', Journal of Medicine and Philosophy, 29, pp. 717-38.
46. Stephen Wilkinson (2003), Bodies for Sale: Ethics and Exploitation in the Human Body Trade (London: Routledge), p. 131.
47. Dworkin, 'Markets and Morals', p. 157.
48. This view is also plausible as it is plausible to believe that a person is less autonomous, less able to direct his own life in accordance with his desires and his values, if he has a low number of eligible options. I address this below, in the section entitled 'Autonomy, Poverty, and Welfare'.
49. See Harry G. Frankfurt (1999) 'Autonomy, Necessity, and Love', in Harry G. Frankfurt, Necessity, Volition, and Love (Cambridge: Cambridge University Press), pp. 129-41.
50. Gerald Dworkin (1988) The Theory and Practice of Autonomy (Cambridge:Cambridge University Press), p. 80.
51. Madhav Goyal et al. (2002) 'Economic and Health Consequences of Selling a Kidney in India', Journal of the American Medical Association, 288(13), pp. 1589-93.
52. The findings of Goyal et al. are also outlined in Taylor, Stakes and Kidneys, pp. 77-8, 84-5.
53. Goyal et al., 'Economic and Health Consequences of Selling a Kidney in India', pp. 1590-2.
54. Goyal et al., 'Economic and Health Consequences of Selling a Kidney in India', p. 1591.
55. Praveen Swami (2003) 'Punjab's Kidney Industry', Frontline, 20(3), 1-4 February.
56. Such medical care for persons who undergo nephrectomies is suggested by Working Party of the British Transplantation Society and the Renal Association, United Kingdom Guidelines for Living Kidney Donor Transplantation (2000).
57. See also Taylor, Stakes and Kidneys, pp. 87-8, where I develop this pro-market argument further.
58. I argue against all of these further objections to markets in human kidneys in Stakes and Kidneys, chapters 6, 7 and 8.
59. An earlier version of this chapter was presented at the Murphy Institute, Tulane University, in January 2005. I thank my audience on that occasion (especially Eric Mack and Bill Glod) for their helpful comments. I also thank Nafsika Athanassoulis for her useful comments on an earlier version.