Free Market versus Free Will

“The demand for organ transplantation has rapidly increased in the past decade, due to the increased incidence of vital organ failure. However, the unavailability of adequate organs for transplantation to meet the existing demand has resulted in a major organ shortage crisis.” (Abouna, 2008). The question of whether to establish a market for human organs has sparked considerable debate among ethicists, medical professionals, and policymakers. On the surface, while the notion of an organ market may seem like a viable solution to the pressing issue of organ shortages, it raises significant ethical concerns that render it more morally reprehensible than the practice of organ donation. However, while the ethical concerns surrounding an organ market are significant, it could also easily be argued that such a system could offer several potential benefits.

At the core of the ethical objections to an organ market lies the concern about the commodification of human life and the high potential for exploitation. In a society that prioritizes profit over people, the danger arises that the most vulnerable individuals—those in dire financial circumstances—may be compelled to sell their organs, not out of choice, but out of necessity. Furthermore, in a market-driven system, the most disadvantaged populations are at the highest risk of being exploited for their organs. In contrast, the wealthy benefit from the increased availability of organs at their disposal, further reinforcing the social hierarchy and the rich-poor divide. This dynamic creates a two-tiered system where one’s access to life-saving medical interventions is determined by their financial status, exacerbating existing inequalities in healthcare. This model is demonstrated time and time again, where developed countries can buy exports, such as cacao, oil, cotton, etc. from developing nations at disadvantageous prices, creating a cycle of dependency that only serves to further commoditize and take advantage of developing nations.  

It is also important to consider that organ donation is fundamentally rooted in altruism—a selfless act aimed at saving or improving the lives of others. An organ market shifts the focus from altruism to individual gain on the part of the seller, turning a person’s life into a viable commodity for sale. This shift in the understanding of intrinsic value can undermine the social fabric that supports voluntary donation, as the act of charity becomes tainted by the idea of profit. Furthermore, the introduction of financial incentives may lead to a decline in genuine altruism, as individuals begin to prioritize personal gain over the wellbeing of others.

While the ethical concerns surrounding an organ market are significant, there are still undeniable benefits to be offered by a regulated market system. 

Firstly, a regulated organ market could potentially ensure the safety and ethical treatment of donors and recipients. Unlike illegal black markets, a regulated system could establish strict guidelines to protect the rights and well-being of all parties involved. This regulation could help minimize health risks associated with organ donation and ensure that medical standards are upheld. It could also be reasoned that an organ market could help reduce the prevalence of illegal organ trade, which often exploits vulnerable populations. By providing a legal and regulated framework for organ transactions, the risks associated with black market activities—such as unsafe medical procedures and lack of oversight—could be mitigated, possibly leading to better outcomes for both donors and recipients.

An organ market would also significantly increase the supply of available organs. Currently, many individuals die while waiting for a transplant due to shortages - 17 people die each day in waiting for a transplant (HRSA, n.d.). In theory, by allowing individuals to sell their organs, more people would be therefore willing to participate, ultimately leading to a greater number of organs being available for those in need. With a higher supply of organs, the wait times for transplants could be substantially reduced, not only saving lives but also improving the quality of life for patients in need of transplants. Shorter wait times can also lead to better health outcomes, as patients will be less likely to experience medical complications post-transplant (HRSA, n.d.). However, once again, it is important to consider the reasons for individuals being compelled to sell their organs, but patients will benefit nonetheless, highlighting the moral dichotomy and the basis of this entire argument - which lives are more worthy of being lived: the sickly rich, or the healthy poor?  

While the morality-based conclusion would ultimately seek to prioritize enhancing and promoting voluntary organ donation, the capitalist quality of contemporary society seeks financial gain above all, disregarding the interest of the individual in favor of profit. As such, though it could be argued to be unethical, the idea of an organ market grows more tantalizing an idea by the day. However, there is an admirable display of humanity that seems to hold the entire idea of an organ market firmly in the realm of imagination - the simple idea of morality. Humans, as a social species, inherently carry a sense of right and wrong that considers the commodification and objectification of human life morally reprehensible (Tomasello, 2018). There is a value assigned by the collective consciousness on the individual, one that intrinsically believes a living person is worth something unto themselves, and that alone has been enough to reduce the notion of an organ market to nothing more than a passing idea, despite the attractive potential benefits. 

In conclusion, while the potential benefits of an organ market are compelling, they must be weighed against the ethical concerns associated with the commodification of human life. Advocates for an organ market could argue that it could address critical issues of supply and access, ultimately saving lives. However, the very human understanding of the inherent value of life and the prioritization of altruism and compassion simply refuses the idea of assigning a price to a person’s existence. 

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