Journal of Medicine and Philosophy - current issue

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Tue, 17 Nov 2009 09:52:21 PST

Editorial Board

Tue, 17 Nov 2009 09:52:21 PST

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Tue, 17 Nov 2009 09:52:21 PST

Introduction: Symposium on a Regulated Market in Transplantable Organs

Hippen, B. E. — Tue, 17 Nov 2009 09:52:21 PST

A Litmus Test for Exploitation: James Stacey Taylor's Stakes and Kidneys

Kuntz, J. R. — Tue, 17 Nov 2009 09:52:21 PST

James Stacy Taylor advances a thorough argument for the legalization of markets in current (live) human kidneys. The market is seemly the most abhorrent type of market, a market where the least well-off sell part of their body to the most well off. Though rigorously defended overall, his arguments concerning exploitation are thin. I examine a number of prominent bioethicists’ account of exploitation: most importantly, Ruth Sample's exploitation as degradation. I do so in the context of Taylor's argument, with the aim of buttressing Taylor's position that a regulated kidney market is morally allowable. I argue that Sample fails to provide normative grounds consistent with her claim that exploitation is wrong. I then reformulate her account for consistency and plausibility. Still, this seemingly more plausible view does not show that Taylor's regulated kidney market is prohibitively exploitative of impoverished persons. I tack into place one more piece of support for Taylor's conclusion. (wc. 148)

Autonomy, Moral Constraints, and Markets in Kidneys

Kerstein, S. J. — Tue, 17 Nov 2009 09:52:21 PST

This article concerns the morality of establishing regulated kidney markets in an effort to reduce the chronic shortage of kidneys for transplant. The article tries to rebut the view, recently defended by James Taylor, that if we hold autonomy to be intrinsically valuable, then we should be in favor of such markets. The article then argues that, under current conditions, the buying and selling of organs in regulated markets would sometimes violate two Kantian principles that are seen as moral constraints. One principle forbids expressing disrespect for the dignity of humanity; the other forbids treating others merely as means. In light of the moral danger posed by regulated markets, the article advocates an alternative way of diminishing the current organ shortage, namely opt-out systems of cadaveric organ donation.

Organ Markets and the Ends of Medicine

Davis, F. D., Crowe, S. J. — Tue, 17 Nov 2009 09:52:21 PST

As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these "gifts of the body" has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused.

Constraint, Consent, and Well-Being in Human Kidney Sales

Hughes, P. M. — Tue, 17 Nov 2009 09:52:21 PST

This paper canvasses recent arguments in favor of commercial markets in human transplant kidneys, raising objections to those arguments on grounds of the role of injustice, exploitation, and coercion in compromising the autonomy of those most likely to sell a kidney, namely, the least well off members of society.

Autonomy and Organ Sales, Revisited

Taylor, J. S. — Tue, 17 Nov 2009 09:52:21 PST

In this paper I develop and defend my arguments in favor of the moral permissibility of a legal market for human body parts in response to the criticisms that have been leveled at them by Paul M. Hughes and Samuel J. Kerstein.

Why Should We Compensate Organ Donors When We Can Continue to Take Organs for Free? A Response to Some of My Critics

Cherry, M. J. — Tue, 17 Nov 2009 09:52:21 PST

In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective—and morally justified—means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where "market-place morality" is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves.