Justice_ What's the Right Thing to Do_ - Michael Sandel [33]
The idea that we own ourselves figures in many arguments for freedom of choice. If I own my body, my life, and my person, I should be free to do whatever I want with them (provided I don’t harm others). Despite the appeal of this idea, its full implications are not easy to embrace.
If you are tempted by libertarian principles and want to see how far you would take them, consider these cases:
Selling kidneys
Most countries ban the buying and selling of organs for transplantation. In the United States, people may donate one of their kidneys but not sell it on the open market. But some people argue that such laws should be changed. They point out that thousands of people die each year waiting for kidney transplants—and that the supply would be increased if there existed a free market for kidneys. They also argue that people in need of money should be free to sell their kidneys if they wish.
One argument for permitting the buying and selling of kidneys rests on the libertarian notion of self-ownership: If I own my own body, I should be free to sell my body parts as I please. As Nozick writes, “The central core of the notion of a property right in X… is the right to determine what shall be done with X.”12 But few advocates of organ sales actually embrace the full libertarian logic.
Here’s why: Most proponents of markets in kidneys emphasize the moral importance of saving lives, and the fact that most people who donate one of their kidneys can manage with the other one. But if you believe that your body and life are your property, neither of these considerations really matters. If you own yourself, your right to use your body as you please is reason enough to let you sell your body parts. The lives you save or the good you do is beside the point.
To see how this is so, imagine two atypical cases:
First, suppose the prospective buyer of your spare kidney is perfectly healthy. He is offering you (or more likely a peasant in the developing world) $8,000 for a kidney, not because he desperately needs an organ transplant but because he is an eccentric art dealer who sells human organs to affluent clients as coffee table conversation pieces. Should people be allowed to buy and sell kidneys for this purpose? If you believe that we own ourselves, you would be hard pressed to say no. What matters is not the purpose but the right to dispose of our property as we please. Of course, you might abhor the frivolous use of body parts and favor organ sales for life-saving purposes only. But if you held this view, your defense of the market would not rest on libertarian premises. You would concede that we do not have an unlimited property right in our bodies.
Consider a second case. Suppose a subsistence farmer in an Indian village wants more than anything else in the world to send his child to college. To raise the money, he sells his spare kidney to an affluent American in need of a transplant. A few years later, as the farmer’s second child approaches college age, another buyer comes to his village and offers a handsome price for his second kidney. Should he be free to sell that one, too, even if going without a kidney would kill him? If the moral case for organ sales rests on the notion of self-ownership, the answer must be yes. It would be odd to think that the farmer owns one of his kidneys but not the other. Some might object that no one should be induced to give up his life for money. But if we own our bodies and lives, then the farmer has every right to sell his second kidney, even if this amounts to selling his life. (The scenario is not wholly hypothetical. In the 1990s, a California prison inmate wanted to donate a second kidney to his daughter. The ethics board of the hospital refused.)
It is possible, of course, to permit only those organ sales that save