The Commonwealth of Pennsylvania is considering a law that would pay families of organ donors $300 to help cover the donors funeral costs. This has raised in many minds the possibility that in the near future organs could be bought and sold on the open market.
Christians ought to take advantage of the publicity surrounding these developments to rethink the moral dimensions of organ donation, procurement, and transplantation. These issues have been neglected in our churches and even in seminary bioethics courses in favor of topics such as abortion, active euthanasia, physician-assisted suicide, and health-care reform.
Some would make organ transplantation compulsory. Hospitals would simply "harvest" all usable organs from patients at time of death. However, for others this would be considered a desecration of the body. Respect for religious liberty and the convictions of others should lead us to resist such mandatory procurement schemes. There is no inherent "right" to anothers organs.
Should society move from a system of voluntary organ donation to an open market in organs? Currently, viable human organs for transplanting are a scarce medical resource, and many patients die while on waiting lists for donor organs. Would a "free market" in organs distribute them more efficiently, while helping many poor families with funeral expenses? Perhaps it would. Market distribution is often remarkably efficient. Yet, as Princeton political philosopher Michael Walzer argues in Spheres of Justice, no market system is ever completely "free." Every society has found items that it refuses to distribute by market means. Prostitution is illegal in most of the United States because, however incoherent the society has become about sex in general, it still believes that sex should not be distributed by market forces. Should organs be so distributed?
Christians have to answer in the negative. We affirm the goodness of the human body as Gods creation. Thus, we resist turning the body into simply one more commodity in a consumer society. Indeed, our disgust at the buying and selling of human body parts is connected to our revulsion at prostitution, slave labor, sweatshops, and other practices that are so dismissive of human flesh.
The Pennsylvania proposal, of course, is not for a complete market system of organ procurement, but just for compensating organ donors families by offsetting funeral costs. Yet this will surely lead more poor families to agree to organ donation than the rich. This will be the beginning of a market system in which the wealthy, who already have more access to health care than the poor in our nation, can obtain the organs of the poor for their benefit in the same way that they already use the labor of the poor for their benefit. Christians, shaped by the Bibles overwhelming concern for justice for the poor, ought to resist any move that would make them so vulnerable to the further predations of the wealthy and powerful. The current system, in which donors and recipients remain anonymous, is designed to protect against just such predation.
This is not, however, an argument for Christian support of the status quo. Organs are too scarce for needed recipients under the current system. Far more people want to be recipients of a healthy organ than are willing to donate their own organs. We should support initiatives like that of the United Network for Organ Sharing for greater participation in voluntary organ donation. Organ donation ought to be encouraged by ministers as a proper instance of Christian stewardship and a response to Gods grace. The broken body of Christ is the means of our salvation. When our own bodies give out, we ought likewise freely to give of them for the healing of others bodies.
We ought also to encourage wide discussion of such matters in families. At the time of death, especially if that death is sudden, removal of a body part of a loved one can seem like a desecration instead of a gift of life for others. Encouraging discussion of organ donation so that loved ones know of our decisions to donate well ahead of time could prevent such reversals during the grief of loss. When discussed ahead of time, families often come to see organ donation as a way that God brings good out of a tragic death.
Voluntary organ donation flows out of central Christian convictions and allows us to respect the convictions of those who disagree. It also resists the further vulnerability of the poor to a system that increasingly sees them as simply means to the self-interested ends of others. But voluntary donation can only meet the needs for organ transplantation if Christians, in congregations and in families, get involved in these matters. It is time to end the silence.
MICHAEL L. WESTMORELAND-WHITE lives in Louisville, Kentucky, where he is an adjunct instructor in religion and philosophy at Spalding University. In the winter and spring 2000 quarters, he will be visiting assistant professor of Christian ethics at Fuller Theological Seminary in Pasadena, California. Glen Stassen, the Lewis B. Smedes Professor of Christian Ethics at Fuller, serves as consultant and adviser for this Ethics page.