How much does a kidney cost?

Should we allow people to die for a principle? This is how the issue of Organ Trade is more likely to crawl into people’s conscience. What is heavier in the ethical scale, organ trade or human lives?

The Church has stubbornly maintained that “the human person” should be at the centre of all ethical decisions. Doesn’t this imply that the morality of organ trade depends on how many human persons may benefit from it?

Some think that legalizing the organ trade will resolve the problem of the shortage of kidneys and save the lives of kidney patients waiting for a transplant. An ethical and controlled kidney market will also wipe out the unethical black market that already exists.

Others disagree. They think the poor, (who are more likely to be the sellers), will be exploited by the rich, (who are more likely to be the buyers). The organ trade will also increase the demand for kidneys, since those who sell their kidneys will be more likely to need a kidney themselves, when, in their old age, their only kidney may start to fail. Furthermore, organ trade will discourage possible donors to donate when they see that others are getting paid for what they would give freely.

These two opposite conclusions are however both based on considering only the consequences of legalizing organ trade. If legalizing organ market brings about more benefits than harm, then it should be pursued.

This kind of pragmatic thinking was “invented” by Jeremy Bentham (1748-1832), is known as utilitarianism and has become the way ethical issues are decided in our culture. Utilitarians claim that if a Nobel Prize and a beggar share a waterlogged raft that could only support one person, the laureate could ethically push the beggar off since he would be more useful to society. In other words, killing is neither right nor wrong; it all depends on the beneficial consequences of each particular act of killing. Thus, it does not really matter what you are doing but what happens as a consequence of your action.

This system forgets that human actions are moral or immoral because they make the person moral or immoral, independently on what happens after their decision is made.

Socrates believed that it was better to suffer injustice than to cause it. There is nothing practical about that, but it is sublimely ethical. Jesus said, the man “who looks at a woman lustfully, has already commited adultery in his heart” (Mt 5:28 ) independently on whether the physical adultery is committed or not. What we choose to do certainly affects the world around us, but it also affects us. By deciding to commit murder, we have changed ourselves into persons capable of murdering, even if we later fail to carry out the actual murder.

Then the main ethical question is not, “How useful would this policy be?” “but “What do people do to themselves when they sell their organs?”

John Paul II in his address to the Organ Transplant Society (August 29, 2000, # 3) claimed

…”every organ transplant has its source in a decision of great ethical value: ‘the decision to offer without reward a part of one’s own body for the health and well-being of another person. Here precisely lies the nobility of the gesture, a gesture which is a genuine act of love. It is not just a matter of giving away something that belongs to us but of giving something of ourselves, for ‘by virtue of its substantial union with a spiritual soul, the human body cannot be considered as a mere complex of tissues, organs and functions . . . rather it is a constitutive part of the person who manifests and expresses himself through it’.”

In today’s Cartesian mentality, the body is something the “person” uses; not something the person is. If that if the case, we certainly may sell our organs as we could sell our cars, but, we might similarly charge for sexual intercourse since sexual activities are also one of the possible uses of the body. The new cultural understanding of sexual freedom has the same cultural background: we own our bodies and we may use them as we want to as long as no harmful consequence is derived.

It took the Church more than 600 years and 6 ecumenical councils, from Nicea (325) to Constantinople (681) to understand that Jesus Christ was truly God, truly human, with one divine nature, a divine will and a human will. This understanding did not fall from the sky. It took centuries of pondering, debating and defining before the church reached these conclusions.

We should not be surprised if after thousands of years, we are still grappling with the issue of how to relate to our bodies. Are we only material beings like animals? Are we spirits temporarily wearing and using material bodies? Or are we as much spirited bodies as we are embodied souls? Which one of these three understandings is true? Is our body something we have, or someone we are?

Putting a price to motherhood or to friendship simply corrupts them. Putting a price to the intimate sexual act deprives it of any personal meaning or intimacy. Putting a price to human organs makes the human body a merchandize.

Organ donation, unlike organ trade, is not just the disposal of a body part, but the gift of oneself, an act of true charity. Organ donors are heroes; organ sellers sell themselves.

Kidney patients are not dying because of a principle. If not enough kidneys are available, kidney patients will die because their kidneys failed, because our bodies will inevitably fail sooner or later, no matter how much medicine advances. What matters most is not how soon we die but how ethically we live.

Moral principles are not a luxury of a few philanthropists. A right life and a good heart are the only things worth living for and the only luggage we are allowed to carry with us beyond the grave. That’s not a luxury, it is the minimum bare necessities.

There are two things the debate about organ trade is teaching us. First, we are barking at the wrong tree of decision-making. It is not only the consequences of the act that matter, but the morality of the acts in themselves that matter most in morality. The second is that we are now still understanding who we really are and what our bodies mean to us.