Journal of Medical Humanities

, Volume 40, Issue 1, pp 101–116 | Cite as

What Money Cannot Buy and What Money Ought Not Buy: Dignity, Motives, and Markets in Human Organ Procurement Debates

  • Ryan GillespieEmail author


Given the current organ shortage, a prevalent alternative to the altruism-based policy is a market-based solution: pay people for their organs. Receiving much popular and scholarly attention, a salient normative argument against neoliberal pressures is the preservation of human dignity. This article examines how advocates of both the altruistic status quo and market challengers reason and weigh the central normative concept of dignity, meant as inherent worth and/or rank. Key rhetorical strategies, including motivations and broader social visions, of the two positions are analyzed and evaluated, and the separation of morally normative understandings of dignity from market encroachment is defended.


Dignity Markets Organs Neoliberalism Autonomy 


  1. Aquinas, Thomas. 2007. Summa Theologica, Vol. 1, Part 1. New York: Cosimo.Google Scholar
  2. Assessing Initiatives to Increase Organ Donations: Hearing Before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, 108 Cong. 1 (2003).Google Scholar
  3. Banet-Weiser, Sarah. 2012. Authentic: The Politics of Ambivalence in Brand Culture. New York: New York University Press.Google Scholar
  4. Caplan, A. 1992. If I Were a Rich Man Could I Buy a Pancreas? And Other Essays on the Ethics of Health Care. Bloomington, IN: Indiana University Press.Google Scholar
  5. Capron Alexander M. & Gabriel Danovicth. 2014. “We Shouldn’t Treat Kidneys as Commodities.” Los Angeles Times, June 30.
  6. de Castro, L.D. 2003. “Commodification and Exploitation: Arguments in Favour of Compensated Organ Donation.” Journal of Medical Ethics 29:142-146.CrossRefGoogle Scholar
  7. Cherry, Mark. 2005. Kidney for Sale by Owner. Georgetown: Georgetown University Press.Google Scholar
  8. ———. 2009. “Why Should We Compensate Organ Donors When We Can Continue to Take Organs for Free? A Reply to Some of My Critics.” Journal of Medicine and Philosophy 34 (6): 649-673.CrossRefGoogle Scholar
  9. Childress, James F. 1997. Practical Reasoning in Bioethics. Bloomington, IN: Indiana University Press.Google Scholar
  10. Cohen, Cynthia B. 1999. “Selling Bits and Pieces of Humans to Make Babies.” Journal of Medicine & Philosophy 24:292-293.CrossRefGoogle Scholar
  11. Delmonico, Francis L., Robert Arnold, Nancy Scheper-Hughes, et al. 2002. “Ethical Incentives—Not Payment—for Organ Donation.” New England Journal of Medicine 346:2002-5.CrossRefGoogle Scholar
  12. Dennett, Daniel C. 2008. “How to Protect Human Dignity from Science.” Human Dignity and Bioethics.
  13. Elias, Julio J., Nicole Lacetera, and Mario Macis. 2015. “Sacred Values? The Effect of Information on Attitudes Toward Payments for Human Organs.” American Economic Review 105 (5): 361-65.CrossRefGoogle Scholar
  14. Epstein, Richard. 1997. Mortal Peril. New York: Addison-Wesley Publishing.Google Scholar
  15. ———. 1998. Principles for a Free Society. Cambridge, MA: Basic Books.Google Scholar
  16. Gneezy, Uri, and Aldo Rustichini. 2000. “A Fine is a Price.” Journal of Legal Studies XXIX: 1-17.Google Scholar
  17. Goodwin, Michele. 2004. “Altruism’s Limits: Law, Capacity, and Organ Commodification.” Rutgers Law Review 56 (2): 305-407.Google Scholar
  18. ———. ed. 2015. The Global Body Market: Altruism’s Limits. Cambridge: Cambridge University Press.Google Scholar
  19. Habermas, Jürgen. 2010. “The Concept of Human Dignity and the Realistic Utopia of Human Rights.” Metaphilosophy 41 (4): 464-480.CrossRefGoogle Scholar
  20. Hensley, Scott. 2012. “Poll: Americans Show Support for Compensation of Organ Donation.”, May.
  21. Hennette-Vauchez, Stéphanie. 2011. “A Human Dignitas? Remnants of the Ancient Legal Concept in Contemporary Dignity Jurisprudence.” International Journal of Constitutional Law 9:32-57.CrossRefGoogle Scholar
  22. Hippen, Benjamin and J.S. Taylor. 2007. “In Defense of Transplantation: A Reply to Nancy Scheper-Hughes.” American Journal of Transplantation 7:1695-1697.CrossRefGoogle Scholar
  23. Human Dignity and Bioethics: Essays Commissioned by the President’s Council on Bioethics. 2008.
  24. Kant, Immanuel. 1994. Ethical Philosophy, edited by James Ellington. Indianapolis, IN: Hackett.Google Scholar
  25. Kass, Leon. 1991. “Death with Dignity and the Sanctity of Life.” In A Time to be Born and a Time to Die, edited by B. S. Kogan, 117-146. New York: Aldine de Gruyter.Google Scholar
  26. Landes, Elisabeth & Richard Posner. 1978. “The Economics of the Baby Shortage.” Journal of Legal Studies 7:323-348.CrossRefGoogle Scholar
  27. Lewis, C.S. 2013. The Screwtape Letters: Annotated Edition. New York: HarperCollins.Google Scholar
  28. Macklin, Ruth. 2003. “Human Dignity is a Useless Concept.” British Medical Journal 327:1419-1420.CrossRefGoogle Scholar
  29. Mantel, Barbara. 2011. “Organ Donations: Can the Growing Demand Be Met?” CQ Researcher 21 (15): 346-350.Google Scholar
  30. McRorie, Christina. 2016. “Rethinking Moral Agency in Markets: A Book Discussion on Behavioral Economics.” Journal of Religious Ethics 44:195-226.CrossRefGoogle Scholar
  31. National Organ Transplant Act: Hearings on H.R. 4080 Before the Subcommittee on Health and the Environment of the House Committee on Energy and Commerce, 98 Cong. 4 (1983).Google Scholar
  32. National Organ Transplant Act. Pub.L. No. 98-507. 98 Stat 2339 (1984).Google Scholar
  33. Nussbaum, Martha. 1998. “‘Whether from Reason or Prejudice’: Taking Money for Bodily Services.” Journal of Legal Studies 27:693-723.CrossRefGoogle Scholar
  34. Pinker, Steve. 2008. “The Stupidity of Dignity.” The New Republic
  35. Prottas, Jeffrey. 1994. The Most Useful Gift: Altruism and the Public Policy of Organ Transplants. San Francisco: Jossey-Bass Publishers.Google Scholar
  36. Parekh, R. 2013. “The New Buzzword in Marketing? Human. Advertising Age.
  37. Radin, Margaret Jane. 1987. “Market Inalienability.” Harvard Law Review 100 (8): 1849-1937.CrossRefGoogle Scholar
  38. ———. 1989. “Justice and the Market Domain.” In Markets and Justice, edited by John W. Chapman and J. Roland Pennock, 165-197. New York: New York University Press.Google Scholar
  39. Rosen, Michael. 2012. Human Dignity. Cambridge, MA: Harvard University Press.Google Scholar
  40. Roth, Alvin E. 2007. “Repugnance as a Constraint on Markets.” Journal Economic Perspectives 21:37-58.CrossRefGoogle Scholar
  41. Sandel, M. 1998. “What Money Can’t Buy: The Moral Limits of Markets.” The Tanner Lectures on Human Values. Oxford: Brasenose College, May 11-12.
  42. ———. 2012. What Money Can’t Buy: The Moral Limits of Markets. New York: Farrar, Straus and Giroux.Google Scholar
  43. Satel, Sally. 2006. “Death’s Waiting List.” New York Times, May 15.
  44. ———. 2008. When Altruism Isn’t Enough. When Altruism Isn’t Enough. Washington D.C.: The American Enterprise Institute Press.Google Scholar
  45. ———. 2010. “Altruism + Incentive = More Organ Donation.” The Times [online]
  46. Satz, Debra. 2010. Why Some Things Should Not Be For Sale. New York: Oxford University Press.CrossRefGoogle Scholar
  47. Schopenhauer, Arthur. 1995. On the Basis of Morality, translated by E.F.J. Payne. Indianapolis, IN: Hackett Publishing Company.Google Scholar
  48. “Should We Legalize the Market in Human Organs?” 2008. National Public Radio, May 21.;
  49. Singer, Peter. 1973. “Altruism and Commerce: A Defense of Titmuss against Arrow.” Philosophy & Public Affairs 2:312-320.Google Scholar
  50. Smith, Adam. 1986. The Essential Adam Smith. New York: Norton.Google Scholar
  51. “The Market for Human Organs?” 2006. Think Tank/PBS, July 16.
  52. Toulmin, Stephen. 1981. “The Tyranny of Principle.” Hastings Center Report 11:31-39.CrossRefGoogle Scholar
  53. Waldron, Jeremy. 2015. Dignity, Rank, and Rights. New York: Oxford University Press.Google Scholar
  54. Yanklowitz, Shmuly. 2015. “We Badly Need More Donated Kidneys. Let’s Start Paying for Them.” The Guardian, October.
  55. Zelizer, Viviana. 1978. Morals and Markets: The Development of Life Insurance in the United States. New York: Columbia University Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.University of California, Los AngelesLos AngelesUSA

Personalised recommendations