In addition to case that the selling of organs would create an inappropriate commodification of the human body, there are also very strong arguments for the idea that buying and selling organs would lead to the exploitation of the poorest segments of society. Selling an organ is dangerous, so why should people be pressured into doing it?
There are two possible forms which selling organs could take: selling organs of the living and selling organs of the dead. Because it is difficult to live without your internal organs, the former would be limited just to selling kidneys because people can generally live with only one kidney if necessary.
Selling Kidneys: Having a kidney removed is a difficult, painful, and dangerous process. It hurts a lot and the pain continues long after the surgery. Like any surgery, the process itself is dangerous and it is possible that the patient will not wake up. If they do, there remains the problem of post-operative infection â€" which can kill â€" and the muscles of their abdomen may never regain their former strength and elasticity.
Finally, there is no guarantee that the person really will be able to live with just one kidney â€" disease or injury later on could be fatal for a kidney donor. This is even more likely with the poor because of their health, behavior, where they live, etc.
Given the above circumstances, why would anyone sell a kidney? The rich don't do it, and neither does the middle class â€" only the poor are likely to do it, and it is without question an act of desperation. When such desperation is the motive for selling a kidney, to what degree can we argue that the decision is genuinely voluntary?
In a just society, no person should have to sell off pieces of their body in order to survive. Do we really want to start flying poor people from Africa or Asia to Europe and North America so that they can sell a kidney to the wealthy? This, then, is why these issues cut to the heart of what we want our society to be like: will it be just enough that selling organs is something people can, but never feel they need, to do?
Paying for Organs Means Increasing Costs: Organ transplantation is already an expensive process â€" so expensive that many poor people are unable to have it done and simply end up dying. Paying people for the organs of deceased relatives may make more organs available, but it would also increase the cost of the process, shutting out more poor people and increasing the cost for those who do have enough insurance to pay.
Neither of those results is desirable and both can occur not simply when paying living people for organs (like kidneys) but also paying for organs taken from the deceased. If one of the reasons for allowing the sale of organs is to make more organs available and save more lives, it can’t be done in a way that effectively prevents many people from ever obtaining an organ at all.
Pressuring the Sick: There are already serious ethical concerns when it comes to doctors recommending that a person on life support be taken off the machines and their organs donated. These questions will increase if money changes hands. Will families be tempted to have their relatives denied medical care in order to sell the organs? Will hospitals be tempted to withhold treatments for the sake of money?
Compromise: A general policy against selling organs does not necessarily mean that such sales should not be allowed in very narrow circumstances or in the context of special exceptions. For example, it might be legitimate for two families to "trade," perhaps a kidney for a bone marrow transplant. This sort of trade is also prohibited as a type of sale, but it is not an unreasonable exception.
Narrow allowances for selling would have to ensure that the poor have other, genuine options in order to prevent exploitation. There would have to be safeguards to prevent things like bidding wars and "organ markets" which would cause problems with the general costs of transplantation. Finally, there would have to be sound measures to ensure that no one is pressured or tempted to allow others to die for the sake of cash. All of this would be difficult, but without it, the ethical problems with unregulated and unmanaged trafficing in human organs would be enormous and unacceptable.
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