Ethical market in organs

doi:10.1136/bmj.325.7368.835

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Market of organs is unethical under any circumstances

Ignazio R Marino, professor of surgery (marinoir@msx.upmc.edu),
Claudia Cirillo, administrative coordinator for international relations,
Alessandra Cattoi, chief, news bureau, University of Pittsburgh Medical Center in Italy

University of Pittsburgh, Thomas E Starzl Transplantation Institute
University of Pittsburgh Medical Center, Suite 10097, Forbes Tower, 200 Lothrop Street, Pittsburgh, PA 15213, USA
Sheffield North Primary Care Trust, Sheffield S5 6NU
Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW

EDITOR—Although we admire Harris and Erin's commitment to solve the dilemmas posed by a shortage of organs, we strongly disagree not only with their conclusions but also with their assumption—namely, that the selling and buying of human organs can be made ethical. 1

Harris and Erin harness their theory to the laudable commitment to raise donation rates but arrive at the definition of an ethical market by promoting a system that seems to depend only on a restricted group of citizens—those who find the monetary incentives proposed appealing.

Firstly, the integrity of the human body should never be subject to trade. Can we truly define this system as ethical because the selling and buying of organs is administered by the state?

Secondly, how can a system be called ethical when it implicitly penalises the weakest people and exacerbates discrimination based on census? Will a healthy well-off citizen ever decide to give away part of his or her body for monetary gain? Donation rates might be boosted, but, although both the rich and the poor will continue benefiting from transplantation indiscriminately, organ procurement will be increased only by contributions from poor people.

Any commitment towards raising donation rates can …