In Salon, Frances Kissling raises an ethically thorny question: Do we treat potential living organ donors fairly? She says the medical community is overly cautious because of the possibility of bribes or rewards for living organ donation. In fact, "Even without incentives, no group of do-gooders is treated with more suspicion by the medical community." The medical community is so cautious that donors have to cover their own medical expenses* for the donation and then insurance provides nothing later for long-term comprehensive health insurance or life and disability insurance. 

She says something telling: 

Transplants are still a little creepy, and the idea of sharing your body with someone else is still science fiction. It's scary.

I think she's touching on something uncomfortable. It’s possible that the whole issue —- not just “rewards” or “incentives”, but the entire idea of giving your body —- is more complicated than we assume. Gilbert Meilaender is my favorite bioethicist and in his profound little book, Bioethics: A Primer for Christians, he reflects on the issue:

Not every gift can properly be given by those who know themselves to be creatures rather than Creator. The body, as the place of personal presence, has its own integrity, which ought to be respected. … Thus, even when we approve donation (of, for example, a kidney) from a living donor, we should retain a lively sense of the moral complexity of such an act. …

But consent is not the only moral issue here, and those concerns should not obscure a larger underlying issue: the integrity of bodily life. If we learn to regard our bodies simply as collections of organs potentially useful to others (and available whenever our true inner self chooses to give them), we are in danger of losing any close connection between the person and the body. That connection has always been affirmed in Christian thought, although it has often been a fragile connection. We are regularly tempted to suppose that the “real” person transcends the body. When we do that, dehumanization lies near at hand.

Then he says Leon Kass refers to organ donation as a “noble form of cannibalism.” Yes, it is noble and altruistic —- maybe even a picture of Christ in that he gave his body for us; but it is also morally complex. Based on this Christian emphasis on the integrity of the body, the medical community’s present caution seems wise — especially since it's too easy to endorse ethically dubious practices as necessary for the greater good of mankind. But Meilaender’s questions are worth some thought.

*Correction: The donor's own insurance covers medical expenses. 

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Alisa Harris

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