Words that aren’t arguments: ‘commercialization’
I frequently find myself reading or talking to people who oppose organ markets. When the usual arguments (I won’t bore you by listing them here) are done with, they frequently say something along the lines of ‘we can’t legalize organ markets because that would lead to the commercialization of organs’.
What’s interesting is that this is not being said as a statement of facts – it’s said as an argument. It isn’t one. Arguments against X are meant to explain why X is bad. But there isn’t anything automatically bad about commercialization. Bread is highly commercialized, as are healthcare, tea pots, deodorants, music, airplanes and books. This is not necessarily bad: we get more tea pots in this commercialized world than in a world where everyone has to either make their own, or receive one from someone who loved them and had a spare lying around, or wait until somebody died and they could inherit it (provided that person made arrangements to have it passed on and not buried with them).
To understand why commercialization isn’t bad, let’s think of a situation where it could be bad – when countries like the US started introducing (small) monetary incentives for individuals donating blood (who had hitherto been doing it for free), the number of people donating actually declined. Let’s understand what’s happening here: we live in two worlds, the economic and the social. In the economic, it is acceptable to give someone money for a favor. In the social, it isn’t: imagine trying to pay your mother for a meal well-cooked. Donating blood is an altruistic act, part of the social world, and has many social ‘incentives’ (so to speak) to induce this kind of altruistic behavior. By offering money, the US government transferred it to the economic world, the act become tainted by the presence of the monetary award, and the warm-glow evaporated, taking most of the donors with it. Put in harsher terms: the incentives being offered by the economic sphere couldn’t match the incentives being offered by the social sphere.
That’s an example of a situation where commercialization is bad because it reduced the amount of blood being donated. The problem with generalizing this example (i.e. claiming it to be proof that commercialization is always bad) is that it is so unusual: the ‘supply’ of blood is reasonably certain, thanks to blood donation drives etc. The ‘supply’ of kidneys isn’t as plentiful and the reason is obvious: donating a kidney is nowhere nearly as painless and easy as donating blood. New York Times writer Alexander Berger altruistically donated his kidney to a stranger:
When I first told some friends and family that I wanted to donate a kidney, they assumed I’d gone off my rocker. They saw it as a crazy act of self-sacrifice, rather than what it is — one of the many ways a reasonably altruistic person can help others.
Unless you can magically change people’s minds overnight, you’re going to have to explore other options. Commercialization is one. The level of altruistic donations is currently so low that it’s very hard to make the case that commercialization would reduce the overall supply of kidneys. Altruism has been given a chance and it hasn’t done well.
Commercialization brings a lot of benefits – even if we forget the thousands of lives that will be saved, there’s the fact that right now, the poor individuals in third world countries who sell their organs on the dangerous black market where they’re frequently paid one half to one tenth the amount they’re owed would find their situation far better off as they have access to courts, qualified doctors, complete information and clean hospitals.
In order to argue against organ donations on the grounds that it’ll lead to ‘commercialization’, you have to explain what’s so bad about commercialization that it swamps all the good things. I suspect that, put into this position, most people would realize that they’re mostly appalled by the notion that an activity should be transferred from the social sphere to the economic sphere*. But other than this bad feeling, they’ve really got nothing – and the social sphere is doing a terrible job. It’s wrong to sentence people to death, misery and fraud because you feel that something you have nothing to do with would be tainted by the presence of money. People selling their body parts might revolt you – but that you find something gross isn’t an argument that ought carry weight when the health and welfare of others is at stake.
Bonus: highlights from a paper on Iran’s kidney market.
On a final note, this argument applies not only to organ markets but also things like commercial surrogacy (also banned in many countries). In India, surrogate mothers earn the equivalent of 5 years income** from ‘selling their wombs’ – if you want to stand between her and this ticket out of poverty, you’d better have a strong reason for it.
For the rest of you, the proper response to “But that would lead to commercialization” is “Yes, so?”
Next word: exploitation.
*Yes, yes. All these are artificial social constructs. But they’ve been constructed and they deeply affect the way people think of things, so we’ll have to argue within them, my friend.
** 2 lakhs per baby in a country where the median annual income is in the range of Rs.40,000 per annum.