The shortage of transplantable organs and the growing demand for them has made the legalisation of the organ market an attractive option. Proponents have argued that by legalising organ sales and by subjecting the market to strict regulations and protocols, not only will the supply of organs be greatly increased but exploitation would also be contained. Even those who generally find the marketing of human organs repulsive are sometimes compelled to support its legalisation and control. Torn by sympathy and disgust these people support the legalisation of organ sales and governmental control because the latter is able to eliminate coercive pressure from unscrupulous middlemen by criminalising brokering.
There has been intense debate in recent months in Singapore about the legalisation of organ sales. The Straits Times has recently published a number of articles that argue in favour of legalisation. Health Minister Khaw Boon Wan suggests that he is open to this possibility when he said, ‘Let’s push within the current regime … but at the same time, let’s not write off an idea just because it sounds radical or controversial … We may be able to find a compromise which is workable and yet does not offend people’s sensibilities’ (Straits Times, 21 July 2008).
Although the practical concerns are pressing and the humanitarian arguments compelling, Christian reflection on the purchase and sale of human organs should not begin with them. Rather it must begin with more profound questions like what is the human body and what exactly is our relationship with our bodies? Put differently, we must inquire about the moral status of the human body. Amidst the pressing need for transplantable organs, some would argue that we simply do not have the luxury to indulge in such philosophical reflections. This sentiment is understandable but misguided. Whether we realise it or not, our images of the body do influence our policies regarding the procurement of certain of its parts. Those who want to hasten the legalisation of the organ market already hold a certain view of the human body, which must be subjected to theological and ethical analysis and critique.
The Bible teaches that the human being is a psychosomatic being made up of body and soul. The narrative in Genesis 2:7 describes man as created out of the dust of the earth and animated by the life-giving spirit when God breathed into his nostrils. The human being is therefore an embodied soul created in the image of God. As embodied beings, we cannot be understood without our bodies for it is our bodies that locate us in time and space, and it is our bodies that enable others to ‘find’ us. In other words, we are our bodies. Consequently, our bodies cannot be seen as mere instruments or properties that are at the discretionary disposal of our essential selves. Our bodies are the visible forms of our selves, and they distinguish us from other selves. This means that we cannot alienate certain parts of the body – we cannot dis-organ-ize our bodies – without in some sense alienating the whole person. In the same way we cannot sell parts of our body without changing the way in which we understand ourselves.
To sanction the purchase and sale of human organs is to view the human body (and thus the human being) as a property or commodity that can be acquired if the price is right. This cannot be done without seeing the body – and thus the self – as a mere thing. But the sale of human organs does not only debase the persons from whom the organs are procured; it arguably also debases those who trade in it. Contemporary medicine has already transformed the human body into a source of instrumental value by viewing it as a resource that may benefit others: patients, physicians and researchers. This view of the body is in many ways undergirded by Cartesian dualism, which separates the body from the essential self. This dualism, and the body-as-property paradigm it inspires, is most pronounced when the body is not even seen as an organic whole but as a source of ‘spare parts’. The fact that these ‘spare parts’ collected from different bodies are stored in ‘banks’ further reinforces the instrumental value of the human body.
For Christians the body cannot be commodified in this way because it is the temple of the Holy Spirit (1 Cor 6:19).
However, while the Christian Faith opposes the sale of human organs, it supports voluntary donation. The profound difference between a donation and a sale is that the gift always carries with it the presence of the giver in the way that a commercial transaction does not. The person who donates his / her organ gives himself or herself, not a thing that is owned. The decision to offer without reward a part of one’s body for the health and well-being of another must therefore be seen as a noble gesture because it is an act of love, analogous to the self-sacrificial love of Christ. As Pope John Paul II has so eloquently put it, ‘For Christians, Jesus’ offering of himself is the essential point of reference and inspiration for the love underlying the willingness to donate an organ, which is a manifestation of generous solidarity, all the more eloquent in a society which has become excessively utilitarian and less sensitive to unselfish giving’.
Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity.