Taylor James Stacey
Department of Philosophy and Religious Studies, Louisiana State University, Baton Rouge, LA 70803, USA.
J Appl Philos. 2002;19(3):273-85. doi: 10.1111/1468-5930.00221.
Although there continues to be a chronic shortage of transplant organs the suggestion that we should try to alleviate it through allowing a current market in them continues to be morally condemned, usually on the grounds that such a market would undermine the autonomy of those who would participate in it as vendors. Against this objection Gerald Dworkin has argued that such markets would enhance the autonomy of the vendors through providing them with more options, thus enabling them to exercise a greater degree of control over their bodies. Paul Hughes and T.L. Zutlevics have recently criticized Dworkin's argument, arguing that the option to sell an organ is unusual in that it is an autonomy-undermining "constraining option" whose presence in a person's choice set is likely to undermine her autonomy rather than enhance it. I argue that although Hughes' and Zutlevics' arguments are both innovative and persuasive they are seriously flawed--and that allowing a market in human organs is more likely to enhance vendor autonomy than diminish it. Thus, given that autonomy is the preeminent value in contemporary medical ethics this provides a strong prima facie case for recognizing the moral legitimacy of such markets.
尽管移植器官长期短缺的状况仍在持续，但关于我们应该通过允许当前的人体器官市场来缓解这一短缺的建议，仍然遭到道德谴责，通常理由是这样一个市场会损害那些作为供体参与其中的人的自主性。针对这一反对意见，杰拉尔德·德沃金认为，这样的市场会通过为供体提供更多选择来增强他们的自主性，从而使他们能够对自己的身体行使更大程度的控制权。保罗·休斯和T.L. 祖特列维克斯最近批评了德沃金的论点，认为出售器官的选择很特殊，因为它是一种损害自主性的“受限选择”，其在一个人的选择集中的存在可能会损害而不是增强她的自主性。我认为，尽管休斯和祖特列维克斯的论点既新颖又有说服力，但它们存在严重缺陷——而且允许人体器官市场更有可能增强供体的自主性而非削弱它。因此，鉴于自主性是当代医学伦理学中的首要价值，这为认可此类市场的道德合法性提供了一个强有力的初步证据。
