从定向捐赠到肾脏买卖:这一论点站得住脚吗?
From Directed Donation to Kidney Sale: Does the Argument Hold Up?
作者信息
Taylor James Stacey
机构信息
The College of New Jersey, Ewing, NJ, USA.
出版信息
J Med Philos. 2017 Oct 1;42(5):597-614. doi: 10.1093/jmp/jhx016.
The UCLA Medical Center has initiated a "voucher program" under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable. Hence, kidneys might be exchanged for kidneys but not sold for cash. Second, voucher programs respect donor autonomy, whereas the offer of cash payments does not. Third, the burden of proof lies with the advocates of cash payments for kidneys to show that their benefits would outweigh the costs of their legalization. Fourth, allowing cash payments for kidneys would stifle medical innovation. Fifth, allowing cash payments for kidneys would result in these organs being used as collateral to secure loans-and that this would disadvantage potential borrowers who did not want to risk their kidneys in this way. This paper will rebut all these objections.
加州大学洛杉矶分校医疗中心启动了一项“代金券计划”,根据该计划,捐赠肾脏的人将获得一张代金券,她可以把这张代金券提供给她选择的某个人,这个人随后可以用它插队到肾移植等候名单的首位。如果将此类代金券用作对捐赠者的激励在道德上是允许的,那么用现金购买肾脏在道德上也是允许的。但是,这一论点面临五个反对意见。第一,有些物品的性质使其可以与类似物品进行交换,但使其不能用金钱转让。因此,肾脏可以用来交换肾脏,但不能出售换取现金。第二,代金券计划尊重捐赠者的自主权,而提供现金报酬则不然。第三,肾脏现金支付的倡导者有责任证明其好处将超过合法化的成本。第四,如果允许用现金购买肾脏,将会抑制医学创新。第五,允许用现金购买肾脏将导致这些器官被用作贷款抵押品,而这将使那些不想以这种方式拿肾脏冒险的潜在借款人处于不利地位。本文将反驳所有这些反对意见。