Koplin Julian J
Monash University, Melbourne, Australia.
J Med Philos. 2017 Oct 1;42(5):575-596. doi: 10.1093/jmp/jhx017.
An innovative program recently initiated at the University of California, Los Angeles (UCLA) Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to the meaning and moral salience of commodification. I first consider whether the literature on commercial markets in organs--a longstanding topic of bioethical debate--can meaningfully inform ethical analysis of kidney voucher programs. Specifically, I consider whether and to what extent common objections to the exchange of kidneys for cash also apply to the exchange of kidneys for "kidney vouchers." Second, I argue that the contrast between the ethical issues raised by these two practices highlights the need to understand commodification as existing on a continuum, with different degrees of commodification giving rise to different ethical issues. Doing so can help sharpen our understanding of commodification as a moral concept, as well as its relevance to broader debates about the moral limits of markets.
加利福尼亚大学洛杉矶分校（UCLA）医学中心最近启动了一项创新计划，允许人们捐赠肾脏以换取一张代金券，亲人在需要时可以凭此券兑换肾脏。作为一种相对较新的做法，提前肾脏捐赠的伦理影响尚未得到广泛讨论。本文思考了这一新的捐赠计划中一些利害攸关的生物伦理问题，以及一些与商品化的意义和道德显著性相关的更广泛的哲学问题。我首先考虑关于器官商业市场的文献——生物伦理辩论的一个长期话题——是否能对肾脏代金券计划的伦理分析提供有意义的参考。具体而言，我思考对用肾脏换现金的常见反对意见是否以及在多大程度上也适用于用肾脏换“肾脏代金券”。其次，我认为这两种做法引发的伦理问题之间的对比凸显了将商品化理解为一个连续统一体的必要性，不同程度的商品化会引发不同的伦理问题。这样做有助于深化我们对商品化作为一个道德概念的理解，以及它与关于市场道德界限的更广泛辩论的相关性。
