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Organ sales and paternalism
  1. Gerald Dworkin
  1. Correspondence to Professor Gerald Dworkin, Department of Philosophy, University of California, Davis, CA 95616, USA; gdworkin{at}

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Simon Rippon believes that a certain argument is not sound.1 I agree. I do not agree with the role he assigns the argument in the debate about organ sales. Nor do I agree with the much stronger argument he puts forward that organ sales should be forbidden.

The argument he believes unsound, which I shall use his terminology to refer to as the Laissez-Choisir or LC argument, has three premises. The one be believes false says, “If we take away what some regard as their best option, we thereby make them worse off, at least from their own perspective”.

Applied to the case of a market for organs, this says that if we take away what the potential organ seller regards as his best option, that is, there being a market for his organs, we make him worse off as judged by him. The reason Rippon thinks this argument is false is that, as I have argued and have been cited by Rippon, adding an option can, in addition to merely adding a choice, have adverse effects on the agents, can harm the agent by his own lights. Thus, says Rippon, if the argument is unsound, then it does not follow that if we deny the agent the option to sell his organs, we must be acting paternalistically. The option we are taking away is one that the agent himself regards as harmful.

This is correct as far as it goes, but it might leave the reader thinking that the premise is never true. This would be to overlook the fact that even if the additional option …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • i It is, of course, a distinct claim that we act wrongly when we act paternalistically.

  • ii Interestingly, he does not consider an alternative route which is to show that establishing markets violates a right of the potential participants. Some have argued that blackmail—the offer to sell secrecy about one's past actions—is a violation of the right of the purchaser not to be offered such a transaction.

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