Organs for sale

March 12, 2015

I was reading an essay by Leon Kass called “Organs for sale?”1, which argued against organ transplantation markets, and it kind of rubbed me the wrong way, so I decided to collect my thoughts here. It’s not so much that I disagree with his position- organ markets come with a whole thicket of tricky moral issues, and I’m in broad agreement with many of his conclusions. It’s the way he justified his conclusions that left me rather nonplussed.


Kass begins by recounting his precognitive repugnance toward organ transplantation, claiming he was “repelled by the prospect” of even reviewing an article on the matter. He notes the difficulties in holding this view, admitting that “regardless of all my arguments to the contrary, I would probably make every effort and spare no expense to obtain a suitable life-saving kidney for my own child.” Despite these tensions, however, Kass feels this attitude is tenable precisely because it acknowledges the ethical dilemmas he believes to be irreducible, instead of explaining them away in a neat utilitarian calculus.


Kass claims that allowing a price for organs will reduce “generosity into trade,” and “gratitude into compensation”. The only reasonable response, he claims, is a rejection of “the simple utilitarian calculation” that might condone organ markets, and an insistence on free donation, because only donated organs carry with them the donor’s “generous good will”2.

But of course, the same thing could be said about any transaction. You don’t call for your local supermarket to be replaced by communal food-sharing because you think supermarkets “reduce generosity into trade”. Kass realises this, so he distinguishes organ transplantation from other transactions by claiming organ donation violates a number of “repugnances”, which he claims are not culturally-contingent, but rooted in our fundamental humanity

And because the repugnant feelings Kass has are not culturally-contingent- and definitely not a product of personal prejudice- Kass feels pretty comfortable condemning a culture in which aversion to organ transplantation, cosmetic surgery, sexual liberation, and homosexuality is rapidly diminishing. This bundle of pernicious cultural attitudes, Kass thinks, ominously signposts the way toward a profound, irrational disrespect for the self.


Kass’ argument that transplantation violates fundamental proprieties is vague and not straightforwardly deductive; he adopts a loosely antireductionist stance that is suspicious of analytic attempts to characterize the relationship between the self and the body. Instead, Kass offers numerous sketches of the embodied nature of humanity, hoping by sheer volume to cross a gestalt threshold where the faint outlines coalesce into a convincing chiaroscuro depicting the intrinsic dignity of the human form.

For his first sketch, Kass is willing to “transplant the conclusions without the argument” from his essay Thinking About the Body3, in which he denies that his repugnance toward transplantation can be dismissed as culture-bound, advancing instead the notion of “psychophysical unity”, a doctrine that asserts the monism of body and mind.

I had been feeling like Kass had been doing a bit too much of “transplanting conclusions without arguments”, so I took a look at that essay that supposedly housed these arguments.


In Thinking About the Body, Kass is again acutely aware that his aversion to organ donation, which he acknowledges is not universally held, might appear to others as merely reflecting a certain cultural prejudice. So in order to quell this notion that he might be even a little prejudiced, Kass attempts to ground the repugnance he feels within a culturally agnostic framework. Unfortunately, Kass’s acrobatic, post-hoc rationalizations only serve to underscore the ethnocentric solipsism he continually displays throughout these essays.

Kass begins the essay with a story, taken from a generous quote from Herodotus’ Inquiries, in which the Greeks vehemently declare “no sum would tempt them” to adopt the Indian custom of eating their deceased fathers. The Indians, in turn, refuse to even speak about the Greek custom of burning their dead, neatly illustrating that funereal practices are both intensely held and culturally-bound4.

In an astonishing sophistic judo flip, however, Kass goes on to immediately and completely dismiss Herodotus’ very explicitly stated relativistic conclusion that culturally dictated law is “king over all”, citing two farcically generic “universal and related facts” that the story apparently “presents”: the fact that everybody dies and becomes a body, and the fact that every culture “does something with the bodies” (italics his). Having looked past Herodotus’ superficial conclusions to identify these universal thanatological truths, Kass triumphantly claims “licence to try to think- and not merely ventilate the prejudices of my culture- about the body” (italics his).

Strangely, Kass seems reluctant to use the licence for cultural transcendence he so proudly grants himself, promptly launching into an extended etymological analysis of the rather culturally-bound English word “body”, and then tediously enumerating the various senses in which the first-person pronouns are used in the English language (replete with a Rolf Harris reference), limply interpreting the polysemy of the English first person pronouns as implying the fundamental inscrutability of the self-body relationship- a relationship that, like “our language” (i.e., English), apparently vacillates helplessly between the twin peaks of ethereal dualism and Gradgrindian scientific reductionism.

Given that Kass’s stated goal is to think on the universal features of the human body, it is unclear how this informal morphosyntactic analysis of English pronouns is any more illuminating than noting that the pronomial systems in Old Japanese exhibit no polysemy at all, even if, hypothetically, their diachronic instability did turn out to be connected with a shift in Japanese self-body conception.


If you think that particular sketch failed to establish a repugnance toward organ transplantation as more than a culturally-contingent artefact, don’t worry- Kass quickly produces another that depicts the idea of psychophysical unity, forming his sketch out of repetitious, rhetorically extravagant assertions:

Mind and hand, gait and gaze, breath and tongue, foot and mouth- all are part of a single package, suffused with the presence of intelligence.

Not one to belabour the point5, Kass concludes dramatically:

We are rational (i.e., thinking) animals, down to and up from the very tips of our toes. No wonder, then, that even a corpse shows the marks of our humanity.

For Kass, the human animal is rationality embodied; a mutilation of the human body is a mutilation of reason. Psychophysical unity thus offers another path to an acultural aversion to transplantation, allowing us to equate tampering with the human body with irrationality itself.


Kass then launches into a lengthy defence of psychophysical unity, asking us to meditate upon the human body and its “upright posture, and on the human arm and hand, face and mouth”6. He borrows liberally from Erwin Straus’ phenomenological essay The Upright Position, which lists various features of the human form that apparently demonstrate its unmistakable orientation toward rationality:

In getting up, in reaching the upright posture, man must oppose the forces of gravity. It seems to be his nature to oppose nature in its impersonal, fundamental aspects with natural means… As upright, we enjoy our dignity and bearing and opportunity to encounter one another “face-to-face”…

The implications that quadrupeds are untroubled by the forces of gravity, or the fact that humans are by no means the only bipedal species, are left unaddressed.

But Kass is a busy guy, and he quickly moves on to show off another enlightening sketch in which Straus points out a profound fact: that man no longer “move[s] in the line of his digestive axis”. Apparently untroubled by the yawning ontological chasm between premise and conclusion, Straus transitions seamlessly from the anatomical to the astronomical, pronouncing that this bodily reconfiguration has enabled “[g]alaxy and diluvium, the infinite and the eternal” to “enter into the orbit of human interest”.


Having fortified his subrational repugnance against any reasonable objection, Kass finally feels comfortable enough to construe his personal repugnance, under the banner of “propriety”, as axiomatic, and reasons from it four “beginning presumptions” that he feels we must have very good reason to overcome:

  1. The presumption that living organ donors are engaging in self-mutilation
  2. The presumption that cadaver donation is a defilement of the corpse, and prevents a fitting “ceremonial disposition”
  3. The presumption that recipients of organs feel a self-directed revulsion that is shared by their immune systems
  4. The presumption that organ transplantation should not be publicized

Kass has helpfully sorted his list of presumptions in order of increasing absurdity, so let’s just consider the last two. Citing the immune system’s propensity for rejecting transplanted organs, he claims:

Even the silent body speaks up to oppose transplantation, in the name of integrity, selfhood, and identity

This is a breathtaking exercise in promiscuous ontological conflation. Personification of the immune system in the name of psychophysical unity would allow us to help ourselves to the beliefs that arthritis is an act of self-mutilation, or that type 1 diabetes is an existential crisis.

Kass then grumpily condemns what he perceives is the voyeurism of the media, terming it a “cannibalism of the eyes”, and wistfully pines for a time when it was considered crude to show a surgical scar on television. I guess it’s sufficient to note that Kass seems to have abandoned all attempts to speak aculturally, and settled instead for discussing television programming.

  1. I would link it but it’s paywalled.

  2. Presumably Kass has performed a less simplistic calculation to determine that the generosity of the donor is sufficient to cancel out the considerations of propriety, possibly accounting for variance in good-will among donors.

  3. Which might be uncharitably synopsized as: Kass can write an incoherent essay about the human body, ergo the human body is inscrutable and beyond quantification.

  4. Kass revisits Herodotus later in the same essay, reminding us that the Persians belonged to a culture comprised of “hyperrational” people “indistinguishable from atheists”. He goes on to smugly claim that “their funereal practice is what you might expect… the body of a male Persian is never buried, until it has been torn either by a dog or a bird of prey”. For Kass, the Persians, exemplars of cold rationality, demonstrate where a strictly materialist conception of the body will lead.

    Kass reasons from his universalised, a priori vantage to pronounce the Greeks, with their conventionally Western burial practices (what a coincidence!), as the perfect “mean between the superstitious Indians and the autonomous Persians”. However, his attempt to situate himself squarely in the Goldilocks zone of rationality is complicated by the fact that the Persians, by not immediately burying their dead, were observing their distinctly theistic tradition of Zoroastrianism. Adherents placed their dead on towers expressly built for exposure to wild animals, to avoid contaminating the Empedoclean elements of fire, earth or water with dead bodies, believed to be defiled by corpse demons- hardly a reasonable parallel with methodological reductionism.

  5. A fun game: try reading these quotes aloud.

  6. Yes, the whole essay is like this.