The Bioethics of Dying: Dignity, Commercialisation and the Organ as a Gift

The shortage of donor organs is an acute problem of modern transplantology. One of the solutions proposed in the literature is the adoption of a market model of organ donation, in which the organ is no longer a gift, but a commodity traded on a regulated or free market. Current criticisms of the market model of organ donation include the risks associated with the commodification of the body and its parts and the denial of the value content of the gift of the continuation or preservation of life. However, the article argues that the market model of organ donation, which is shown to be embedded within the context of biocapitalist and neoliberal logics, has another negative manifestation: the loss of dignity. In a model of organ donation based on the organ as a gift, donation is accompanied by an intangible asset, which is diverse, but the article problematises two parts of it: the status dignity of the person for lifetime donation and symbolic immortality for posthumous donation. Organ donation based on gift is what actualises the discourse on dignity and symbolic immortality, as it allows the free choice of the individual in performing a moral act to be realised, whereas in the market model moral choice is replaced by economic choice, which can be dictated not only by direct monetary reward, but by any kind of profit in the form of benefits or status. The market model of organ donation commodifies and economises the process of organ donation and therefore leaves no room for free moral and autonomous action. The case of the Scott sisters is used to illustrate that the market model of organ donation in its broadest sense destroys the discourse on the dignity of both donor and recipient.