The Auto-Vivisectors

Every week now we get a new miracle story from the world of biotechnology and medicine. Whether it’s the capacity to make partial organ donations, so that sections of an adult’s liver can be implanted in a dying child, or to genetically modify a yet-to-be-born child so that it can act as a marrow donor for a sibling, the leaps and bounds of science outdistance our capacity to anticipate them. A decade or so ago the tone in which such advances was reported was one of unambiguous admiration, and a marvelling at our capacity to fight off death and ill-luck. Recently a more circumspect tone has crept in, as people begin to question whether the implantation of animal organs into human beings benefits the individual at the expense of a society exposed to trans-species infections. Uncritical cheerleading of scientists was seen to be inappropriate to a society in which cloning had become possible, and a more questioning tone has become the norm. People react to such things with hope — that they may one day benefit and be saved from certain death — and a deeper fear and bewilderment at the effect of such technologies on what it is to be a person, on human being? At what point do we begin to regard that disquiet as something other than ‘technophobia’ or the shock of the new, and to really act on it?

One could suggest that such a point has been reached with the news that Kerry Packer has received a kidney donated by one of his employees. The donor, his pilot and good friend, may be left with chronic pain down one side of his abdomen as a result of the operation, and he has a 1 in 500 chance of suffering kidney failure himself.

The spectacle of Australia’s richest man copping an organ from a loyal retainer after a lifetime of robust drinking and smoking will fill many people with fear of a world in which the rank-and-file act as little more than organ banks for the super-rich, yet that’s hardly the issue here. The donor is apparently not only willing to give Kerry his kidney, but eager to do so. Nor is there any suggestion of coercion or money changing hands. The pilot is apparently doing this as an act of love.

Yet it’s the very altruistic nature of the act that’s the problem, more so than the possible corrupt use of it. It’s the fact that we can now give a friend a vital organ in the same way we could once have given them a loan or a blood transfusion which raises dilemmas that can’t be solved within our existing assumptions about what we owe to each other.

Every significant relationship — kinship, friendship, love — carries with it the expectation of risk and sacrifice to varying degrees. Parents will risk their lives to save a drowning child even in circumstances where the risk that both parent and child will then drown is high, and anyone who made a rational calculation about the futility of the attempt would be seen as something less than human. The same would apply to live donation from parent to child — in most circumstances it would be simply unbearable for the parent not to make the effort. What is then owed to adult siblings? To spouses? To partners? To friends? A moment’s reflection will tell you that what we have hitherto understood as the obligation of risk — that we would, or hope we would, rescue a stranger from a burning building — does not even start to extend to something like live organ donation. To have a world in which we routinely assume that others will submit to voluntary dismemberment in order that we can continue to live is not the gift of life, but something like the reverse. The unrestrained assumption that we are an organ bank for our close others would poison human relationships to such a degree that such closeness would be replaced by a savage calculus of obligation and demand. And beyond that power — economic, social, emotional — would come into play.

But how does one handle something like this — a historical development which appears to have its own momentum, running on the automatic assumption that the level of technology should determine the overall framework within which we make moral decisions?

Many would suggest that live organ donation should be illegal, with the exception of parent-to-child cases, and some other exceptions. And it should be, but that is hardly the key issue. More importantly, there needs to be a broadened understanding of the deeper consequences of these individual acts. A starting point would be an emphasis on the onus of the would-be recipient to refuse any offer. For what sort of person would not consider making the offer faced with the fear and pain of someone close? But what sort of person would accept such an offer?

Yet any attempt to argue for addressing both the legal and moral limits to live organ donation come up against the widespread belief that legal limits to any consensual activity cannot be justified. Leaving aside drug laws — which are unjustified — aiding suicide and consensual mutilation are the only private acts deemed illegal. Yet in other areas — wage rates for example — restrictions on private arrangements are widely accepted as right and just, and the social consequences of the deregulation of such widely understood. This did not just happen — it occurred as a consequence of transforming the political culture, of raising the level of public understanding and consciousness. Everyone knows this, yet few think of this new wave of social developments as amenable to a similar process — perhaps because such attitudes — those which make laissez-faire organ exchange seem an unqualified social good — run so deep. Yet it is their very depth which makes such a political circumstance ripe with possibility for the transformation of public attitudes.

Some of that will come from religious groups — one would hope. The Catholic bishops, so eager to intervene in the IVF access debate, may be less keen to tackle the capacity of the super-rich to furnish themselves with reconditioned body parts. Such would be a test of whether their motives for public intervention are motivated more by the ethical or prejudicial dimensions of their beliefs. But there is also a need to make visible an argument against living organ exchange on secular grounds — and thereby emphasising that if you start by dismembering living bodies you end up by dismembering the body of life.

No issue so vividly accentuates the dilemma of the individual and the social so viscerally as does that of organ donation. Nor does any other issue so neatly demonstrate the manner in which morality has been submerged within the limits of nature for all our history. In an era when possibilities reach towards the infinite, the onus falls on culture to understand and the manner and preconditions by which it lives — or fails to.

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