You may have read stories on the coming challenges with self-driving cars, including this Crux piece by Timothy Carone. You may also have read pieces on coming challenges with organ shortages for transplant. But you likely haven’t read a piece which attempts to demonstrate a strong connection between the two.
A recent Slate article by Ian Adams and Anne Hobson began by noting about 6500 Americans die each other waiting for an organ transplant. Waiting lists, they say, have doubled in the last generation especially as chronic diseases affecting the liver and kidneys have become more and more prevalent.
The hook of the article, however, is kind of shocking and morbid: fatal car crashes are a main reason the problem isn’t even worse. Given that 1 in 5 organ donations come from such events, the advent of self-driving cars—and significantly fewer fatal accidents—suggests the fact that more people will die waiting for organ transplants.
Just because a truth is shocking or morbid doesn’t make it any less worthy of our attention. If it is true that we are going to face even more organ shortages in the future then we ought to be thinking about how to address the coming problem.
But is it actually the case that we will face such new and dramatic shortages?
Maybe not. Autonomous cars are still at least five years away in terms of technological development, and many more years of waiting will be added in light of the legal, social, and economic changes that will be necessary to make self-driving cars become the new norm.
How will the relationship between computer and human driving work itself out? How will insurance function and legal responsibility be decided? How likely is it that the computer driving the car could be hacked? How long will it take the technology to become cheap enough for regular folks to afford it?
The years it will take to answer these questions are a lifetime in the world of technological innovation.
In the meantime, technological advances in organ creation will be proceeding apace. It is now over a decade since the first laboratory-created bladder was successfully implanted into a human being and we are on the verge of several new and important breakthroughs when it comes to creating human organs.
Small, functioning human “liver buds” have already been created by Japanese scientists—and they have been shown to connect to blood supply and function in mice.
When it comes to kidneys, lab experiments creating these organs for rats and pigs have been successful, and 2016 saw scientists figure out how to produce virtually unlimited numbers of kidney cells. Wake Forest researchers even have incredible video of a kidney prototype being “printed” in a laboratory.
It may be the case that, before self-driving cars replace the current fleet of those driven by humans, we may be able to “print” the organs we need on demand in a hospital.
But suppose I am wrong. Suppose self-driving cars arrive well before we can print human organs on demand. Should Catholics take the lead in encouraging more organ donors?
The history of Catholic teaching on organ donations and transplants has been complex. The Church rightly started out skeptical when the technology arrived on the scene, at first thinking that it might constitute a kind of bodily mutilation.
But upon moral-theological reflection, the Church has come to see organ donation and transplant as a good to be pursued. Pope St. John Paul II, for instance, insisted that we “should rejoice that medicine, in its service of life, has found in organ transplantation a new way of serving the human family.”
Pope Benedict used the language of “gift” in calling organ donation and transplant a “witness of love.”
But Benedict also had a warning to go along with his affirmation. The logic of “gift,” he said, is incompatible with raw utilitarian calculations about the most efficient way to save the most number of lives. Attempts to save lives via organ implants are very good things which ought to be pursued, but we must not ignore moral and anthropological truths in so doing.
“The body,” he says, “can never be a mere object.” If we make policies which treat it as such, then “the logic of the market” becomes dominant.
Going down the road of organ sales, the pope rightly points out, would make utilitarian and discriminatory judgments the norm. Those of us with a preferential option for those on the margins, should be concerned about tremendous, even coercive social pressure that would be put on economically disadvantaged people to sell their organs.
Unfortunately, broad-based organ sales are precisely what Adams and Hobson are calling for in their article. While they admit “it isn’t unreasonable to surmise that some in these [poor] communities might have strong monetary incentives to sell their organs,” they nevertheless claim that the very same communities would be the one to benefit the most from fewer organ shortages.
The authors even use egg sales for IVF as an example where, presumably, what they are calling for has worked out just fine.
On the contrary, the commodification of the human body present in allowing sales of ova, sperm, gestational services, etc. is the canary in the coal mine which should warn us against doing anything similar. Nearly the entire reproductive process is currently being defined by market forces and assumptions.
India, for instance, recently banned foreigners from buying gestational surrogacy services because the market created by this process was exploiting poor women.
Though Adams and Hobson invoke it in support of their position, our culture’s market-induced shift from procreation to reproduction is precisely what Pope Benedict had in mind when he offered his warning about applying the same logic to other body parts.
Organ donations and transplants are indeed witnesses of love. But in order for them to remain such (and not just another market transaction governed by utilitarian calculations) they should be pursued in ways which honor the truth of the human person and what it means to give someone a gift.
Charles C. Camosy is an associate professor teaching biomedical ethics in the theology department at Fordham University.
