Who am I if all my cells have been built up again upon an identical pattern or if all my organs have been replaced?
SCENARIO
Imagine a technology that allows all the particles of which you are composed to be copied down to the last detail and to be reconstructed at a distance so that they are absolutely identical. You are transported by means of this technology to another planet. Unfortunately, the operator, a scientific genius, is a little absentminded, like all scientific geniuses. He forgets to destroy the original. There are therefore at the same moment two “you’s,” wholly identical, particle for particle. Who is the real “you”? The one who stayed on Earth or the perfect copy on another planet?
1 There exists a very ancient version of this kind of problem.
THESEUS’S BOAT
According to the legend, the Athenians were supposed to have preserved Theseus’s boat for centuries by replacing its planks one by one as they wore out.
2Some asserted that the boat remained the same. But others thought that it no longer had anything to do with the original, that it was a different boat.
Philosophers are still divided over this question, as of course they are over all the others bequeathed to them by the Greeks.
Be this as it may, what should interest us, from the point of view of moral reflection, is the fact that, once it has become technically possible to replace our original organs with other organs, natural or artificial, grafted or prosthetic, an identical problem now arises for us, and in a quite concrete sense.
Is the body of a person whose organs have been replaced by grafts or prostheses still the same?
As our laws are presently constituted, and independently of any metaphysical commitments, we should, according to certain jurists, answer that it is still the same.
3The body would thus be an entity that remained identical to itself regardless of any modification of its parts.
A criminal who, prior to his trial, had replaced all his organs (with the exception perhaps of his brain) with grafts and prostheses would nevertheless be liable to the same penalties. He would be the same but with different organs.
In other words, the body as support for identity and personal responsibility is an abstract and unalterable totality, and never a simple sum of its detached parts. It is as such that it is inalienable, that it is the bearer of certain rights even after death, whereas its elements and its products can, for their part, be yielded, exchanged, and replaced.
Insofar as the replacement of parts of the body does not alter identity and personal responsibility, there ought not to be any insurmountable moral or political obstacle to the circulation of elements of the body removed with the actual or presumed consent of its owner. For it would not be a violation of the body itself, which would remain an inalienable moral and juridical entity.
From all of the above, it follows that trading in elements or functions of the body does not at all signify commercializing the body itself.
Various “questions having to do with society” such as the legislation covering sex workers, the remuneration for blood or sperm donorship, and surrogate motherhood could be rendered less inflammatory if this legal distinction were respected.
Furthermore, it could be the case that in the future, through the advances made by medicine, we will end up seeing our organs as things that are somewhat alien to ourselves and that do not determine our identity.
The existence of a trade in organs would then become scarcely any more repugnant than that of a fruit and vegetable market or a market for items of furniture sold as separate units.
Will the moral problems posed for us by the “commodification” of the functions, products, and elements of the human body have disappeared?
Can we reduce to the status of cultural prejudices, destined soon to become obsolete, all the reservations that exist regarding the trade in organs or salaried surrogate mothers?
Do there exist universally and eternally valid moral arguments that could tell us why the trade in the parts and reproductive functions of the human body should be disallowed, even if the partners to such an exchange will it?
A disciple of Kant would say that it is because this trade is contrary to human dignity.
Why? Because every human person has a value and not a price. It is moreover precisely in this that their dignity consists. The human body being the support of the person, it inherits its moral properties. It has a value and not a price. Giving it a price, as is necessary when it is bought or sold, is violating its dignity.
Consequently, for the disciple of Kant, what is wrong in the commodification of the body is not the fact of its contradicting certain cultural norms that have nothing eternal or universal about them, but the fact of its violating this eternal and universal moral principle: the dignity of the human person.
However, does the appeal to human dignity enable us to distinguish in a sufficiently precise fashion between what can legitimately be bought and sold and what cannot in any circumstance?
Is it contrary to human dignity to receive remuneration in return for putting at someone else’s disposal our image or our scientific discoveries?
Why would it be contrary to human dignity to sell our skills at giving sexual pleasure or at bearing a child for another, but not to sell our skills as an athlete, our patience, our dexterity, our knowledge, or our intelligence?
It is contrary to the laws and mores of our society to receive remuneration in return for the gift of an organ. But in what respect is it contrary to human dignity?
