When Altruism Isn't Enough

Sally Satel wants kidney donors to be paid:

Financial and humanitarian motives do not reside in discrete realms. Moreover, it is unclear how their comingling is inherently harmfulthe goodness of an act is not diminished because someone was paid to perform it. The great teachers who enlighten us and the doctors who heal us inspire no less gratitude because they are paid. A salaried firefighter who risks her life to save a child trapped in a burning building is no less heroic than a volunteer firefighter. Soldiers accept military pay while pursuing a patriotic desire to serve their country. The desire to do well by others while enriching oneself at the same time is as old as humankind. Indeed, the very fact that generosity and remuneration so often intertwine can be leveraged to good ends: to increase the pool of transplantable organs, for instance.

The practice of assigning values to body parts has roots in antiquity. The Code of Hammurabi provides an elaborate schedule of compensation for them; for example, it specifies that if an individual should “knock out the teeth of a freed man, he shall pay one-third of a gold mina.” Today we routinely assign valuation to the body. Human blood plasma is collected primarily though paid donation. Personal injury lawyers seek damages for bodily harm to their clients. The Veterans Administration puts a price on physical disabilities. We pay for justice in the context of personal injury litigation in the form of legal costs, and for our very lives in the form of medical fees. There is little reason to believenor tangible evidence to suggestthat these practices depreciate human worth or undermine human dignity in any way.