We might want to idealize the distinction between morally virtuous gift-exchange and selfishly-motivated market transactions, but this boundary is crossed too often in practice for us to draw a bright line. Moreover, it is crossed in both directions: gift-exchange is often made a vehicle for self-interest; market transactions routiney have strongly moralized or normative aspects.

True enough. Most real-world practices do not neatly conform to one side or another of an ideal-typical dichotomy. But does this (perhaps inevitable) blurring of boundaries mean that we must give up making all such distinctions in the first place?

It is illegal to buy and sell babies on an open market (and, interestingly enough, the woman who places a child for adoption is said to be “giving up” her baby). But of course money does change hands in many adoptions, via the intermediary of the adoption agency. From one persepective, I suppose one could say that paying thousands of dollars to an adoption agency is not so very different from buying a baby on a market? In fact, I think it is sufficiently different to warrant our making a distinction, but still, it does look as though the transaction is not purely non-market, either. Is the blurring of the boundaries in this instance enough to justify our lifting the prohibition against baby-selling?

I found your post thought provoking and am crossposting this on OrgTheory.

Why should people feel any moral obligation to participate in a system that does not serve them well in other respects? To think otherwise is a kind of gift fetishism – the belief that we can guarantee the fairness of an exchange simply by insisting that it take the form of a morally obligatory gift.

You are right. Organ exchanges in the form of gifts are similar to aid disbursements from rich governments to poor ones. There’s a tangible benefit in that someone gets something but the fairness of the exchange is often in doubt.

But I do agree with Etzioni’s point that there should be a readily accessible online honor roll of organ donors. That actually would make the importance of organ donation real in an informational sense. Right now it’s like computer code that hasn’t run through a compiler. Individual acts of kindness do have an assigned value, often a huge one, but people must know about the donation in order for the value to become clear.

My dear friend and former colleague Saneeya Hussain, a peioneering Pakistani journalist and environmental campaigner, died two years ago in Sao Paulo, Brazil and took the unusual step, for a Muslim woman, of donating her kidneys. They went to Brazilian recipients, a fact reported with pride and awe in newspapers across her native Pakistan and in Nepal, where she had worked for an NGO. Her one individual act changed attitudes profoundly across South Asia and I have met people since who are inspired and will donate as a result.

What we need is a well-designed, multi-language organ donation portal with relevant links, community forums, and an honor roll. That would obviate the value of organ donation and set it apart from mere “gifts.”