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Accepting Organ Donation

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I recently had a discussion with a friend about objectivism. I explained that I am against an unequal exchange of value either in the form of giving or receiving. I used Galt's analogy of the cake:

"I who do not accept the unearned, neither in values or in guilt, am here to ask the questions you evaded. Why is it moral to serve the happiness of others, but not your own? If enjoyment is a value, why is it moral when experienced by others but immoral when experienced by you? If the sensation of eating cake is a value, why is it immoral indulgence in your stomach, but a moral goal for you to achieve in the stomach of others? Why is it immoral for you to desire, but moral for others to do so? Why is it immoral to produce a value and keep it, but moral to give it away? And if it is not moral for you to keep a value, why is it moral for others to accept it?"

She found the idea interesting, but quickly responded by replacing the cake with an organ. The scenario goes that I am dying and in need of a vital organ. A stranger, acting under altruistic motives, offers to give their organ to me (it is understood that the stranger will die).

I said that the stranger's act of sacrificing himself was immoral. She said that it was honorable. I was initially opposed to the idea of accepting the organ as it was an unearned value, yet I couldn't justify willingly extinguishing my own life and happiness as a matter of principle. I wouldn't accept the cake, but I would accept the organ. There is an obvious contradiction between action and ideology here.

Any ideas how to eliminate this contradiction?

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Any ideas how to eliminate this contradiction?

A couple of questions first:

  • Have you ever heard of this happening? Someone who does not know another person offers to give that other a person a vital organ and to accept death for himself?
  • Are you familiar with the essay "Ethics of Emergencies"?

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Now if the person was near suicide ANYWAY, and they saw that you valued life and they thought you were doing good things, then it's pretty plausible imo. But that's not a stranger. They'd have to know you. Maybe that's unrealistic though, because when a person sees someone that inspires them, they probably want to live life...

Edited by musenji
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  • Have you ever heard of this happening? Someone who does not know another person offers to give that other a person a vital organ and to accept death for himself?
  • Are you familiar with the essay "Ethics of Emergencies"?

No, I haven't heard of this happening. And, yes, I've read "Ethics of Emergencies" when I read The Virtue of Selfishness.

I just re-read it and found a few applicable quotes:

"if one is drowning, one cannot expect a stranger to risk his life for one's sake, remembering that one's life cannot be as valuable to him as his own."

This is the equivalent to the scenario that I proposed. I am drowning, or dying in need or organ, and I agree I cannot expect anyone to save me or donate their organ. What Rand never did was write from the perspective of the person being saved. Suppose it is your spouse who swims out to save you, or donates her organ. She dies out of rational knowledge that life would be unbearable without you. But what about your life? Would it not be unbearable with out her? She has potentially condemned you to the world she was escaping.

"Observe also that the advocates of altruism are unable to base their ethics on any facts of men's normal existence and that they always offer "lifeboat" situations as examples from which to derive the rules of moral conduct. ("What should you do if you and another man are in a lifeboat that can carry only one?" etc.)

The fact is that men do not live in lifeboats—and that a lifeboat is not the place on which to base one's metaphysics."

Ok, so yes I agree, these situations don't happen often and they are not good examples to base a morality on. However, the contradiction is bothersome. And perhaps there is a middle ground example- cake being at the insignificant end of the scale and organ donation being at the most extreme.

Also, a stranger was picked instead of a loved one to eliminate the situation in which you would deny the offer so as to save someone you valued.

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Ok, so yes I agree, these situations don't happen often and they are not good examples to base a morality on. However, the contradiction is bothersome.
The best way to resolve the contradiction is to accept that Objectivism has no answer to give one way or the other.

If I really faced a situation like this, I would assume that the gifter was insane and it would be wrong to take advantage of his condition. Of course, one can always keep tightening up a hypothetical in order to force a person to choose. Playing along with that, I would take the organ. I cannot see any contradiction and I reject whyNOT's claim that doing so would be immoral.

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A stranger's suicide on another's behalf, is insane, irrational and immoral.

To benefit from another's self-sacrifice is self-sacrificial, too.

So, you are given an organ (you might well receive in due course, anyhow) and

get a new lease of life - but could you live with yourself after?

After a self-sacrifice of this magnitude, one has opened the door to

any future selfless act in one's favor. Where do you draw the line?

Edited by whYNOT
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A contradiction, strictly speaking, is the simultaneous assertion of a statement and its negation. What exactly is the contradiction supposed to be?

If you didn't ask the stranger to make this sacrifice you didn't seek the unearned. If he really gets off on such bizarre activities, you're probably doing him a favor. Go ahead and take it (unless it's a brain).

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She found the idea interesting, but quickly responded by replacing the cake with an organ. The scenario goes that I am dying and in need of a vital organ. A stranger, acting under altruistic motives, offers to give their organ to me (it is understood that the stranger will die).

Legally speaking, would a doctor be able to perform that sort of operation (ie: killing a patient in good health)?

  • Have you ever heard of this happening? Someone who does not know another person offers to give that other a person a vital organ and to accept death for himself?

The movie 'Seven Pounds' comes to mind- Will Smith has to commit suicide before his organs can be harvested and given to specific people. (He actually falls in love with a woman who has a failing heart and at the end of the movie, she receives his.)

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Another thought comes to mind: "unearned" applies and makes sense only in situations where you might have earned but didn't; you get money by pestering your family rather than working, or you get somebody's respect by intimidating him or lying to him rather than showing real capability or virtue. I'm not sure that you can earn an organ donation (which typically comes from someone you never heard of, already dead), so I'm correspondingly unsure you could accept an unearned one.

I could live with myself in the situation described, as easily as I live with myself listening to NPR without donating.

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A contradiction, strictly speaking, is the simultaneous assertion of a statement and its negation. What exactly is the contradiction supposed to be?

If you didn't ask the stranger to make this sacrifice you didn't seek the unearned. If he really gets off on such bizarre activities, you're probably doing him a favor. Go ahead and take it (unless it's a brain).

I suppose the contradictory statements are as follows: 1.It is wrong to receive un-earned value (cake). 2.It is right to receive un-earned value (organ).

I think that the organ is legitimately unearned. Many altruists give without accepting payment, they just won't let you "earn" the value that they are trying to give. To accept this form of value would be immoral (cake, etc). The organ situation is the same - an altruist is offering a value (his life), and rejecting compensation.

Is it only in life or death situations in which it is acceptable to receive un-earned value at the expense of others?

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I don't see it, Reidy. This scenario is a different order of magnitude to your

mentioned examples. I think we are well aware that the 'trades' we make in life

are seldom totally even: in disconnected situations we sometimes emerge

with some sort of "profit", others we end up behind..

What is "earned" is what one gains in justice to reality - one's effort,

character, morality - and many immeasurables also.

I think it's rational to accept that we lose on the swings, gain on the

roundabouts, and don't worry about it.

But another person's deliberate death is way off the scale of earned 'trade'.

Edited by whYNOT
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Is it only in life or death situations in which it is acceptable to receive un-earned value at the expense of others?

Yes, I agree with that.

There is an important distinction between a person RISKING his life for a stranger (as one

might do oneself) - or, risking his life for a friend, etc. - and GIVING

it without a chance for that stranger.

If one accepts the second, one accepts altruism as principle; while the first indicates one's

value of life, and benevolence to others - or one's high value in a friend.

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I suppose the contradictory statements are as follows: 1.It is wrong to receive un-earned value (cake).
What underlies this principle though? Why is this wrong? What makes it wrong?

Since we're talking about unreal hypotheticals how about this: someone maroons you on a island in the middle of nowhere. It appears to have been inhabited once, many years ago, because you find some huts and even a small trench dug that brings water to the huts. Will you refuse to live in these huts and use that water because you did not build them yourself? What would be the reasons for your choice?

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What underlies this principle though? Why is this wrong? What makes it wrong?

Since we're talking about unreal hypotheticals how about this: someone maroons you on a island in the middle of nowhere. It appears to have been inhabited once, many years ago, because you find some huts and even a small trench dug that brings water to the huts. Will you refuse to live in these huts and use that water because you did not build them yourself? What would be the reasons for your choice?

Because "You didn't build that!" maybe? :)

I'd say the huts are a 'metaphysical given' (although man-made) and therefore fair game.

Neither earned, nor unearned.

A roughly equivalent scenario to a registered organ donor dying, and you are first on the list for his organ.

Edited by whYNOT
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Mm? I wrote "neither earned, nor unearned".
Fair enough, but in that case taking it from a donor who is giving it in all sanity, not in depression etc., and who will almost certainly give it to someone else, is just as "neither earned nor unearned". No pragmatism is presumed in the slightest.
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Fair enough, but in that case taking it from a donor who is giving it in all sanity, not in depression etc., and who will almost certainly give it to someone else, is just as "neither earned nor unearned". No pragmatism is presumed in the slightest.

Giving it in all sanity would indicate altruism/self-sacrifice in the extreme, and my rhetorical

question is should one benefit from self-sacrifice?

Besides, I'd have to check the OP again, but I was under the impression the guy commits

suicide with 'you' as beneficiary, alone.

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  • 3 weeks later...

Any ideas how to eliminate this contradiction?

I like your question, Luke. It's a challenging one. I hope you pass on my answer to the person you were talking to (she deserves the effort, it's a really smart question). Here's the source of your problem:

Objectivist Ethics is not a collection of principles that guides individual choices at various moments in a person's life. It's a set of principles that guides an individual's life, throughout his existence.

The statement "I, who do not accept the unearned, either in values or in guilt" does not mean "I live by the principle 'Thou shalt not accept the unearned, even if you need it'". It instead is a more literal statement of fact: "I have lived my life in such a way that I don't need any unearned values, therefor I don't accept them".

In the case of your example, the relevant Objectivist principle would be "make sure you have an organ at the ready (well, the resources needed to get one), from someone who doesn't need it anymore (a dead guy who left a will stating that his organs should be either sold or given to someone deserving), just in case something bad happens". If that proves impossible due to the immorality of others (in this case, a government ban on the free trade of organs), then the relevant principle becomes: "Morality ends where a gun begins". In that case, you are free to accept the organ wherever you can get it from.

The fact is, in a mixed capitalist/statist society, in some areas of life individuals are forced to survive, rather than live (in the fullest sense of the word). Because the area of organ transplants is fully communistic (nothing mixed about it, the government handles organ transplants the exact same way the Soviet Union handled more basic material values like food), this is definitely the case in your example.

Edited by Nicky
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I suppose the contradictory statements are as follows: 1.It is wrong to receive un-earned value (cake). 2.It is right to receive un-earned value (organ).

I think that the organ is legitimately unearned. Many altruists give without accepting payment, they just won't let you "earn" the value that they are trying to give. To accept this form of value would be immoral (cake, etc). The organ situation is the same - an altruist is offering a value (his life), and rejecting compensation.

Is it only in life or death situations in which it is acceptable to receive un-earned value at the expense of others?

No. In the Soviet Union, accepting the unearned would've been an act of survival in the face of a gun (hence, not immoral, because morality doesn't apply) in even the most common of circumstances. You could've still tried to escape, or used the black market to some extent, but neither of those would've been always possible.

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Rejecting something unearned when there is no option to earn it and you need it, is itself a form of self-sacrifice.

This applies to societies with mixed economy, as Nick has clearly pointed out. We benefit everyday from goods provided by the State from coercitive expropiation of others' wealth.

Rejecting such benefit when all other options have been closed by the current system would be self-sacrificial.

Other situations involving the unearned is good luck. From time to time, you happen to find goods or oppotunities that you didn't strive for, and nevertheless you take advantage of.

As Nick suggests, living by principle does not imply rationalism (an epistemological flaw by which we deprive concepts from their referents in reality). A principle is a valid code of conduct as long as it remains connected with the facts of life.

"Wake up early" "Work hard" "Brush your teeth" are not absolutes. And neither "Don't accept gifts from strangers" is an absolute.

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