The trouble with many significant advances in medicine is that that they take us out of our moral depth. They may raise quite different problems from the ones we are used to and, if we are not careful, we may inadvertently undermine the wonderful potential of new technologies by forcing them into existing legal, ethical and institutional frameworks.
Transplantation is a case in point. Transplants save and transform lives; but the only way to get an organ is to take it from someone else, and this has produced a quite distinctive set of moral and practical problems. Not surprisingly, people have strong feelings about their organs, and ever since they understood that parts of their own bodies could be transferred to others, they have demanded explicit rights to control their use. Thousands of people deteriorate and die every year because the organs that could save them are not available, but transplantation scandals are hardly ever about lives unnecessarily lost: they are about organs said to have been improperly procured. Those are the stories that really stir up the public, and cause donation rates to drop still further.
This is something of which the transplant community is acutely aware. In a democracy, transplantation is entirely dependent on public support, and its practitioners know they must tread carefully, and not appear too rapacious in their search for organs. So they concentrate on working through persuasion (‘education’), constantly reassuring us that nobody has any right to demand the use of our organs. If we allow others to use the ones we can spare while we are alive, or the rest after we are dead, that is entirely through our altruism and generosity.