Organ transplantation is at once a technology that raises new ethical problems and a good testing ground for various moral principles. It has become a common procedure in some countries and, at least in the United States, promises to become even more so. It poses questions about costs and benefits as well as the very large question of whether we should try to renew human life indefinitely and, if so, at what cost. It raises the problem of whether organs are the property of their possessors – at least when the possessors are competent adults. It raises issues of organ sales, of what might be called donor recruitment, of informed consent, of reparations when transplant fails, of eligibility for transplant, and of competition for medical time and expertise between transplantation and other, less dramatic kinds of medical care. This essay touches on all of these topics, with the aim of identifying the broad dimensions of the ethical problems of organ transplantation and some of the moral principles that may help us solve them.

Morally speaking, is abortion murder? This is what I am calling the ‘abortion problem’. I claim that neither pro-life nor pro-choice advocates have the correct solution; that the correct solution is instead one considered correct by relatively few people. But if this solution really is correct, then why, after years of intense debate, is this solution not more widely accepted? Many, no doubt, are precluded from accepting it by religious dogma. But others, I think, fail to arrive at a correct solution because they have been approaching the problem from the wrong theoretical framework. Or they have been approaching it without any theoretical framework at all. That is, they have no theoretical framework beyond that of merely examining their moral intuitions and, if anything is clear so far from the abortion debate, it is that intuitions alone, which differ radically from person to person, are not sufficient to solve the problem. In short: one is unlikely to arrive at the correct solution unless one starts from a sound theoretical framework. I shall, in what follows, sketch what I take to be a sound theoretical framework. Then I shall try to show what solution to the abortion problem follows from it.

There are a variety of arguments regarding which entities on earth have intrinsic value and therefore deserve ethical consideration. The thesis that only human beings have intrinsic value has waned considerably in recent years, mainly thanks to the efforts of animal liberationists. There now seems to be wide agreement that ethical consideration should be extended to entities beyond human beings. Disagreements are concerned with how far it should be extended: to animals with similar capacities to humans, to all sentient beings, or to all living beings, or even to the whole ecosystem?

Women tend to earn less than their male colleagues. Furthermore, women tend to earn less than men who hold jobs that are nominally different but relevantly similar to their own. Advocates of ‘comparable worth’ protest these facts. Their protest sometimes takes this form: Those differences in pay between men and women are undeserved. The argument for this claim is simple. Some facts are relevant to the wage one deserves for performing a given job; some are not. In the vast majority of cases, the argument continues, gender is not relevant to the wage one deserves; relevant are, say, the skill, responsibility, and working conditions required by the job. When jobs are comparable with respect to these facts, those who work in them deserve equal pay. Therefore, women and men who work the very same jobs deserve equal pay; likewise for women and men whose jobs are nominally different but relevantly similar.

It has been commonly accepted that Bentham, in his theory of constitutional law, aimed to replace the natural opposition of interests which existed between rulers and subjects with an artificial identification or junction of interests. This was brought about by making it the self-interest of rulers to act in such a way as to promote the general interest. In other words, any sinister interest to which the ruler was exposed, that is any desire he might feel to sacrifice the general interest to his own particular interest, had to be nullified: this would leave that part of his interest which coincided with the general interest as the only interest by which his conduct could be determined.