Corrupt autocracy. Theocratic oppression. Legal and illegal organ markets. If this description screamed “Iran” at you, you’d be correct. Recently, investigative work by the likes of the Guardian, Los Angeles Times and New York Times, among others, has revealed the pervasiveness and scope of the kidney trade in the world’s largest and strictest theocratic state. While these revelations dismayed many in the West on supposedly moral grounds, Iran’s organ trade ironically represents one of the most individualist and libertarian economies in the world. By offering every citizen complete economic rights over their own body, the Iranian government sets a global example in changing anachronistic and paternalistic attitudes toward self-ownership and the inherent body sovereignty humans ought to enjoy.
As the only country worldwide where buying and selling one’s organs is legal (since 1967), Iran is commonly viewed within medical circles as an oddity. Prospective donors, through Ministry of Health-affiliated organizations, are matched up with potential recipients. In a government-mediated transaction, the approximately 1400 Iranians who annually undergo this operation are put under the knife. The flat-rate, $2,000-4,000 compensation provided by the government, is usually sorely inadequate and extremely belated. And in a country where the poorly designed and regulated system nevertheless allows for such transactions, economic necessity and time constraints have birthed a flourishing black market.
A black market kidney can net thousands more than the legal alternative and circumvent the lengthy, often months-long waiting period inherent to government-facilitated exchanges. The risks are real and the cost high; travel is often required to seedy clinics, and one can only imagine the draconian punishments meted out by Iran’s moralistic law enforcement. The costs are high, the potential for trouble and complications evident. And despite these substandard conditions, the popularity of these important markets highlights one of the rare moral successes of Iran’s otherwise broken system.
The humanism on which modern, Western culture is founded professes respect for individual humans. This respect is contingent on the recognition of one’s ownership of their self; essentially their body and whatever “soul” may or may not be posited to reside within. Property can be taken to denote a relationship between an individual and an object, over which he or she exercises certain rights. If we accept such a definition and we accept the human body as the most intrinsic and inviolable example of private property, we must conclude that self-ownership forms the basis for respect of one’s body and the rights to freedom from harm and oppression.
This self-ownership, then, denotes one’s right to do with one’s body as he or she will. Given that no harm befalls anyone else, selling one’s body for any purpose is fully compatible with liberal, humanist notions of personal freedom. The extent of this right can know no bounds; limiting it would raise serious ethical problems about the freedom allowed to the individual. Therefore, we can conclude that restricting one’s ability to, say, sell their organs or prostitute themselves is a serious infringement on their rights as a human being.
From these premises, we can also deduce that any attempts to limit these rights are illiberal and immoral. Governments have often done more harm than good when trying to limit individual freedoms and contravening the moral imperative to protect their citizens and their personal rights. Conversely, whenever states have loosened the aforementioned restrictions, societal benefits have been realized. From Portugal’s comprehensive drug decriminalization scheme (and a subsequent drop in HIV and AIDS and overdose death rates) to Australia’s diverse regulations on legal prostitution (e.g. Australia’s approximately 20,000 prostitutes must undergo rigorous STI testing), ceding body sovereignty to the public has been widely successful. It must be noted that similar arguments are used by pro-choice advocates; the mostly male politicians who constantly shoot down pro-abortion legislation in the US don’t have a uterus, so why should they get a say in what women do with their bodies?
In all these cases, more personal freedom has resulted in more favorable social conditions and attitudes towards human beings as worthy of personal autonomy. One can safely point to Iran’s respect for body sovereignty as an example to be followed, especially by Western, liberal societies which have so long championed progressiveness and individuality as foundational tenets.
Critics of this position are always quick to point out that organ sellers often have no choice but to sell non-vital organs, due to economic hardship and necessity. Many will also point out that legalizing the organ trade could lead to the blurring of the fine lines between permitted and illicit. I concede that these are valid points, but both fail to address a key ethical question: Is it moral to condemn someone to economic hardship and refuse them the right to do with their own body as they wish? The main motivation for most Iranian organ sellers is indeed a desperate, exploitable need to escape dire financial straights, but is this not all the more reason to offer a legal, regulated way to economic stability?
From the premises laid out above, it seems quite evident that Iran leads progress on at least one social issue. Despite the autocracy’s obvious and reprehensible human rights record, and perhaps because of it, we should revisit our own progressive society’s immoral and illiberal ban on exercising one’s ownership of their body in accordance with his or her personal sovereignty.