Many people find the idea of selling human organs for transplant to be repugnant which is why Roth argues that we should focus more on improving efficiency through kidney swaps. I’m all in favor of swaps and have also suggested that one argument in favor of no-give, no-take rules is that they are ethically acceptable to more people than organ sales.
Nevertheless, I think Roth assumes too quickly that repugnance is a constraint to be respected rather than an outrage to be denounced and quashed. People’s repugnance at inter-racial dating or homosexual sex is no reason to prevent free exchange – the same is true for organ donations. Repugnance itself can be repugnant.
Is it not repugnant that some people are willing to let others die so that their stomachs won’t become queasy at the thought that someone, somewhere is selling a kidney?
What people think repugnant can change rather quickly with changes in the status-quo. Adam Smith said that in his time there were "some very agreeable and
beautiful talents of which the possession commands a certain sort of
admiration; but of which the exercise for the sake of gain is
considered, whether from reason or prejudice, as a sort of public
prostitution." What were these talents that people in Smith’s time thought akin to prostitution? Acting, opera singing and dancing. How primitive, how peculiar.
In the not to distance future I think people will look back
on the present and think us
primitive and peculiar. Letting thousands of people die while organs that could have saved their lives were buried and
burned. So much unnecessary pain; all for fear of a little exchange. How primitive, how peculiar. How repugnant.