Beyond fair benefits: Reconsidering exploitation arguments

Julian J. Koplin1

1 Centre for Human Bioethics, Menzies Building, 20 Chancellors Walk, Monash University VIC 3800,

The question of whether we should allow the sale of ‘contested commodities’ such as organs, sex, gametes, and surrogacy services is of enduring interest within bioethics. One objection to such markets holds that they would be exploitative. I consider how we should understand these claims about exploitation, focusing on debates surrounding live donor kidney markets. Notably, exploitation arguments against kidney sales have been widely rejected in the bioethical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to kidney sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation (which I refer to as ‘fair benefits’ exploitation), and outline two additional ways that the charge of exploitation can be understood (which I discuss in terms of ‘fair process’ exploitation and complicity in injustice). I argue that although increasing payments to kidney sellers can mitigate or eliminate ‘fair benefits’ exploitation, such measures will not necessarily address ‘fair process’ exploitation or complicity in injustice. I conclude by considering the relevance of each of these forms of exploitation to the design of public policy.


Julian Koplin is a PhD candidate at Monash University’s Centre for Human Bioethics. He has published on the topics of organ transplantation, blood donation, and the methods of bioethics.