Published online by Cambridge University Press: 30 January 2009
In ‘The Survival Lottery’ John Harris raises the following issue. Suppose it is possible for physicians to save the lives of two patients, Y and Z, otherwise doomed to die through no fault of their own, by taking the life of a third person, P, and using various of his organs appropriately for transplants. To provide a fair and impartial way of selecting the organ donor, a survival lottery is proposed for the society. This lottery randomly selects an organ donor from the population at large. Harris, speaking from the point of view of Y and Z, defends the demand that such a lottery be established. What if anything is wrong with this scheme?
1 Harris, John, ‘The Survival Lottery’, Philosophy 50, No. 191 (01 1975), 81–87CrossRefGoogle ScholarPubMed, For other commentary, see: Morillo, Carolyn R., ‘As Sure as Shooting’, Philosophy 51, No. 195 (01 1976), 80–89CrossRefGoogle ScholarPubMed; Hanink, J. G., ‘On the Survival Lottery’, Philosophy 51, No. 196 (04 1976), 223–225CrossRefGoogle ScholarPubMed; Singer, Peter, ‘Utility and the Survival Lottery’, Philosophy 52, No. 200 (04 1977), 218–222CrossRefGoogle ScholarPubMed; Trammell, Richard L. and Wren, Thomas E., ‘Fairness, Utility and Survival’, Philosophy 52, No. 201 (07 1977), 331–337CrossRefGoogle Scholar. Future references are to these papers.
2 Trammell and Wren note this lottery of Nature, but their claim to have thereby found a reductio against Harris for generating an infinite regress of lotteries is vitiated because they consider only the organ redistribution lottery without utilitarian gain (op. cit., 333).
3 Morillo assimilates the proposed society to our own by asserting: ‘Perhaps… we do require saintliness of those eligible for the draft’ (p. 81). This is misleading. The draft is more reasonably construed as a risk incurred to avoid a greater harm.
4 Hanink notes this point, but his example is very weak. It is arguable, contra Hanink, that a ship's crew should expel an immune carrier of a highly contagious fatal disease if quarantine were not possible (op. cit., 225).
5 For the first, see this paper supra and Trammell, and Wren, (p. 322passim)Google Scholar. For the second, Morillo, (pp. 88–89)Google Scholar. Third, Hanink, (pp. 224–225)Google Scholar and this paper infra.
6 Op. cit., 88.
7 I do not intend C to be strictly true. Its purpose is merely to spell out the sticking point at which we find B unacceptable as it stands.
8 I have spoken as though the lottery were a good idea to bring out the strength of B′. This is unlikely. Singer remarks that ‘to pool the risk [of producing bad health] with others reduces the incentive to avoid loss…’ (p. 221). Worse yet, since the lottery reverses natural selection, it guarantees progressive genetic decline.
9 Op. cit., 218–219.