ABSTRACT
This chapter argues that the major autonomy-based arguments against the moral acceptability of a current market in human kidneys are all mistaken. Paul Hughes's anti-market argument is based on the recognition that removing barriers to one's ability to exercise personal autonomy in certain ways need not be required by respect for that autonomy because the possession of certain 'constraining options' might lead to the autonomy of those who possess them becoming impaired. The chapter discusses such constraining options and provides two examples: Mill's option to sell oneself into slavery, and an addict's option to take the drug to which he was addicted. It is plausible to hold that if a system presupposes and/or reinforces an autonomy-impairing situation, then that system is itself autonomy impairing. The evidence from both Chennai and Villivakkam shows that the sale of a kidney is not likely to enhance the economic status of the typical vendor.
