In On Liberty, John Stuart Mills sets out the utilitarian proposition that societies should grant individuals certain freedoms of action. To the extent that these freedoms do not hurt others or the society at large, Mill believes that people of sound mind and who are adults should be granted the right to make their own decisions.
In the case of a patient in need of a heart transplant (Mr. Doe) who wishes to pay a willing healthy man (Mr. Donor) to donate his heart, so that Mr. Doe may live, the ideas of Mill can be evaluated in a hypothetical scenario. Mr. Donor is assumed to be of sound mind and he is not a child who should be watched over. His decision to donate his heart and thus die in the process is made for a rational cause: he believes that in doing so, he will be able to support his family. Is this decision grounds for a doctor or governing body to step in and prevent Mr. Donor from going through with the exchange?
To many, this scenario might trigger a visceral response, perhaps of nausea, because in our society, we most likely would not consider going through with the exchange ourselves. However, in other societies, people might find this to be something they might consider. The rationality of the decision thus depends on one's societal context. If we as a society were to regulate such transactions, where should our power of the majority end? Should we regulate who has children, which occupations people should pursue, who has the right to receive education, etc.? Our society professes itself to be one which cherishes freedom. In this spirit, we might allow such a transaction to occur.
However, the case can be made that allowing such an act to occur could lead to other, even more questionable situations. For instance, should we allow people to be tortured and mutilated in a transactional exchange? There comes a point in which each society must decide on what it means, in the society's view, to be moral. This...