If you are not OK with this, then your solution seems to fail. If you are OK with it, we still need to know why pharmacy policies will be allowed to be based upon some values (Catholic ones, say), but not others (White Pride ones, e.g.). This is not to say that these two perspectives are equally odious–they’re obviously not. But that doesn’t change the fact that we seem to need some criterion by which to rule some exclusionary policies as admissible and others as impermissible.

So basically, the problem goes away if you situate choice at the institutional level.

Another point I want to address. “The inclination, never mind the action, that one would like to engage in sexual intercourse with their direct sibling is a definite sign of inner confusion.” This claim seems to be unacceptably vague. Just what would the siblings be confused about? Are you referring to the transference of feelings for some non-related person to my sibling? In all fairness, this seems to be covered in the conditions of the situation where we specifically state that the attraction is genuine and mutual and in that case I fail to see any kind of “confusion” that could be taking place.

The issues raised in the cases presented are really no different than any other case where a woman struggles with the decision to carry a pregnancy to term or to terminate. Had either of the surrogates opted to terminate, we can no more say that decision was wrong than any other decision to terminate.

The larger ethical issue that arises out of these cases is the appropriateness of paid surrogacy. Is paid surrogacy any different from an ethical standpoint than buying a kidney for transplant? If a woman can rent out her uterus for financial gain, why can I not sell one of my kidneys for the same reason? Certainly there is a role for surrogacy as there is a role for organ donation, but it should be an altruistic gift. Donors or surrogates should not have to incur expense for their gift, but nor should there be financial profit for the donor/surrogate.

http://www.prospect.org/csnc/blogs/ezraklein_archive?month=04&year=2009&base_name=paul_ryan_embraces_health_care

Meanwhile, Republicans conjure up the Rationing bogeyman to make healthcare reform seem ill-intentioned, for example congressman Wally Herger (R-CA):

http://www.house.gov/herger/eupdate_health_GovtCare_Feb09.shtml

Maybe we should just call it “cost effectiveness” like the Brits do and wink.

For a variety of blog posts on organ markets and related matters, check out http://marketdesigner.blogspot.com/search/label/compensation%20for%20donors.

For a more general discussion of “repugnant markets,” you might be interested in my paper “Repugnance as a constraint on markets,” at http://kuznets.fas.harvard.edu/~aroth/papers/Repugnance.pdf

To the thought experiment proposed above. It is indeed an interesting case, but I would disagree with some of John’s conclusions. True, if there are only two people on the ship there is no one else to keep moral score. But, why are you so quick to discount the astronauts themselves? While this is a speculation, if I was in that situation I would very much care about my own internal scoreboard. It would matter to me that I have killed, regardless of who else is witness to the act. You seem to be assuming a rather Hobbesian conception of human nature and I do not think that it is all that justifiable. That being said, I am myself assuming a certain moral upbringing that would hold a norm against unjustified killing.

Interestingly enough, there has been a recent poll that suggests that Catholics are very much in line with the general opinion on many issues that are seen as divisive (homosexuality, abortion, etc):
http://www.gallup.com/poll/117154/Catholics-Similar-Mainstream-Abortion-Stem-Cells.aspx