In Organs for Sale: Bioethics, Neoliberalism, and Public Moral Deliberation, Gillespie examines human organ debates to critique neoliberalism's predominance in and preemption of public moral deliberation. Although organ sales have been previously analyzed by economists and philosophers, Gillespie employs a unique rhetorical lens to discern the positions, justifications, and typical lines of argument representative of each camp. This distinction allows Gillespie to hone in on the argumentative dynamics of public advocates and construct a thorough overview of the debate. The rhetorical landscape is positioned as an exchange between two main camps: the market advocates, who rely on the “autonomy, efficiency, and consistency” allotted by markets, and the altruism advocates, who insist that “virtue, justice, and civic community” are better norms with which to guide the exchange of organs (196–197). This debate is framed in the terms of neoliberalism, a political theory that “asserts the centrality and priority of individual rights, marketization, and free markets in human well-being.” (18) Gillespie argues that the expansion and resonance of neoliberal rhetoric weaken public morality by shrinking the civic duty to deliberate, relegating moral deliberation entirely to supposedly neutral, amoral market forces.In Sections 1 and 2, Gillespie outlines the current organ donation policy and conducts a rhetorical analysis of the main arguments, tropes, keywords, testimonials, horror stories, and urban legends that each camp deploys. The altruistic camp, whose position is reflected in current U.S. law, argues that altruism is “inspirational,” “enacts justice,” and “promotes and performs civic community” (59). The case for the altruistic system is undergirded by an emphasis on civic virtue, an “attitude” that needs to be cultivated and publicized to increase organ supply (55). Official stories, like those on OrganDonor.gov, feature testimonials of organ recipients and public service announcements meant to inspire others to donate. Celebrity organ recipient testimonials, such as those of Alonzo Mourning, Steve Jobs, and Tracy Morgan, give voice to the altruistic system and tend to garner more mainstream attention. Fictional accounts, including films, television shows, and novels, also contribute, albeit in artistic or dramatized ways, to the organ debate. Social media campaigns, either for publicity or crowdfunding, play a similar role in characterizing donors and recipients. These various forms coalesce into a rhetoric of altruism that promotes “a particular view of the virtuous citizen,” who contributes to the organ deficit through the selfless act of donation (51).Market advocates, whom Gillespie contrasts with the altruists, seek to persuade the public that financial compensation for human organs, either through a regulated market or through incentivization, “is rational, efficient, and consistent with public values” (60). Here too, Gillespie conducts a rhetorical analysis of the prominent stories told and language used by market advocates. The horror stories of botched black-market surgeries and deceitful medical malpractice are used ubiquitously by market advocates, implying that a regulated, transparent market would eliminate illicit sales (60, 66). Market advocates also argue that the altruistic system is already undermined by an otherwise thriving market in body parts—like sperm, ova, and plasma—and in the thousands of dollars paid to doctors and medical personnel for transplants. Stories of willing buyers in the United States and of desperate sellers in economically impoverished areas testify to the existence of a market, ostensibly whether altruism advocates like it or not. These arguments, often oriented toward “choice” and “transparency,” make the case for an organ market on the neoliberal premise that it would maintain autonomy, efficiency, and consistency with current practices (83).In Sections 3 and 4, Gillespie crystallizes his critique of neoliberalism, first by providing an overview of the pluralistic dilemma of liberal democracy. Pluralistic democracy demands that “ethically diverse” members of society reconcile their moral doctrines through public deliberation, a perpetual “tension” emblematic of the “cooperative search” for the good life (214). For Gillespie, the quality of contemporary public discourse regarding the morality of the sale of human organs resembles a limp rope rather than a tension. The reason, he argues, is that the supposedly neutral market has become a “default” setting that preempts moral deliberation altogether (177). The neoliberal predominance of the “Civic Restraint Principle,” best known by the colloquial maxim “You do you, and I'll do me,” centers individualism as the essential ethic (99).Dumping the burden of moral deliberation onto the Civic Restraint Principle does not make us principled, Gillespie argues; it makes us pragmatic. This is not to say that neoliberalism is necessarily immoral. Gillespie writes to reinvigorate a public deliberation that “argues about morality—even if those arguments are fierce and at some level intractable,” rather than resigning to individualistic relativism (205). He argues that neoliberalism shouldn't be defaulted to without proper consideration of the ethics of organ sales. If total individualism is taken as an ethic, it effectively opts out of important moral disputes. When “bracketing” is taken as an ethic in itself, the result is a vacancy of any ethic. In this way, neoliberal rhetoric “hijacks the very practice of and space for public moral deliberation,” conceiving it strictly as an individualized affair (201).Gillespie maintains that tolerance is a virtue, albeit a flimsy ethic on its own. Indeed, Gillespie concedes, “the liberal virtue of tolerance is vital” given the dilemmas of pluralism (152). In a healthy democracy, however, citizens owe much more to each other. Moral deliberation cannot be minimized to individualism. In Michael Sandel's words, “‘moral reflection is not a solitary pursuit but a public endeavor’” (16). Moral disputes, which are often categorical, must be justified in the public sphere, given normativity through good reasons. The weighing of reasons is done rhetorically; the stories, characters, and language that make up public moral deliberation have rhetorical force that persuades deliberative participants to make judgments about which reasons matter most. Gillespie sums up his deliberative theory unambiguously: “The search for moral truth, to be codified under law, is collective and procedurally intersubjective, but morality itself is not” (152).Ultimately, whether “dignity is or is not violated by organ sales” represents a key turning point in the organ market debate (158). Markets, even regulated ones, can exploit vulnerable and socioeconomically exploited populations. If a kidney or a piece of liver were worth fifty-thousand dollars, “a struggling low-income person would, ostensibly, be unable to turn down such an offer” (172). The asymmetrical nature of the exchange suggests to status quo altruists that a certain degree of exploitation is taking place. They insist that market mechanisms are blind to the “background condition that makes the actual contractual engagement—even if undertaken voluntarily—morally suspect” (169). Gillespie notes, however, that “the need for an organ by a person in dire straits and facing death is not exactly an empowering situation either” (172).Market advocates use the concept of dignity differently. They consider the blindness of market mechanisms to be a form of fairness and neutrality from the moral paternalism of the allegedly dignified majority, or worse, the state. Dignity, in neoliberal logics, inheres in the freedom to choose whether selling an organ coincides or conflicts with one's own moral compass. Restricting this choice would be to impose a bourgeois definition of dignity on less privileged classes. What dignity means, market advocates argue, may be established by the tyranny of the majority, and thus should remain an individualized, privatized concern.Gillespie ends with a short self-reflection, wherein he acknowledges that, even after gauging the moral complexity of the question of the organ market and criticizing the lethargy with which neoliberalism addresses it, it would make sense, under certain circumstances, to buy an organ. Readers should not look to Gillespie for an answer to the moral question of organ procurement. He insists, rather, on a revitalization of public deliberation on the matter. Public deliberation cannot be reliant on a neoliberal, marketized principle of civic restraint in place of affirmative moral considerations (101–102). Students and scholars of the rhetoric of science, bioethics, and political theory, particularly in the areas of discourse theory and pluralism, would benefit from Gillespie's exploration of the moral deliberation surrounding organ sales.