  It is not hard to see how, in principle, this style of coercion argument could work against organ sale. What is much harder is working out whether, in most of the cases envisaged, organ buyers have a duty to alleviate the poverty. The case most often discussed is where the organ purchaser is a rich Westerner and the vendor is someone desperately poor from the developing world. The Westerner, it is said, uses poverty to ‘force’ (coerce) the poor person into giving up the organ. This may be the case if the Westerner has a duty to alleviate the prospective organ seller's poverty. But, as well as difficult general questions about global distributive justice and the like, there is also the question of whether the individual in question is directly responsible for alleviating the other's poverty in these cases. The problem with attributing responsibility to individual organ purchasers is that the extent to which they have a positive ‘duty to rescue’ those in dire poverty may vary enormously depending on their own positions of wealth and power, and on the extent to which they have already done virtuous things in an attempt to act on their duties towards the poor.  For example, a Western organ purchaser could have already devoted a large part of her income and time to charitable projects aimed at the alleviation of poverty and may herself have relatively little money—just enough to buy a kidney. Do we really want to say that such a person has a duty to give her money to the prospective organ vendor without receiving the kidney (without which she may well die) in return?