Tuesday, June 28, 2011

The flesh market

The World Health Organisation has estimated that about 10 per cent of organ transplants around the world stem from purely commercial transactions. A website in Philippines allows service providers and consumers to find and interact with each other. Naoval, an Indonesian man with "AB blood type, no drugs and no alcohol", wants to sell his kidney. Another man says: "I am a Filipino. I am willing to sell my kidney for my wife. She has breast cancer and I can't afford her medications." Then there is Enrique, 21, who is "willing to donate my kidney for an exchange".

Trade in organs follows a clear pattern: people from rich countries buy the organs, and people in poor countries sell them. Body parts from the poor, war victims and prisoners are bought or stolen for transplant into affluent ill people. Organ trafficking depends on several factors. One is people in distress. They are economically or socially disadvantaged, or live in war-torn societies with prevalent crime and a thriving black market. On the demand side are people who could die if they don't receive an organ transplant. Then there are organ brokers, who arrange the deals between sellers and buyers. Well-equipped clinics and medical staff are also needed. Such clinics can be found in many countries, including Iran, Pakistan, Ukraine, South Africa, and the Philippines. The Philippines is known as a centre of the illegal organ trade and a "hot spot" for transplant tourism. Some people live in such extreme poverty that they will do virtually anything for a chance to escape, however slim.

Trade in humans and their bodies is not new, but today's businesses are historically unique, because they require advanced biomedicine. One of the more obvious manifestations of treating the human body as a resource to be mined is the hospital waiting list, used in many countries. Says one organ recipient "I'm not the kind of man who uses other people, but I had to. I had to choose between dying and getting back my life." The biological imperatives that guide the priority system of waiting lists are easily transformed into economic values. As always where demand exceeds supply, people may not accept waiting their turn - and other countries and other peoples' bodies give them the alternative they seek.

Socialists often point out that the working class are exploited by the capitalist class but here is an example where capitalism not only live off the poor but actually use their body organs to profit!

Middlemen, beyond taking large profits, encourage the trade by assuring buyers that the transaction is conducted ethically. The dramatic medical benefits sanction what would otherwise be seen as exploitation.
"The crimes are covered up," Scott Carney writes in his book The Red Market "in a veil of altruistic ideals."
The economic promise of these compromised transactions is so often elusive. One reality is that people who sell bodies and body parts rarely see their lives improved. Many of these transactions are against the law, of course. Buying and selling transplant organs is illegal almost everywhere, for instance. The trade persists, according to Carney, as a result of two major flaws in the transplant system. First, while the law prohibits the buying and selling of organs, it does not prohibit anyone from billing for the services involved in transplanting organs. This provides doctors and hospitals with a financial incentive to perform transplants, while the costs of the organ are absorbed into the larger transaction and easily hidden from view. The second flaw is the practice of making organ donation anonymous. You can buy an organ without knowing where it came from, and it thus becomes mere tissue rather than part of a human being. Anonymity does not merely dehumanise donors, however; it also endangers them by making it easier for buyers and brokers to escape accountability for deaths and injuries.

Carney estimates he is personlly worth $250,000 if he was sold for body parts. "... bodies are unquestionably commodities... As a product, bodies aren't assembled new in factories filled with sterile suited workers; rather they are harvested like used cars at scrap markets. Before you can write a check and pick up human tissue, someone needs to transform it from a tiny piece of humanity into something with a market value..."

It is feasible to conceive of a system that allows for organ transplants. It would depend on the existing norms of altruism and education. I'll leave the readers of the SOYMB blog to deduce our proposed alternative...it starts with an s...

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