The Economy Fuelled by Flesh and Blood
by Donna Dickenson
Oneworld, 320 pp., $27.95
To be cured by the hangman's noose did not always have so ominous a sound.
Throughout the Middle Ages, executioners routinely dissected the bodies of their victims, and sold the various parts as medicinal remedies. Human fat, rendered from the bodies of criminals, was used to treat a variety of ailments, including broken bones, sprains, and arthritis. For those suffering a bad cough, a potion might be administered, which would include pieces of the human skull ground to a fine powder. Epileptics sought out public beheadings so they could drink from the criminal's blood while it was still warm and supposedly at the height of its efficacy.
If you think such grisly practices have gone the way of feudalism, Body Shopping: The Economy Fuelled by Flesh and Blood will make you think again. A professor of medical ethics and humanities at the University of London, Donna Dickenson gives an account of modern medicine that seems better suited to the Dark Ages or the most dystopian science fiction than the 21st century. For all the talk of "scientific progress," it seems we have become only slightly more sophisticated in our uses and procurement of the human body than the medieval hangman.
Body Shopping describes a science that has become positively vampiric in its insatiable appetite for human tissue and organs, sometimes outright stealing the raw material it needs. A veritable black market in human flesh has been established, with each part individually appraised and priced: "Hand, $350-$850, Brain, $500-$600, Eviscerated torso, $1,100-$1,290." A whole cadaver can fetch up to $20,000. The uses to which this tissue is put are no less gruesome. Bone dust from stolen cadavers might be found in your dental work. The collagen used to plump a starlet's lips is likely derived from the cells of an infant's foreskin. The "secret ingredient" in the various beauty treatments marketed to Russian women? Aborted fetuses from Ukraine.
"One way or another someone makes money off the dead," one proud body snatcher declared, even as he pleaded guilty to over 60 counts of mutilation of human remains, and embezzlement. The entrepreneurial spirit cannot be tamed, it would seem, especially in so lucrative a venture as body shopping. Funeral homes plunder bodies for spare parts and sell them to hospitals and biotech firms. In one much-publicized case a New Jersey mortuary service sold the cancer-ridden bones of Alistair Cooke--along with parts from other unfortunate "clients"--to one of the country's largest tissue banks, netting over $4 million in just three years. China, too, has joined the body- snatchers, selling the organs of political prisoners and members of the despised Falun Gong sect to desperate "medical tourists" from around the world. A Chinese military hospital offers a kidney for the rock-bottom price of 200,000 yuan, a valuable source of revenue for the Chinese police state. As Dickenson wryly notes, "Buy yourself a kidney, keep the Chinese occupation of Tibet going."
But these are only the worst abuses. The means by which many scientists obtain the tissue they need tends to be much more subtle, if no more ethically sound. With the help of U.S. courts, researchers have created a paradoxical legal regime that treats the body as a priceless "gift" when first provided by the donor but as a valuable commodity once in the hands of a corporation or university. Under this model, the donor is a "pure altruist," unable to profit off (or even control) the uses to which his donation is put. Meanwhile, researchers are given the right to sell and patent the donated tissue. Such "one-way altruism," Dickenson writes, would be better termed exploitation.
In many cases, the donor might not even know he has made such a "donation" or how the donation will be used. People who give their bodies to science would no doubt be perturbed to find they are more likely to be sold to the highest bidder by universities and hospitals strapped for cash. One such "corpse wholesaler," Louisiana State University, earned nearly a quarter of a million dollars selling bodies from their "willed-donor" program to private companies and researchers. Doctors use samples taken from patients, without their knowledge or consent, to create cell lines for research. One woman, Henrietta Lacks, dead for over 50 years, is still "alive" in the form of cells taken during a tumor biopsy. In the Lacks case, at least, the cells were freely shared among researchers; today, such cell lines would likely be the subject of defensive patenting in what Dickenson terms the "great genome grab." Already, one-fifth of the human genome has been patented, much to the detriment of scientific research.
The schizophrenia of this system is nowhere more manifest than in the egg trade. By law, egg "donors" are permitted only to donate their eggs; any compensation they receive is purely for time and effort. In reality, eggs are being flagrantly sold on the open market, with "premium" prices going to in-demand donors, usually at a steep mark-up from what was originally given to the donor. In Eastern Europe, so-called egg "donors" are lured by agencies offering as much as $500--a paltry sum to Western college students (who can command as much as $20,000 for their ova) but enough to live on for six months in Russia or Ukraine. Eggs are not all these women sell; as one observer notes, "They work the cabarets, they'll sleep with men, they'll sell their eggs, and then go back again."
The demand for ova will only grow as scientists continue their search for that Holy Grail, stem cell technology. Media coverage rarely notes that demand, enamored as the press is with the promise of "therapeutic" cloning--which Dickenson insists on placing quotes around since, as she correctly notes, "no therapies have actually resulted yet." And human ova do not "grow on trees," as amply attested by the 2005 Hwang Woo Suk scandal. In the "world's biggest scientific fraud of recent times," Hwang coerced his junior researchers into providing eggs, giving them such high dosages of ovarian stimulation that over 15 percent developed severe ovarian hyperstimulation syndrome, a condition which can lead to infertility or even death.
Hwang wasted more than 2,000 eggs and failed to create even a single stem cell line. The much-celebrated creation of Dolly, the cloned sheep, required 400 eggs with only one (much-publicized) success. Given such odds, Dickenson argues, the demand for eggs will likely be unslakeable, despite the many dangers harvesting poses for women. One scholar estimates that developing a personalized stem cell kit merely for every diabetic in Britain would require between one-third and one-half of young British women to donate their eggs.
That these appalling practices have been largely ignored is something Dickenson blames on the media, which cast even "secular bioethicists" (like herself) as Luddites or religious fanatics. Dickenson recalls one particularly bruising experience in which she took part in an ethics committee to consider the world's first human hand transplant. Along with the committee, Dickenson asked that the proposed recipient undergo a psychological consultation to ensure that he understood the risks and complications such surgery would involve. The doctors proposing the operation felt this too onerous a burden and, instead, performed the surgery in France. In the tabloids Dickenson was attacked as a "stick-in-the-mud enemy of medical and scientific progress" who had deprived Britain of its chance in the sun. (Less than three years later, the recipient had to have the hand amputated, having given up his medication regime, convinced that the hand was actually his own.)
Even such an embarrassing outcome as this, Dickenson sadly notes, has not caused scientists or the greater public to reconsider the current state of the body trade, or even to slow down its pace. Proponents of unrestrained scientific research are still portrayed as "valiant mavericks"--even though such "mavericks" are well in the majority of public opinion.
Nonetheless, Body Shopping is not a call to despair. "Resistance is not futile," writes Dickenson, and she has no patience for the would-be legalizers who argue it's better to regulate the body trade than try to eradicate it. "It's a weak-willed way of appeasing lawlessness," she declares, and insists there are better examples to follow. More collaborative models in gene patenting are already emerging, such as PXE International, which shares rights among patients and biotech firms. Britons and Americans would also do well to look to France, which has long banned sales of organs and gene patenting. In France, human dignity is seen not as "stupid" (as some prominent scientists would have it) but as an "inviolable principle" well worth defending.
Dickenson's optimism might seem foolish, given her dark story and the fantastic growth in medical tourism. (That unwavering devotion to human dignity has not stopped the French from traveling to Spain to buy eggs or to China to buy kidneys.) But resistance is the only alternative to an invasion of the body snatchers.
Cheryl Miller is the editor of Doublethink.