The body has become a piece of merchandise like any other, sold off in parts to the highest bidder. Bioeconomics specialist Céline Lafontaine shares her insight into the “body market”.
The development of biotechnology and in vitro conservation techniques has set the stage over the past few decades for a worldwide market for human body parts, which can now be sold off to the highest bidder. In her compelling book The Body-Market, Céline Lafontaine, professor of sociology at the University of Montreal, condemns some of the shady dealings currently plaguing the biomedical industry. Here, she breaks down the ethical and political issues involved in the development of bioeconomics.
IN VIVO Bioeconomics is a new concept. What is it?
Céline Lafontaine The human body has always been the subject of economic models, whether in prostitution, slavery or factory workers during the industrial revolution. But it was always sold as a unit in a work force. Bioeconomics is at the opposite end of the spectrum, dividing the body into biological elements – cells, molecules, bones, etc. – and using them as a source of economic productivity. The oil crises in the 1970s brought people to realise that there are limited reserves of natural resources. Bioeconomics emerged as a response to this issue. The US government has begun investing massively in biotechnology and GMOs, in the hopes of making living organisms a new source of productivity.
IV You refer to organ transplants as an example of how the body has been turned into a commodity. How did this trade develop?
CL It involves selling off the body in parts. The spread of organ transplants in the 1970s created a shortage, which led to the emergence of a black market. Kidneys are the primary organs concerned in trafficking, as people can survive with only one. Left with nothing else to sell but their body, the poor in India and Bangladesh now turn their kidneys for a profit. Doing so often weakens them to the point where they can no longer work and become even more destitute. In China, organs are harvested from prisoners on death row. A test is sometimes even run upstream to determine compatibility with the recipient before choosing which prisoner to execute. In South Africa, medical tourism has developed for transplants. You can have a new kidney and take a safari on the same trip.
"With medically assisted procreation, the industrial productivity model developed for the bovine industry was transposed to women."
IV Participants in clinical trials are also paid. So is it really exploitation?
CL Clinical tests are essential to the pharmaceutical industry in developing new drugs. Trials started being outsourced in the 1990s, following the trend in manufacturing. In the trail of Novartis, a growing number of pharmaceutical companies went to India and China to conduct their clinical trials. But the main problem is that the effects of the drugs tested are often unknown. And the bodies being used in the experiments, and on which data are based that will later be marketed, are often not the ones that will benefit from them most.
IV Do our cells also have a financial value?
CL Now that cells can be kept alive outside the human body and multiply in vitro, they can be given a productive value. Just look at the case of Henrietta Lacks [editor’s note: a young African-American woman who died of a tumour in 1951 and whose cancer cells were multiplied in a laboratory and used to develop vaccines and perform other experiments]. As stem cell research advances, this living material now even plays a key role in treatment. Cells are no longer for research alone. They are now being used to heal other bodies. Broadly speaking, most products from the human body (menstrual blood, umbilical cords, foreskin, aborted foetuses, sperm) now have value. This human waste can be recycled and sold. For example, umbilical cord blood banks are based on the (scientifically controversial) concept that those frozen cells could one day be used to cure the child if he or she develops leukaemia.
IV Medically assisted procreation has given rise to a whole new industry. How did that market begin?
CL It’s the very ideal of bioeconomics. The industrial productivity model developed for the bovine industry was transposed to women. Medically assisted procreation causes women to produce dozens of eggs instead of just one, while minimising the impact on their body, the dangers and even the risk of mortality related to ovarian stimulation. The technology to freeze eggs has created a market for this living material. Women, particularly in India, now take tremendous risks to sell their oocytes. This market grew even larger in the early 2000s after the discovery that stem cells could be generated from embryos. New York recently became the first place in the world to authorise egg donation strictly for the purposes of stem cell research. Surrogate mothers represent another facet of the industry. Their role is similar to that of a slave or prostitute, who sells her body 24 hours a day, seven days a week for nine months.
"The market for living material creates a dual standard in medicine."
IV Does the body contain even more parts that could be sold off in the future?
CL Biobanks have recently sprung up that store a person’s genotype. Personalised medicine requires large databases to identify the biomarkers that cause certain diseases. It’s a perversion of the notion of informed consent. If you sign off on the use of your biological material, it’s usually for a very specific goal. But in this case, no one knows what they’re consenting to. We don’t know what diseases it will be used to study. Instead of donating a piece of your body to another individual, you donate it to the general purpose of research.
IV Who sets the prices on this market for biological material?
CL Organ trafficking, for example, is regulated by supply and demand, like drugs. You also have the traditional intermediaries who take their cut along the way. But even when reduced to being treated as a mere object, body tissue remains symbolically tied to the person. Prices on the egg and sperm market are set based on the social value associated with the donor’s features. Eggs from a European woman with blue eyes go for more than eggs from an Asian woman. A Californian sperm bank has even specialised in high value-added donors, who look like basketball champions or film stars.
IV And when no financial transaction takes place, who benefits from the rewards generated by the living material?
CL The blood banks that emerged after World War II created the notion of donating body tissue. You donate your corpse, you give your blood, you get an organ donor card as a good deed to society, to help advance medical science or help others. But that donation ideology hides the notion of capitalist appropriation that goes with it. The living material will be used for research. But the financial rewards from this research will not go to the donor, but to the scientist. This principle was passed into law with the Bayh-Dole Act adopted in the United States in 1980, making it legal to patent living material. More recently, biobanks and the genetic material they contain have made it possible for private entities to develop and market drugs for which they alone will receive the financial benefits.
IV Fundamentally, why the concern about the development of this market for living material if everyone is supposed to be free to choose whether or not to participate?
CL It creates a dual standard in medicine, amplifying the social inequality that already exists. First, you have the citizens of Southern countries, who sell their bodies, and women, who are more vulnerable to commercial exploitation because their bodies, by their very biological make-up, generate a number of potential stem cells such as eggs, menstrual blood, umbilical cords and embryos. Then, you have people from rich countries, who view health as a right. This propels them into a consumer-driven quest for perfect health, which now goes beyond a mere lack of illness. It means having control over one’s body. They try to push limits and stop the ageing process, especially through regenerative medicine. It’s a form of neo-colonialism.
IV Are these inequities strictly a North-South phenomenon?
CL No, bioeconomics contributes to disparities even within wealthy societies. Private umbilical cord blood banks are only open to those who can pay for them. And the cells stored there sidestep the public banks. They are no longer available for other sick children who might need them. In the age of bioeconomics, not all bodies are equal. Some are exploited for the benefit of others.
Céline Lafontaine is a professor of sociology at the University of Montreal and a member of the research team “Medications as social objects”. Following her books L’Empire cybernétique (2004) and La Société postmortelle (2008), she has recently published Le Corps-marché, la marchandisation de la vie humaine à l’ère de la bioéconomie. Céline Lafontaine studies the social issues involved in regenerative medicine. She is also a member of the Research Centre for Techniques, Knowledge and Practices at Paris University 1.