The commercial trading of human organs, along withvarious related activities (for example, advertising)was criminalised throughout Great Britain under theHuman Organ Transplants Act 1989.This paper critically assesses one type of argumentfor this, and similar, legal prohibitions:commodification arguments.Firstly, the term `commodification' is analysed. Thiscan be used to refer to either social practices or toattitudes. Commodification arguments rely on thesecond sense and are based on the idea that having acommodifying attitude to certain classes of thing(e.g. bodies or persons) is wrong. The commodifyingattitude consists (...) of three main elements: denial ofsubjectivity, instrumentality, and fungibility.Secondly, in the light of this analysis, the claimthat organ sale involves commodifying the human bodyis examined. This claim is found to be plausible butinsufficient to ground an argument against organ sale,because the very same commodifying attitude is likelyto be present in cases of (unpaid) organ donation. Itis also argued that commodifying bodies per semay not be wrong.Thirdly, the view that organ sale involvescommodifying persons is examined. Although this andthe claim that it is wrong to commodify persons areprobably true, there is – it is argued – littlereason to regard organ sale as worse in this respectthan other widely accepted practices, such as thebuying and selling of labour.The conclusion is that although commodification is auseful ethical concept and although commodificationarguments may sometimes be successful, thecommodification argument against organ sale is notpersuasive. This is not to say, though, that thereare no arguments for prohibition – simply that thisparticular justificatory strategy is flawed. (shrink)

Recent books, articles and plays about the ‘immortal’ HeLa cell line have prompted renewed interest in the history of tissue culture methods that were first employed in 1907 and became common experimental tools during the twentieth century. Many of these sources claim tissue cultures like HeLa had a “troubled past” because medical researchers did not seek informed consent before using tissues in research, contravening a long held desire for self-determination on the part of patients and the public. In this article, (...) I argue these claims are unfair and misleading. No professional guidelines required informed consent for tissue culture during the early and mid twentieth century, and popular sources expressed no concern at the widespread use of human tissues in research. When calls for informed consent did emerge in the 1970s and 1980s, moreover, they reflected specific political changes and often emanated from medical researchers themselves. I conclude by arguing that more balanced histories of tissue culture can make a decisive contribution to public debates today: by refuting a false dichotomy between science and its publics, and showing how ethical concepts such as informed consent arise from a historically specific engagement between professional and social groups. (shrink)

It has been argued that organs should be treated as individual tradable property like other material possessions and assets, on the basis that this would promote individual freedom and increase efficiency in addressing the shortage of organs for transplantation. If organs are to be treated as property, should they be inheritable? This paper seeks to contribute to the idea of organs as inheritable property by providing a defence of a default of the family of a dead person as inheritors of (...) transplantable organs. In the course of discussion, various succession rules for organs and their justifications will be suggested. We then consider two objections to organs as inheritable property. Our intention here is to provoke further thought on whether ownership of one's body parts should be assimilated to property ownership. (shrink)

Ownership of the body, its organs, tissues, marrow, fluids, secretions, and other component parts and products must always be contested, for what appears to belong to the individual may instead be turned into property at the expense of the individual and to the benefit of the social collectivity. Legal discourse relies upon and supports scientific discourse. Both are the product and the producer of utilitarian commercial interests. Collectively, they displace the individual self with a ‘body’ of social interest, encouraging entrepreneurship (...) over the interests of the individual, and quieting social and philosophical discussions concerning self and its location. (shrink)

This essay develops a framework for thinking about the moral basis for the commodification of human reproductive materials. It argues that selling and buying gametes and genes is morally acceptable although there should not be a market for zygotes, embryos, or genomes. Also a market in gametes and genes should be regulated in order to address concerns about the adverse social consequences of commodification.

Les prélèvements et les transplantations de tissus et d'organes renvoient à des problèmes très variés au plan éthique en raison des types d'organes ou de tissus prélevés et transplantés, du statut du donneur et enfin de la finalité du prélèvement. Soyons plus précis: aujourd'hui, on prélève en vue d'une transplantation: les reins, le cœur, les poumons, le foie, le pancréas, la cornée mais aussi, la moelle osseuse, la peau. On prélève à diverses fins — thérapeutique ou de recherche — : (...) le sang, la rate, les cellules embryonnaires, les gamètes. Le donneur quant à lui, suivant les organes prélevés, sera: vivant ou mort, adulte, enfant, nouveau-né anencéphale ou embryon. (shrink)

This special volume of Health Care Analysis is dedicated to a consideration of the status of body parts and products and the roleof law in regulating them. We argue that such a discussion is timely giventhe conflation of technological and academic concerns posed by thecomplex legal framework within which these issues are currentlyaddressed and in the light of debates such as those regardingthe storage of children's organs addressed by inquiries atAlder Hay and Bristol, United Kingdom. The contributors addressspecific legal problems (...) which have been brought before the courts in the UK and other jurisdictions, something which wesuggest is likely to occur with increasing regularity oncethe Human Rights Act 1998 comes into force in October 2000.The issues are also considered on a more theoretical level with papers exploring the role of concepts such as property, donation, commodification and kinship in these debates.While the volume focuses principally upon the manner inwhich these issues have arisen in a UK context, though withreference to certain comparative examples, the concepts discussed here are of more general application acrossother jurisdictions. (shrink)

The Neuroscience Institute of Schizophrenia and Allied Disorders’s “Gift of Hope” Tissue Donor Program is a volunteer programme for people who wish to donate their brain when they die for neuroscience research into schizophrenia. Organ donation for purposes of research differs from transplant donation in a number of ways, most notably the absence of a single recipient. Within a particular community, however, the single recipient is replaced by a sense of shared experience and preventing suffering in others. Donors have an (...) investment in the research. (shrink)

Proponents of permitting living kidney sales often argue as follows. Many jobs involve significant risks; people are and should be free to take these risks in exchange for money; the risks involved in giving up a kidney are no greater than the risks involved in acceptable hazardous jobs; so people should be free to give up a kidney for money, too. This paper examines this frequently invoked but rarely analysed analogy. Two objections are raised. First, it is far from clear (...) that kidney sales and dangerous jobs involve comparable risks on an appropriately broad comparison. Second, and more importantly, even if they do involve comparable risks it does not follow that kidney sales must be permitted because dangerous jobs are. The analogy assumes that kidney sales are banned for paternalistic reasons. But there may be other, non-paternalistic reasons for the ban. And paternalists, too, can consistently defend the ban even if kidney sales are no riskier than occupations that they find acceptable. Soft paternalists may want to protect would-be vendors from harms that they have not voluntarily chosen. Egalitarian hard paternalists may want to protect already badly off vendors from further worsening their situation. For neither species of paternalist is the size of the risk prevented decisive. I conclude that the analogy with dangerous jobs, while rhetorically powerful, pulls little real argumentative weight. Future debates on living kidney sales should therefore proceed without it. (shrink)

The idea of paying donors in order to make more human bodily material available for therapy, assisted reproduction, and biomedical research is notoriously controversial. However, while national and international donation policies largely oppose financial incentives they do not treat all parts of the body equally: incentives are allowed in connection to the provision of some parts but not others. Taking off from this observation, I discuss whether body parts differ as regards the ethical legitimacy of incentives and, if so, why. (...) I distinguish two approaches to this issue. On a ”principled” approach, some but not all body parts are inherently special in a way that proscribes payment. On a ”pragmatic” approach, the appropriateness of payment in relation to a specific part must be determined through an overall assessment of e.g. the implications of payment for the health and welfare of providers, recipients, and third parties, and the quality of providers’ consent. I argue that the first approach raises deep and potentially divisive questions about the good life, whereas the second approach invokes currently unsupported empirical assumptions and requires difficult balancing between different values and the interests of different people. This does not mean that any attempt to distinguish between body parts in regard to the appropriateness of payment necessarily fails. However, I conclude, any plausible such attempt should either articulate and defend a specific view of the good life, or gather relevant empirical evidence and apply defensible principles for weighing goods and interests. (shrink)

Opposition to `ownership' of cells and tissues often depends on arguments about the special or sacred nature of human bodies and other living things. Such arguments are not very helpful in dealing with the patenting of DNA fragments. Two arguments undergird support for patenting: the notion that an author has a `right' to an invention resulting from his/her labor, and the utilitarian argument that patents are needed to support medical inventiveness. The labor theory of ownership rights is subject to critique, (...) though it may still have enduring value. The more important argument is that deriving from the common good. If patents on DNA are supported on the basis of their contributions to the common good, then they can also be limited based on considerations of the common good. (shrink)

Opposition to `ownership' of cells and tissues often depends on arguments about the special or sacred nature of human bodies and other living things. Such arguments are not very helpful in dealing with the patenting of DNA fragments. Two arguments undergird support for patenting: the notion that an author has a `right' to an invention resulting from his/her labor, and the utilitarian argument that patents are needed to support medical inventiveness. The labor theory of ownership rights is subject to critique, (...) though it may still have enduring value. The more important argument is that deriving from the common good. If patents on DNA are supported on the basis of their contributions to the common good, then they can also be limited based on considerations of the common good. (shrink)

The ArgumentCell lines and other human-derived biological materials have since 1980 become valuable forms of patentable matter. This paper revisits the much-critiqued legal caseMoore v. Regents of the University of Cahfornia, in which John Moore claimed property rights in a patented cell line made from his spleen. Most work to date has critiqued the text of the decision and left the relevant scientific and technical literature unexamined. By mapping out the construction of discontinuity and continuity between human body and cell (...) line in this literature, this paper provides a novel critique of the Moore case regarding the source and mobilization of scientific information in the decision. At the same time, the elisions of the case are used to move to a larger set of questions. Comparative material from the history of the first widely used cell line, HeLa, and a discussion of the relation of the scientific and economic value of cell lines, are aimed at analysis of how new objects such as patented human cell lines come into existence through science and law, and what kinds of definitions and practices make them valued objects of contention in the first place. (shrink)

NIMBY (Not In My Backyard) refers to an oppositional attitude from local residents against some risk generating facility that they have been chosen to host either by government or industry. The attitude is claimed to be characteristic of someone who is positive to a facility but who wants someone else to be its host. Since siting cannot be provided if everyone has this attitude, society ends up in a worse situation. The attitude is claimed to be egoistic and irrational. Here (...) it is argued that the NIMBY critique rests on questionable assumptions about the rightness of weighing total benefit against total cost. This weighing-principle will sometimes have to yield so that the rights of individuals can be acknowledged. (shrink)

Immer mehr Menschen unterziehen sich chirurgischen Eingriffen, um ihr äußeres Erscheinungsbild zu verändern. Angesichts der omnipräsenten Konfrontation mit medial vermittelten Schönheitsstandards stellt sich die Frage des selbstbestimmten Umgangs mit den zur Verfügung stehenden Techniken der kosmetischen Chirurgie. Dieser Aufsatz analysiert die Frage, ob (und in welchem Sinne) die Inanspruchnahme schönheitschirurgischer Maßnahmen als Ausdruck einer autonomen Entscheidung von Individuen betrachtet werden kann, oder ob sich entsprechende Körpereingriffe vielmehr dem Diktat von moralisch fragwürdigen Normen äußerer Erscheinungen verdanken und damit Ausdruck des zunehmenden (...) Konformitätsdrucks und der Unterwerfung des Individuums unter soziale Standards sind. Im Ergebnis wird gezeigt, dass ein subjektivistisches Autonomieverständnis für eine normative Bewertung schönheitschirurgischer Körpereingriffe unangemessen ist und anschließend ein Autonomiekonzept skizziert, das Bedingungen dafür formuliert, welche Formen der Nötigung als autonomiebeschränkend gelten können. (shrink)

ZusammenfassungImmer mehr Menschen unterziehen sich chirurgischen Eingriffen, um ihr äußeres Erscheinungsbild zu verändern. Angesichts der omnipräsenten Konfrontation mit medial vermittelten Schönheitsstandards stellt sich die Frage des selbstbestimmten Umgangs mit den zur Verfügung stehenden Techniken der kosmetischen Chirurgie. Dieser Aufsatz analysiert die Frage, ob die Inanspruchnahme schönheitschirurgischer Maßnahmen als Ausdruck einer autonomen Entscheidung von Individuen betrachtet werden kann, oder ob sich entsprechende Körpereingriffe vielmehr dem Diktat von moralisch fragwürdigen Normen äußerer Erscheinungen verdanken und damit Ausdruck des zunehmenden Konformitätsdrucks und der Unterwerfung (...) des Individuums unter soziale Standards sind. Im Ergebnis wird gezeigt, dass ein subjektivistisches Autonomieverständnis für eine normative Bewertung schönheitschirurgischer Körpereingriffe unangemessen ist und anschließend ein Autonomiekonzept skizziert, das Bedingungen dafür formuliert, welche Formen der Nötigung als autonomiebeschränkend gelten können. (shrink)

Human tissue and body parts have been used in one way or another for millennia. They have been preserved and displayed, both in museums and public shows. Real human hair is used for wigs, while some artists even use human tissue in their works. Blood, bone marrow, whole organs and a host of other structures and human substances are all transplanted into living persons to treat illness. New life can be created from gametes through in vitro fertilisation , while the (...) creation of cell lines keeps tissue alive indefinitely. These uses create significant challenges for the legal system in the UK. The major challenge for the law is to balance the competing demands of those groups who have vested interests in human tissue—researchers, medical practitioners, patients, families, the community and the police, among many others. It must provide sufficient control to users of tissue, but also take account of the fact that our bodies hold psychological importance for us while we live and, after we die, for those we leave behind. To some degree the law has been successful, but we still lack a comprehensive, coherent approach to the regulation of human tissue. Partially as a reaction to this lack of a comprehensive approach, some commentators have turned to applying the concept of property to human tissue means to achieve regulatory outcomes they support. (shrink)

ABSTRACT Does genetic relatedness define who is a mother or father and who incurs obligations towards or entitlements over children? While once the answer to this question may have been obvious, advances in reproductive technologies have complicated our understanding of what makes a parent. In a recent publication Bayne and Kolers argue for a pluralistic account of parenthood on the basis that genetic derivation, gestation, extended custody and sometimes intention to parent are sufficient (but not necessary) grounds for parenthood.1 Bayne (...) and Kolers further suggest that definitions of parenthood are underpinned by the assumption that ‘being causally implicated in the creation of a child is the key basis for being its parent’.2 This paper examines the claim that genetic relatedness is sufficient grounds for parenthood based on a causal connection between genetic parents and their offspring. I argue that parental obligations are about moral responsibility and not causal responsibility because we are not morally accountable for every consequence to which we causally contribute. My account includes the conditions generally held to apply to moral responsibility, i.e. freedom and foreseeability. I argue that parental responsibilities are generated whenever the birth of a child is a reasonably foreseeable consequence of voluntary actions. I consider the implications of this account for third parties involved in reproductive technologies. I argue that under some conditions the obligations generated by freely and foreseeably causing a child to exist can be justifiably transferred to others. (shrink)

Most opponents of somatic cell nuclear transfer and embryonic stem cell technologies base their arguments on the twin assertions that the embryo is either a human being or a potential human being, and that it is wrong to destroy a human being or potential human being in order to produce stem cell lines. Proponents’ justifications of stem cell research are more varied, but not enough to escape the charge of obsession with the status of the embryo. What unites the two (...) warring sides in ‘the stem cell wars’ is that women are equally invisible to both: ‘the lady vanishes.’ Yet the most legitimate property in the body is that which women possess in their reproductive tissue and the products of their reproductive labour. By drawing on the accepted characterisation in the common law of property as a bundle of rights, and on a Hegelian model of contract as mutual recognition, we can lessen the impact of the tendency to regard women and their ova as merely receptacles and women’s reproductive labour as unimportant. (shrink)

Biomedical research has always relied on access to human biological materials and clinical information, resources that when combined form biobanks. In the past, it appears that investigators sometimes used these resources with relatively little oversight, and without the consent of the individuals from whom these materials and information were obtained. Several developments in the last ten to fifteen years have converged to place greater emphasis on the role of individual consent in the creation and use of biobanks. The most important (...) by far is the power of information technology, which has transformed our lives in almost every domain. In the research setting, it is now easy to abstract information from electronic medical records. Computers make it possible to analyze enormous datasets and have contributed in essential ways to the dramatic increases in our understanding of genomics and other areas of biomedical science. (shrink)

Biomedical research has always relied on access to human biological materials and clinical information, resources that when combined form biobanks. In the past, it appears that investigators sometimes used these resources with relatively little oversight, and without the consent of the individuals from whom these materials and information were obtained. Several developments in the last ten to fifteen years have converged to place greater emphasis on the role of individual consent in the creation and use of biobanks. The most important (...) by far is the power of information technology, which has transformed our lives in almost every domain. In the research setting, it is now easy to abstract information from electronic medical records. Computers make it possible to analyze enormous datasets and have contributed in essential ways to the dramatic increases in our understanding of genomics and other areas of biomedical science. (shrink)

We not only own our bodies, we are our bodies. Can we simply alienate parts of them? Both a theology of stewardship and the principle of self‐ownership would seem to permit or even encourage us to do this.

Due to the shortage of organs, it has been proposed that the ban on organ sales is lifted and a market-based procurement system introduced. This paper assesses four prominent proposals for how such a market could be arranged: unregulated current market, regulated current market, payment-for-consent futures market, and the family-reward futures market. These are assessed in terms of how applicable prominent concerns with organ sales are for each model. The concerns evaluated are that organ markets will crowd out altruistic donation, (...) that consent to sell organs is invalid, that sellers will be harmed, and that commodification of organs will affect human relationships in a negative way. The paper concludes that the family-reward futures market fares best in this comparison but also that it provides the weakest incentive to potential buyers. There is an inverse relationship between how applicable prominent critiques are to organ market models and the increase in available organs they can be expected to provide. (shrink)

This thesis aims to determine whether international gestational surrogacy contracts are exploitative, and whether they should be prohibited. I chose a group of women working as surrogates at Kaival Maternity Home and Surgical Hospital, in Anand, Gujarat, India as a study group. After examining their life circumstances, I argue that these women live in unjust circumstances caused by institutional sexism and poverty. I critically assess arguments launched against surrogacy, organ trade, and prostitution and find that none of these are sufficient (...) for demonstrating that contracts involving the sale of the body are necessarily exploitative. I find that surrogacy is exploitative because of a complex set of social conditions. Further, the contracts are beneficial to both the woman acting as surrogate and to the couple hiring her. I conclude that international gestational surrogacy is exploitative yet mutually beneficial, and prohibiting surrogacy would be harmful unless accompanied by drastic social change. (shrink)