This article argues that actor-network theory, as an alternative to critical theory, has lost its critical impetus when examining commodification in healthcare. The paper claims that the reason for this, is the way in which actor-network theory’s anti-essentialist ontology seems to black box 'intentionality' and ethics of human agency as contingent interests. The purpose of this paper was to open the normative black box of commodification, and compare how Marxism, Habermas and ANT can deal with commodification and ethics in healthcare. (...) Moreover, a new account of 'intentionality' in critical thinking was elaborated. Using Strawson's analysis of 'reactive attitudes and resentment,' the ethical implications of commodification in health care were examined as an assessment of intentions. Synthesizing critical theory with the relational materialism of actor-network theory, this article advances a new approach that seeks to bridge interdisciplinary boundaries, and guide actor-network theory in a critical and humanist direction. Providing new theoretical insights on commodification and 'intentionality' in health care. (shrink)

One of the most common arguments against legalising markets in human kidneys is that this would result in the widespread misuse that is present in the black market becoming more prevalent. In particular, it is argued that if such markets were to be legalised, this would lead to an increase in the number of people being coerced into selling their kidneys. Moreover, such coercion would occur even if markets in kidneys were regulated, for those subject to such coercion would not (...) be able to avail themselves of the legal protections that regulation would afford them. Despite the initial plausibility of this argument, there are three reasons to reject it. Firstly, the advantages of legalising markets in human kidneys would probably outweigh its possible disadvantages. Secondly, if it is believed that no such coercion can ever be tolerated, markets in only those human kidneys that fail to do away with coercion should be condemned. Finally, if coercion is genuinely opposed, then legalising kidney markets should be supported rather than opposed, for more people would be coerced were such markets to be prohibited. (shrink)

In this article, based on a critical metaphor analysis, we identify and describe multimodal metaphors involving the human body and its conceptualizations in five auteur films of the 2010s. Studies on the human body in cinema have documented how it changes according to underlying ideologies. Our research focuses on the role of image schemas and metaphors as they embody meanings and sociocultural paradigms. Metaphors also frame how the body is conceptualized according to dominating ideological practices such as (a) commodification, (b) (...) the integration between artificial and organic, (c) dissatisfaction, (d) dynamics of beautification and idealization, and (e) politicization of the human body. We show how metaphors are creative tools to reframe meanings and representations of the body and how the body is a construct refashioned within the cinematic discourses of these films. (shrink)

BackgroundThe increasing debate on financial incentives for organ donation raises concerns about a "commodification of the human body". Philosophical-ethical stances on this development depend on assumptions concerning the body and how people think about it. In our qualitative empirical study we analyze public attitudes towards organ donation in their specific relation to conceptions of the human body in four European countries (Cyprus, Germany, the Netherlands and Sweden). This approach aims at a more context-sensitive picture of what "commodification of the body" (...) can mean in concrete clinical decisions concerning organ donation.ResultsWe find that moral intuitions concerning organ donation are rooted in various conceptions of the human body and its relation to the self: a) the body as a mechanical object owned by the self, b) the body as a part of a higher order embodying the self, and c) the body as a hierarchy of organs constitutive of the self.ConclusionThe language of commodification is much too simple to capture what is at stake in everyday life intuitions about organ donation and organ sale. We discuss how the plurality of underlying body-self conceptions can be taken into account in the ethical debate, pointing out consequences for an anthropologically informed approach and for a liberal perspective. (shrink)

More and more areas of medicine involve subjects donating tissues to another — blood, organs, bone marrow, sperm, ova and embryos can all be transferred from one person to another. Within the technical frameworks of biomedicine, such fragments are generally treated as detachable things, severed from social identity once they are removed from a particular body. However an abundant anthropological and sociological literature has found that, for donors and patients, human tissues are not impersonal. They retain some of the values (...) of personhood and identity, and their incorporation often has complex effects on embodied identity. This article draws on feminist philosophy of the body to think through the implications of some of these practices. Specifically, it draws on the idea of intercorporeality, wherein the body image is always the effect of embodied social relations. While this approach is highly productive for considering the stakes involved in tissue transfer, it is argued that the concept of body image has been too preoccupied with the register of the visual at the expense of introceptive data and health/illness events. Empirical data around organ transplant and sperm donation are used to demonstrate that the transfer of biological fragments involves a profound kind of intercorporeality, producing identifications and disidentifications between donors and recipients that play out simultaneously at the immunological, psychic and social levels. (shrink)

Breastmilk is bought, sold, and donated in a global marketplace, which risks exploiting the women who produce it. In Detroit, black mothers are targeted as paid milk donors; milk from Cambodian and Indian mothers is sold to parents in the United States and Australia; and the International Breast Milk Project sends donated milk from the United States to Africa. Drawing on transnational care work and affect theory, I argue that merely refraining from paying women does not eliminate potentially harmful effects. (...) Addressing the ethical implications of these exchanges requires reconsidering the relationship between gift and commodity and between love and work. (shrink)

With breakthroughs in science and reproductive technologies, “natural” birthing has undergone change due to the “assisted” use of conceptive technologies. Bodies and their parts have become commodities, to be sold and purchased in medical markets. In the literature, there have been numerous debates on commercialization and commodification, which have addressed the biopolitical and bioethical aspects of organ, egg and sperm donations, and gestational commercial surrogacy. This paper examines the everyday experiences of surrogates and egg donors, coerced and enticed into selling (...) their reproductive services, which become commodities for the larger medical markets of India's In Vitro Fertilization industry. Based on a qualitative study of 4 IVF clinics and 28 surrogates in a state capital city of a southern state in India, this paper addresses the issue of commodification of women's bodies, where the women from lower socio-economic families are either lured or pushed to respond to the demands of reproductive markets. However, legal gestational commercial surrogacy in India, without clear laws and regulations to guide it, is a complex issue and raises many bioethical concerns. This paper limits itself to addressing the commodification of surrogates’ bodies. (shrink)

Reviewing "The Ethics of Gender, Feminism and Christian Ethics," and "The Cambridge Companion to Feminist Theology," the author suggests that Susan Parsons responds to questions postmodernism has posed to both feminism and Christian ethics by using insights gained from various accounts of the moral subject found in feminist philosophy, ethics, and theology. Hesitant to embrace postmodernism's critique of the possibility of ethics, Parsons redefines ethics by establishing a moral point of view within discursive communities. Yet in her brief treatment of (...) Emmanuel Levinas, Parsons does not explore the postmodern option he offers feminists: an understanding of moral responsibility that can be critical of ethics. Parsons also ignores some feminist perspectives in the physical and natural sciences, thereby missing valuable insights of feminists who insist upon the materiality of the body. (shrink)

As a neo-liberal economy, India has become one of the new health tourism destinations, with commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. Through empirical research in (...) New Delhi, the capital of India, from December 2011 to November 2012, issues of decision-making on embryo transfer, fetal reduction, and mode of delivery were identified. Interviews were carried out with doctors in eighteen ART clinics, agents from four agencies, and fourteen surrogates. In aiming to fulfil the commissioning parents’ demands, doctors were willing to go to the greatest extent possible in their medical practice. Autonomy and decision-making regarding choice of the number of embryos to transfer and the mode of delivery lay neither with commissioning parents nor surrogate mothers but mostly with doctors. In order to ensure higher success rates, surrogates faced the risk of multiple pregnancy and fetal reduction with little information regarding the risks involved. In the globalized market of commercial surrogacy in India, and with clinics compromising on ethics, there is an urgent need for formulation of regulative law for the clinical practice and maintenance of principles of reproductive ethics in order to ensure that the interests of surrogate mothers are safeguarded. (shrink)

Private cord blood banking is the practice of paying to save cord blood for potential future use. Informed by the literature on corporeal commodification and feminist theories, this article analyses women’s work in banking cord blood. This article is based on in-depth interviews with 13 women who banked in a private bank in Canada. From learning about cord blood banking to collecting cord blood and transporting it to the private bank’s laboratory, women labour to ensure that cord blood is successfully (...) banked. Private cord blood banking involves the overlap or insertion of commercial practices, and relations with clinical practices and relations that may cause tensions and confusion for women and clinical practitioners. Moreover, private banking reinforces and is reinforced by an ‘intensive mothering’ ideology. This article shows that corporeal commodification is not confined to a laboratory and the work of experts but extends into women’s everyday lives. (shrink)

Critical analysis of the biotechnological reproduction of biological life increasingly emphasises the role of value-producing labour in biotechnologically reproductive processes, while also arguing that Marx’s use of the terms ‘labour’ and ‘value’ is inadequate to the critical scrutiny of these processes. Focusing especially on the reformulation of the value-labour relation in recent work in this area by Melinda Cooper and Catherine Waldby, this paper both critiques this reformulation and questions the explanatory efficacy of the category ‘labour’ in this context. Emphasising (...) the contemporary global expansion of capital relative to value-producing labour – specifically, the expansion of fictitious capital and debt on the one hand, and of global surplus populations on the other – it argues that this reformulation misrepresents the mediated capacities of capital as the immediate capacities of labour. This reformulation, moreover, is indicative of broader tendencies in the contemporary theorisation of labour, tendencies exemplified by autonomist Marxism. (shrink)

This article employs the concept of affective assemblage to discuss how fertility travelers make sense of their decision to travel to Spain for oöcyte donation. Motherhood is brought into being through racialized and gendered discourses on ova exchange; idealized and feminized Spanish donor bodies. In their accounts, fertility travelers employ a narrative in which oöcytes become necessary spare parts, yet also, exotic substances with temperament and racialized nationality as well as collective bodies – shaped by the recipient woman’s body, intent, (...) and desire. In this manner, kinship is created through shared blood and space, desire and intent while differences between recipients and donors are minimized. The directionality of desire, hope, and imagination has the effect of naturalizing transnational egg donation and transforming it into a shared western European femininity of sorts. (shrink)

This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent about a child’s genetic parentage affects recipient parents’ choices of (...) donor, about who is allowed to “know” children’s genetic backgrounds, and how important it is to be able to “pass” as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating “matching” donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize “matching,” and actively disclose the process of children’s conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families. (shrink)

We draw on the concept of dignity to consider the ethics of the disposal of amputated limbs. The ethics of the management and disposal of human tissue has been subject to greater scrutiny and discussion in recent years, although the disposal of the limbs often remains absent from such discourses. In light of the recent UK controversy regarding failures in the medical waste disposal and the stockpiling of waste (including body parts), the appropriate handling of human tissue has been subject (...) to further scrutiny. Although this scandal has evoked concern regarding procurement and supply chain issues, as well as possible health and safety risks from such a ‘stockpile’, the dignity of those patients’ implicated in this controversy has been less widely discussed. Drawing at Foster’s (2014) work, we argue that a dignity framework provides a useful lens to frame consideration of the disposal of limbs after amputation. Such a framework may be difficult to reconcile with the logic of business and the ‘biovalue’ of the medical waste, but would we argue afford more patient-centred approaches towards disposal. It may also facilitate better practices to help mitigate future stockpiling incidences. (shrink)

Commentators frequently point to the involvement of biomedicine and bio-science in the objectification and commodification of human body parts, and the consequent potential for violation of personal, social and community meanings. Through a study of UK media coverage of controversies associated with the removal of body parts and human materials from children, we argue that an exclusive emphasis on the role of medicine and the bio-sciences in the commodification of human materials ignores the important role played by commercially motivated mass (...) media organizations. Analysis of the language of news reports covering the period of the organ retention controversies in the UK reveals the ways in which the mass media contribute to the commodification of body parts by recruiting them for use in the manufacture of a media scandal. This is achieved through use of horror language, the fetishization of certain body parts, emphasis on the fragmentation of the body, and the use of a variety of rhetorical devices to convey enormity and massive scale. Media participation in the commodification of children's body parts has profound implications for practices and policies in relation to use of body parts, and has significantly influenced the governmental regulation of science and medicine. The role of mass media deserves fuller recognition by theorists of body commodification. (shrink)

European Enlightenment thought was the privileged model upon which intellectuals built a Chinese modernity since the decline of the Qing dynasty in the late nineteenth century. Aesthetically, a turn towards literary realism was successfully implemented. These Western legacies dominated the literary field until they lost their persuasive power in the 1990s. Beyond cultural production, the entanglements of a nation in transition with Eurocentric ideological paradigms influenced statecraft and nationalistic thought to our days. In his novel Frogs Mo Yan revisits the (...) heritage of May Fourth modernism to expose its transmogrification into the dehumanizing reality effects accompanying birth control from Mao to the Deng regime and thereafter. Employing images that suggest recent, science-based governance to have triggered local regimes of cosmic un-creation, the novel focuses on a global modernization that is perceived as socially as well as environmentally destructive. (shrink)

Commercialisation and consumerism have had lasting and profound effects upon the nature of oral health and how dental services are provided. The stigma of a spoiled dental appearance, along with the attraction of the smile as a symbol of status and prestige, places the mouth and teeth as an object and product to be bought and sold. How the dental profession interacts with this acquired status of the mouth has direct implications for the professional status of dentistry and the relationship (...) between the profession and society. This essay examines the mouth’s developing position as a symbol of status and prestige and how the dental profession’s interaction and response to this may have important effects on the nature of dentistry’s social contract with society. As rates of dental disease reduce in higher socioeconomic groups, dentistry is experiencing a reorientation from being positioned within a therapeutic context, to be increasingly viewed as body work. This is not in of itself problematic; as a discipline dentistry places a very high value upon the provision of enhanced or improved aesthetics. This position changes when the symbolic exchange value of an aesthetic smile becomes the main motivation for treatment, encouraging a shift towards a commercialised model of practice that attenuates professional altruism. The dental profession should not welcome the association of the mouth as a status and prestige symbol lightly; this article examines how this paradigm shift might impact upon the social contract and dentistry’s professional status. (shrink)