Commodification is a broad and crosscutting issue that spans debates in ethics (from prostitution to global market practices) and bioethics (from the sale of body parts to genetic enhancement). There has been disagreement, however, over what constitutes commodification, whether it is happening, and whether it is of ethical import. This chapter focuses on one area of the discussion in bioethics – the commodification of human tissue – and addresses these questions – about the characteristics of commodification, its pervasiveness, and ethical (...) significance – in order to clarify and map the commodificatory debate. The chapter does this in three parts. First, it defines commodification as the shift from “persons” to “things” and from “relationships” to services for “contract.” Second, using examples of kidney and gamete sale and commercial surrogacy, it argues that commodification is rife in bioethics. Third, it contends that commodification is an ethical problem for three key reasons: First, because it leads to exploitation; second, because some things should not be for sale; and third, because it damages social goods. The chapter concludes that commodification and commodificatory practices should be resisted. (shrink)

The Red Market: On the Trail of the World’s Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers Content Type Journal Article Category Book Review Pages 1-3 DOI 10.1007/s11673-012-9361-3 Authors Dominique E. Martin, 39 Eltham Street, Flemington, 3031 Australia Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529.

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)

The past two decades have seen the extensive privatisation and marketisation of health care in an ever reaching number of developing countries. Within this milieu, medical tourism is being promoted as a rational economic development strategy for some developing nations, and a makeshift solution to the escalating waiting lists and exorbitant costs of health care in developed nations. This paper explores the need to problematize medical tourism in order to move beyond one dimensional neoliberal discourses that have, to date, dominated (...) the arena. In this problematization, the paper discusses a range of understandings and uses of the term ‘medical tourism’ and situates it within the context of the neoliberal economic development of health care internationally. Drawing on theory from critical medical anthropology and health and human rights perspectives, the paper critically analyzes the assumed independence between the medical tourism industry and local populations facing critical health issues, where social, cultural and economic inequities are widening in terms of access, cost and quality of health care. Finally, medical tourism is examined in the local context of India, critiquing the increasingly indistinct roles played by government and private sectors, whilst linking these shifts to global market forces. (shrink)

Social scientists often lament the fact that philosophically trained ethicists pay limited attention to the insights they generate. This paper presents an overview of tendencies in sociological and anthropological studies of morality, ethics and bioethics, and suggests that a lack in philosophical interest might be related to a tendency among social scientists to employ either a deficit model (social science perspectives accommodate the sense of context that philosophical ethics lacks), a replacement model (social scientists have finally found the “right way” (...) of doing ethics), or a dismissal model (ethics should be abandoned all together as a misconstrued veil of power). Increased awareness of differences in styles of reasoning and objects of research interest might help to overcome the hostility, and an anthropological project is presented as an invitation to a dialogue informed by awareness of such differences. (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)

The emergence of a new tissue economy raises issues for the governance of risk and concepts of the body and self. This article explores the development of autologous cell therapies as a form of tissue engineering and considers how and why autologous applications are seen as less risky and more socially and politically acceptable. In a careful analysis of contemporary debates around the need for new international policies to regulate these technologies, we critically assess the discursive strategies employed to support (...) ideas of the body as a natural entity. Central to these debates are assumptions that autologous applications do not threaten the moral or corporeal integrity of the individual and that they are ‘an ethics-free zone’. Analysis reveals that concepts such as intercorporeality need to be refined if they are to assist our understanding of these cell-based therapies. We consider the biopolitics of Autologous Chondrocyte Implantation (ACI) in order to show the linkages between the culturing of cells, regulation and the reproduction of the self. (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)

Assisted reproductive technology is a global market engaging a variety of local moral economies where the construction of the demand–supply relationship takes different forms through the operation of the politics of value. This paper analyzes how the market–culture relationship works in different settings, showing how power and resources determine what value will, or will not, accrue from that relationship. A commodity’s potential economic value can only be realized through the operation of the market if its cultural status is seen to (...) be legitimate. At the same time, local moral economies and their associated social orders are potentially susceptible to the destabilizing implications of new commodities. The formal or informal organization of power relationships in the market–culture interaction can enable potential value to become manifest and tangible over time or block its path. The interaction is steered through national institutional sources of cultural authority embedded in state and religion, where the visible contest in the politics of value is conducted. Increasingly, that interaction finds its expression in transnational institutions of governance where the struggle for control of the cultural agenda reflects the global nature of the ART market. (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)

Organ transplantation has been central to debates on medical technologies and their complex biopolitical consequences, new forms of medical governance and new opportunities for capital. Attending to transplantation has also opened up new ways of thinking about, acting on and living ‘in’ the body, raising important questions about what it means to be embodied under particular cultural conditions. The specific ways in which a technology like transplantation puts the body parts of some at the disposal of the bodies of others (...) has served to (re)write bodily boundaries, commoditise body parts and reorganise the social relations of exchange, care and responsibility. The controversies that this family of technologies has given rise to are both readable and read as embedded in and expressive of wider forms of conflict and contestation. Putting these controversies and their entanglements centre-stage, this article focuses on the manner in which transplant technologies construct their publics in gendered and socially stratified terms, as they reconstruct the transplanted organ as a new site for the extraction of surplus value. Drawing on data from fieldwork in Mexico, I will examine the catastrophic consequences of transplant medicine for Mexico’s poor, particularly women who bear the burden of care for the country’s predominantly living transplant programme. In carrying the costs (moral, social and economic) their accounts of these processes offer us an important critical vantage point from which to assess the interplay between state, market and the ‘worn’ body in the context of transplantation. (shrink)

This article looks at the history of the stem cell as an experimental life-form and situates it within the context of biological theories of cellular ageing which emerged in the 1960s, under the banner of ‘biogerontology’. The field of biogerontology, I argue, is crucially concerned not only with the internal limits to a cell's lifespan, but also with the possibility of overcoming limits. Hence, the sense of ‘revolution’ that has surrounded the isolation of human embryonic stem cells. The article goes (...) on to situate the problematic of cellular ageing within the larger historical transition from Fordist to post-Fordist modes of production – a transition whose effects on the life sciences have been insufficiently theorized – and points to resonances between the concerns of biogerontology and an emerging political rhetoric on the crisis of ageing and limits to growth. Having surfaced in parallel with the neo-liberal euphoria of the 1990s, the field of regenerative medicine presents itself as a biomedical solution to the problem of limits to growth. What is at stake in the contemporary biosciences, I suggest, is not so much the mass commodification of life itself as its transformation into a source of speculative surplus value. (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)

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)

Moshe Tati, a sanitation worker in Jerusalem, was among the first of more than a thousand mortally sick Israelis who signed up for illicit and clandestine ‘transplant tour’ packages that included: travel to an undisclosed foreign and exotic setting; five-star hotel accommodation; surgery in a private hospital unit; a ‘fresh’ kidney purchased from a perfect stranger trafficked from a third country. Although Tati’s holiday turned into a nightmare and he had to be emergency air-lifted from a rented transplant unit in (...) a private hospital in Adana, Turkey back to Israel, Moshe became a poster-boy of transplant tourism for the next decade. João Cavalcanti was among the first of 38 residents of the slums of Recife recruited by retired military Captain Ivan da Silva and his sidekick Captain Gadddy Tauber to travel to Durban, South Africa to provide a spare kidney to an Israeli transplant tourist in Durban. This article examines the logics and practices through which kidney buyers and kidney sellers, organs brokers, surgeons and their accessories convince themselves that they are engaged in an illegal but still mutually beneficial ‘medical-recreational’ adventure, an ‘extreme medical sport’ of sorts. While life, health and survival motivate ‘transplant tourism’, a euphemism for human trafficking in spare body parts, the freedom to roam, mobility, is an essential feature of transplant tours for kidney buyers and kidney sellers. (shrink)

The paper provides an outline of the Durkheimian cultural sociology of the body as a particular program in corporeal sociology. Rapid development of the sociological theories of body, which takes place during the last quarter century, indicates that body somehow appears to be an arena for the events which are particularly important for the changes in contemporary social life. The problems of bioethics, prominent shifts in lifestyles, wider distribution of the new forms of body care, the new meanings of the (...) sport, transformations in sexual behavior, and the new kinds of violence — all those and many other events and tendencies shape particular “enclaves” of the corporeality as well as huge shifts in the representations of the “natural” with respect to the body. The paper proceeds from the presupposition that the fundamental cause for the mentioned changes to be recognized is that the body remains as most stable, shared and generally valid locus of the sacred, which is being progressively fragmenting and achieving all the more fluid shapes. If the presupposition is correct, then cultural sociology, based on the Durkheimian theory of the sacred, obtains a certain epistemic priority in the field of the sociological studies of body, which is to be resulted in future researches. Accordingly, the paper is to be seen as an invitation to such researches as well as discussions and the argument development. The preliminary outline is performed that situates the suggested program of the cultural sociology of the body in the context of contemporary sociological theory. The statements and hypotheses are made, and the most promising research areas are suggested. (shrink)

In Aotearoa/new Zealand, organ donation and transplantation rates for Māori and non-Māori differ. This article outlines why this is so, and why some groups may be reticent about or object to organ donation and transplantation. In order to do this, I draw on the conceptual and methodological lens of phenomenology and apply what Van Manen calls the existential themes of lived body (corporeality), lived space (spatiality), lived time (temporality) and lived other (relationality and communality) to a discussion of the cultural (...) values and spiritual beliefs of Māori around tissue donation. Specifically, the aim of the article is to encourage non-Māori, who will already be aware that diverse cultural traditions transmit different beliefs about organ donation and transplantation, to recognize the existence of a deeper understanding of what this difference may mean for people on a felt level and how it might impact on lived experience. (shrink)

The disposal of limbs remains absent from our understandings of amputation, with ‘estranged limbs’ occupying a liminal position. Despite acceptance that the appropriate disposal of human tissue matters on moral, ethical and legal grounds, limbs and their disposal is estranged from these discourses, mirroring the experience of the limbs themselves. This article then examines this absence around disposal, considering both the options which exist for the disposal of limbs after amputation, as well as why disposal itself remains sidelined from our (...) broader understandings of the body. Practices for disposal that encompass both traditional clinical approaches and more unusual patient choices will be discussed – through the discussion of these as potential ‘disposalscapes’. Utilising concepts from the work of Crawford, Shildrick and Steinberg and Slatman and Widdershoven, the potential importance of the disposal of limbs to patients and the role of disposalscapes within this are considered. (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)