Globalization and the Trade in Human Body Parts

Article excerpt

"If anything is sacred the human being is sacred." Walt Whitman, "I Sing the Body Electric."

"Two dollars for an eyeball, and a buck and a half for an ear." The Tragically Hip, "Little Bones."

Recent years have witnessed the globalization of markets for resources, technology, manufactured goods, ideas, labour, and capital (Drache and Gertler, 1991; Stubbs and Underhill, 1994). But globalization is not merely economic. It is also political, tied to changes in state roles and functions; cultural, in its extension of certain Western ideas of modernization; and ideological, especially in its neo-liberalist espousal of capitalist relations of exchange (Mittelman, 1996; Boyer and Drache, 1996). One result of globalization has been that existing relationships of unequal exchange and domination have been reinforced, while in some instances others have been created, together with new forms of commodity fetishism (McNally, 1981). Little analysed, but symptomatic of these changes, has been the emergence in recent years of a global trade in human body parts (HBP).(1)

Until recently, human organ transplantation remained a relatively minor and uncertain medical procedure.(2) Since the early 1980s, however, both the number and variety of organ transplants have increased enormously. While transplant surgery offers undeniable benefits to suffering recipients, the emergence of a commercial market for organs has been greeted with concern by governments and professional organizations alike.(3) These concerns are heightened by reports that, in some instances, especially in the underdeveloped world, human body parts are being sourced coercively from the young, the poor, the illiterate, the captive, and the infirm (see National Film Board of Canada [NFBC], 1993; McCullough, 1993; Time Magazine, 1995; Edmonton Journal, 1993; 1994; 1995; 1996a). Frequently, the "consumers" of these organ "products" come from countries other than those in which the organs were obtained.

These concerns are an integral backdrop to this paper. It is argued, however, that the emergence of HBP trade, along with the application of new technologies, must be understood in the broader context of globalization, specifically the extension and intensification of a capitalist mode of exchange. In this regard, it is argued that the HBP trade simply mirrors the "normal" system of unequal exchanges that mark other forms of trade between the developed and undeveloped regions of the world, and between classes, ethnicities, genders, etc. within and across these same regions.

The Market for Human Body Parts

The first successful human transplant - a kidney - occurred in France in 1906. More transplant attempts followed in other parts of Europe and later in the Soviet Union. But the modern era of human transplants only began in the 1950s, and even then transplants remained largely experimental until the mid-1970s (Patrick et al., 1991).

Beginning in the early 1980s, however, the number of transplants began to increase, an increase that continued to accelerate throughout the decades. For example, of 6000 heart transplants performed worldwide by 1988, 80% had occurred during the period 1984-1988 (Patrick et al., 1991). Graph 1 shows the increased occurrence of human organ transplants internationally between 1978 and 1994.(4)

The most rapid increase in transplant procedures occurred in the wealthy and technologically advanced Western countries. Nonetheless, organ transplants came into practice in many parts of the world, rich and poor alike. By 1994, nearly 300,000 transplants (of all types) had been conducted throughout the world (see Table 1).

Moreover, the variety of different types of transplants also "took off," especially following the approval for general use in 1983 of the immunosuppressive drug, cyclosporine. Kidneys, hearts, and lungs remained the organ transplants "of choice," but other types, including multiple transplants, became more common (see, for example, CORR, 1996). …