BODY BAZAAR: The Market for Human Tissue in the Biotechnology Age. - Review - book review

Washington Monthly, May, 2001 by Jacob Heilbrunn

BODY BAZAAR: The Market for Human Tissue in the Biotechnology Age

by Lori Andrews and Dorothy Nelkin

Crown, Books, $24.00

HOW MUCH ARE YOU WORTH? No, not your net assets. I'm talking about your body. When it comes down to the minerals that make up a human body, not very much--probably under $10. But that's hardly the end of the story. In the past decades, the human body has become a hot property in the medical world. As biotechnology takes off, the language of science is becoming permeated with commercial terms such as supply and demand, contracts, and compensation. Body parts are extracted, harvested, mined, tissue procured, cells frozen. Everything from blood to sperm has become fair game. During a recent visit to the UCLA campus, I was mildly taken aback to see a big advertisement in the student newspaper for a sperm donor who had to be Caucasian and have scored higher than 1,500 on the SAT.

Such developments have created a sense of unease on both right and left. The patenting of genes and the growing traffic in body tissue and cells has raised warning flags. For the right, stem cell research, which relies on aborted fetuses, is self-evidently a bad thing; furthermore, the prospect of reengineering human beings held out by genetic advances is seen as a moral outrage. Liberals have causes for concern as well. In 1984, Rep. Al Gore (D-Tenn.) stated that "it is against our system of values to buy and sell parts of human beings ... you don't want to invest property rights in human beings ... It is wrong."

In their highly informative Body Bazaar: The Market for Human Tissue In the Biotechnology Age, Lori Andrews and Dorothy Nelkin agree. Andrews is the director of the Institute for Science, Law and Technology at the Illinois Institute of Technology; Nelkin is a professor at New York University. Their writing style is lucid and vivid. They draw on numerous examples of questionable medical ethics to illustrate their contention that biotechnology is spinning out of control.

No doubt some scientists will view this book as sensationalistic. Plainly, huge advances have been made, or are just beginning to take place, in identifying and curing diseases that have resisted treatment. Utilitarians have no problem with what is taking place; thus Robert Wright, in The New Republic, even defended the apparent Chinese practice of selling the organs of executed prisoners as a sensible measure that shouldn't cause a flurry of indignation. In the vein of numerous recent books on privacy, the authors seek to sound alarms about where society is headed. But some measure of alarmism is perhaps justified when ethical boundaries remain murky and scientific progress has outpaced our ability to comprehend it. In their conclusion, Andrews and Nelkin envision a time when genetic testing becomes mandatory and our DNA becomes the Social Security number of the future. However concerned Andrews and Nelkin may be about the direction of the $17 billion biotechnology industry, they are seldom less than elucidatory, and their tone remains calm and convincing.

At the outset, Andrews and Nelkin show how bodies have become a booming business. They tell the story of John Moore, a Seattle businessman, who fell ill with hairy-cell leukemia and went to a specialist at the UCLA School of Medicine. He underwent surgery and thought he was cured. For the next seven years, the UCLA doctor insisted that he return periodically to Los Angeles for further tests. Moore believed the tests were necessary to monitor his condition. But that wasn't the whole story. His physician, it turns out, was patenting unique chemicals in Moore's blood and setting up contracts with a Boston company worth an estimated $3 million. According to Andrews and Nelkin, "Sandoz, the Swiss pharmaceutical company, paid a reported $15 million for the right to develop the cell line taken from Moore--which the doctors had named the Mo-cell line"

Is this a horror story? The California supreme court didn't think so. In 1990, it ruled that hospitals had to inform patients that their tissue was being used, but that Moore and others had no right to profits. The doctor and the biotechnology company that took the financial risk to extract something of value from his body deserved them. Venture capital investment had to be encouraged. But, as the authors observe, the matter is not settled there. A host of other questions surround the harvesting of tissue. For example, "Doctors may--and do--subject patients to greater physical risks than are strictly necessary for the patient's own health care in order to obtain valuable tissue. Certain risky procedures can enhance the quality or quantity of the tissue recovered"

Indeed, tissue has become so desirable that bodysnatching has apparently made something of a comeback. In the 19th century, grave robbery and the murder of beggars took place. Anatomy departments would pay between $10 and $35 for a body--more than a worker could earn in a week. Now, a brisk business is taking place in organs and tissue. According to Andrews and Nelkin, "[s]cores of coroners, morgue workers, and physicians have removed. organs and other tissue without consent to sell for transplantation. Organs have even been stolen from the victims of accidents, such as the devastating earthquake in Turkey in 1999."