What can someone do to earn 2,500 dollars in a third world country? Join the Mafia, become a contract killer, sell their possessions, sell yourself into slavery, or sell one of your organs. None of these are good decisions but which one is ultimately the one that most people of lesser fortune choose? The brutal truth is that a large group of people are choosing to sell one of their kidneys to help their family pay the bills, keep from starving or stay alive.
Just recently the human organ trade thrived in Pakistan. Pakistan was once the second largest location for kidney transplants and trading of organs. There was once a hospital that did up to 500 transplants per year located near a shopping mall and the airport. The Pakistani people who donated their organs did so “to settle debts, or pay for the marriage of a daughter or sister” they were mostly donating their organs to westerners like US citizens. However the laws changed in 2008 and it is now illegal to sell organs in Pakistan. (Matt Wade) The new laws that are now in place, in Pakistan, allow transplants only from family members and or foreigners if there donor is form a country other than Pakistan. (Wade) The amount of transplants has gone from 500 to about 10. Now some people may think that this is a bad thing for people who need organs but it is much better for the people in Pakistan. The citizens of Pakistan are now much healthier because they have no option to sell their parts. This brings up the question of who is better off the donor or the donee or are they both happy.
Before we get too much into the story lets understand the biology. Basically a kidney transplant is needed when a person’s blood is not being filtered efficiently enough to keep you healthy. If your kidney cannot do this you have a failed kidney and need either dialysis (machine filtering) or a kidney transplant. You can acquire a kidney transplant in two ways either you get put onto a waiting list to receive a kidney from a cadaver or you can find a living donor.
The last commodity post human ethics and the global traffic in fresh organs by Nancy Scheper-Hughes introduces the hardships and ethical dilemmas faced by people who need to be a part of the fresh organ trade. Before we get into the fresh organ trade today let me enlighten on the history that Nancy has bestowed upon me. Organ transplants were once based on medical ethics and responsibility. The doctors “owe his loyalties to the patient alone as if society… did not exist.”(Scheper-Hughes: 146) Nowadays the ethical boundaries of what is right and acceptable have changed. What is more important to save your life and hurt another life, or to let your own life go? There was once an age and type of person that was allowed a transplant because of the ability of the patient to live. Nowadays 70 year old people can acquire organs from teenagers.
What makes the black market trade possible? The organ trade is fueled by a dual waiting list one formed by sickness the other by misery” (Scheper-Hughes:148) the dual system is similar to the fractioned blood system we were exposed to in the book tissues economies. Paid donors and free donation the two ideas that split the world and the heart of all of our problems. The organ trade is just another aspect of the economies of the body
Where do these donors come from? They come from every place on earth. There is a large donor pool in South Asia, South America, eastern European countries. It has been suggested that many of these organs come from refugees, POWs; AWOL soldiers, and the homeless. On the other side of the equation the receiver is present. The term Scheper-Hughes uses to describe the trafficking on people into the donee’s country is Transplant tourism. Transplant tourism is a term used by many that describes the travel of the recipient to these disclosed locations to accept organs. Transplant tourism has made many of these off the map countries and destinations hot spots for affluent sick people. This type of tourism had made many countries leave the 3rd world and improve life for the people around like the Pakistani people.
How much does it cost? It costs about 100,000 to 200,000 dollars for a whole operation from start to finish. The costs incurred with this illegal transaction are numerous. The costs are usually something like buying passports, finding a perfect match, buying fake identities, renting operating rooms, and getting all kinds of reservations. The fresh organ trade is very profitable for middle men and traffickers but the donor only gets a small fraction of this six figure number. The amount that each person gets ranges from 1,200-3,000 dollars.
What happens to these people who donate their organs and the people associated with the trade? It seems that these people who once sold their organs to get ahead in the world are often worse off than they were in the beginning. For some it is the end of their life. Men who have sold their organs are shunned by their communities and cannot usually find work because employers do not want workers who are not as strong because of their missing parts. Doctors also get caught up in the negative effects. Doctors get sucked into the trade deeper then they usually started out to be. They first agree to do these transplants then find themselves helping find donors, making reservations and being much more involved in the illegal aspects of this market. Good intentioned people are becoming black market traffickers.
All countries should take after Pakistan. We should all adopt these laws on organ transplant. People should not have to sell their organs to help pay for bills. In every case that I have found the outcome is less than desirable. The donor is never able to recover fully or hold a respectable job in a physically demanding job. The middle men make money preying on vulnerable people who have no idea the implications of their decisions and the receiver having to take part in this unethical trade. I will end with this quote by Nancy Scheper-Hughes “while many individuals have benefitted enormously from the ability to get the organs they need, the violence associated with many of these new transactions gives reason to pause. Are we witnessing the development of biosocialty or the growth of a widespread biosciopathy?”(164)

Matching [Online Image] Available http://www.cpmc.org/images/kidney/topics/paired_donation.jpg , January 31, 2010
Scheper-Hughes, N. (2006). The Last commodity: post-human ethics and the global traffic in "fresh" organs.
Wade, Matt. (2008, May 12). Dying days for Pakistans kidney tourist trade. The Age, Retrieved from http://www.theage.com.au/news/world/dying-days-for-pakistans-kidney-tourist-trade/2008/05/11/1210444240320.html&usg=__ykk3oA_CwJFODsGcT0UGtbJy3xE=

Informed consent has new meaning for me now. I had surgery on Friday and I signed many consent forms. It was 6 to be exact. They ranged from questions regarding death, to consent forms regarding transfusions, what can and can’t be done to help me. The following release and consent form was the one that related the most to class. I basically had to sign this paper for me to get operated on. It stated

I consent to the transfusion of blood or blood products as deemed necessary by my physician. I have been informed how a transfusion is given. I understand that a blood or blood products transfusion does not always successfully produce a desirable result and that a transfusion may produce ill effects. I understand that transfusions involve risk of incompatibility reaction, allergic reaction, circulatory volume overload, fever, hives, and in rare circumstances infectious diseases such as HIV/AIDS. I understand risks and complications. I have been informed of possible alternative forms of treatment, including non- treatment.

I am not so much of pragmatists that I refused to sign this release / consent form, however it made me weary. If something had gone wrong I think that I would have wanted the option of donating my own blood for myself. That idea was introduced in the Tissue Economies book and I think that would have been the best option for me. The next bullet on the consent form really made me laugh and think about those money hungry doctors.

Ant tissues or parts surgically removed may be disposed of or utilized for educational or research purposes by the hospital or physician in accordance with accustomed standards.
What do accustomed standards mean? Dictionary.com says that accustomed means customary, usual, and habitual. Basically they are saying that people’s waste parts are being utilized for education and research everyday and all of the time so that the process is normal, habitual, in common processes. My next question was what does utilized mean? Does that have any implication for selling my parts? Dictionary.com says that to utilize is to put to use; turn to profitable account. How much does a small piece of vertebrae and disc material go for in the markets today? I wonder. I will get into that next post.
In the Moore case introduced to us in the tissue economies book by Catherine Waldby and Robert Mitchell was a similar happening. Moore had a diseased spleen similar to my hurtful disc. He had it removed and so did I. The only difference here is that Moore’s spleen had a very rare ability to produce lymphokines. Moore’s spleen was later transformed into a very valuable cell line. Moore challenged the doctors he had and the University of California for rights to this cell line. The 3 courts that Mr. Moore went through finally said Moore had no rights to the cell line profits. If I were to act upon my removed disc I would too not have any rights over it. The Moore case was one of the most controversial cases of its time. However it did not set a large amount of precedents. In the next section of the book cord blood was discussed.
“After cutting the cord . . . the doctor usually tosses [the umbilical cord] into a stainless steel bucket with the rest of the medical waste bound for incineration.” ( Kline 2001:114 ) In earlier years this placenta and umbilical cord was just thrown away and had no value. The photo of the umbilical cord and the placenta makes you wonder why this is so valuable now. Why is the nurse carefully harvesting this resource, that is because over the past 15 years or so cord blood has become very valuable for its ability to be used instead of bone marrow. Cord blood has become important because it is from you, meaning that there is no HLA matching needed or testing to be done. Your cord blood that was donated when you were a baby is an exact match and can be used immediately. The cord blood is used to cure blood diseases such as leukemia, sickle cell anemia, and other diseases.
The pages we read in the tissues economy book were linked together by an overarching theme. This theme was what constitutes property in the human tissues aspect. In the Moore case Mr. Moore’s spleen was not his property as ruled by the Supreme Court. It was not his because he had it removed as a favor to him to save his life. Once removed the diseased spleen was then considered “waste.” Once the spleen was considered waste in the legal system it was able to be sold and manufactured into a cell line, which Mr. Moore had no part of. In the chapter following cord blood was considered property of the donor. This is because cord blood was not considered waste at any point of the harvesting process. So in the United States as long as a human tissue is not considered waste it can be the property of the donor. The owner is the parents of the donor or the donor themselves. They donated this for themselves to hopefully later if this cord blood was needed it could be used to save the life of the person. I was very interested in private cord blood banking so I went online to see how much it costs. Cord blood is a very expensive thing to bank for you. It costs anywhere from 900 to 2,100 dollars when the baby is born and an additional 100 or so dollars for every year it is kept. For instance if the blood is used say when the child is 13 the total cost for storing that blood is 3,400 dollars. That seems like a bunch of money for a possible not guaranteed cure for a blood disease.
Cord blood banking. (2007, October). Retrieved from http://www.americanpregnancy.org/labornbirth/cordbloodbanking.html
Cord blood and Placenta. [Online image] Available. Retrieved from http://www.jillstanek.com/archives/cord%20blood%202.jpg retrieved Jan 29, 2010.
Tanks. [Online image] Available. Retrieved from http://www.shanghaicordblood.org/imgs/tank.gif retrieved Jan 29, 2010

Waldby, Cathrine, & Mitchell, Robert. (2006). Tissues economies blood, organs, and cell lines in late capitalism. Durham NC: Duke University.

Just a few weeks ago a movie called Daybreakers premiered. I went to see it and it was great. The movie had the best vampires, actors and actresses. The story was about a huge population of vampires that have blood banks that use human blood to feed its people. It is hard times and the blood banks are drying up, the vampires need more blood. They try to make a blood substitute and try to accumulate more blood through uncivil acts. The idea of blood banking is a popular subject not only in movies but its popularity has leaked into all parts of our lives. There are blood drives in schools, commercials for the Red Cross on TV, books about blood banking, there seems to be an article in some periodical somewhere locally every week. This idea of blood collecting is in the background of everyday life and we don’t even notice it.

What do vampires, scientists, traders, capitalists, doctors and sick people all need to prosper? Blood. Ever since the earlier 1900’s blood has become an important resource. It is such an important resource. Today we are facing almost the same dilemma as the vampires in the movie Day breakers. We need blood to help our people overcome illness. It seems there is always a shortage of blood in the blood banks. In the article Donating Blood is the Recession-Proof gift, Canadians are deciding to donate blood because they don’t have the means of donating money. This is an excellent thing. People have less money to donate; people have less time to donate because they have to work more. Why not donate something that is free?

In the book Tissue Economies Blood, Organs, and Cell Lines in Late Capitalism by Catherine Waldby and Robert Mitchell dove into the idea of the market of blood and tissues. They first presented the ideas of Titmiss. Titmiss, the author of The gift relationship: from human blood to social policy, was talking about how a gift economy, first presented by moss, was the reason that commoditizing blood and the tissues market is a bad thing for every nation and the human race.

He was saying this because of a few reasons. When whole blood donations were made it was given and received anonymously. This created an equal status in the nation. Poorer people weren’t always giving to the rich and the rich were giving to the poor. When blood was given in Titmiss’s time and moss’s time it was given person to person which created a sense of pride, that you’re helping your neighbor, and a sense of belonging and giving, doing your part to help the people in your nation. In the United States there is a dual system of giving blood. “Patients might find themselves in either a voluntary or credit system according to where they fell ill” (Waldby, Mitchell: 11). I even found a company called Bloodbanker.com where they can diredt you to banks that pay, banks that don’t pay, banks that pay for plasma, banks that pay for plasma but not for blood. Titmiss said that the selling of human tissues and blood was “dehumanizing.” The process of selling your body creates a price on your life and a price on your values. This Titmiss says is a social dilemma. The selling of blood and tissues in the United States and other regions created a greater risk of contamination. This is because people desperate for money could and would lie on the applications so they could get there 20 dollars. Titmiss said that a gift system is a “Social pool that pulled from all, better security against infectious contamination, and little wastage of blood supply” (Waldby, Mitchell: 13).

Later in Waldby and Mitchell talk about how Titmiss has very valid observations but that the industry of blood donation has changed. The reasons why Titmiss’s arguments aren’t as warranted is that first blood technology has changes. The reason why technology is a factor now is that blood is being chopped up into many smaller pieces, plasma, red blood cells white blood cells, platelets, etc. The problem with Titmiss’s argument was that people were doing person to person giving and now people don’t know who or where there blood is going to. Another reason why cutting blood up into pieces doesn’t apply to Titmiss’s argument is that people who might have donated their blood could have it cut up without them knowing and then have some company profit from the selling of the parts of the blood. This would unknowingly hurt the gift idea. A third reason why Titmiss’s argument is complicated by technology is that when blood is cut up it is transferred internationally defeating the national pride and connectivity. Also the information age has brought patents and exclusivity making the blood people donates a property used for making money. People with good intensions aren’t really donating. Finally Waldby and Mitchell point out that there is really no such thing as a real free gift. There is always a underlying notion. (Waldby, Mitchell: 23-24).
So what is the answer? I believe that blood donation should be free because people should not have to be desperate enough to donate blood for money and the paying for human tissue is very unethical and disgusting.

Works Cited
Blood Bags. [Online image] Available http://www.bbc.co.uk/radio4/science/media/blood-bag2.jpg, January 22, 2010.
Bloodbanker. (2010, January 20). Retrieved from http://bloodbanker.com/
Cartoon Blood Bank. [Online image] Available http://bloodbankpartners.com/photos/Bloodbank.jpg, January 22, 2010.
Donating blood is the recession proof gift. (2008). Medical News Today, Retrieved from http://www.medicalnewstoday.com/articles/133227.php

Waldby, Cathrine, & Mitchell, Robert. (2006). Tissues economies blood, organs, and cell lines in late capitalism. Durham NC: Duke University.

What is Biocapital?

Capital = Goods used to generate income. Bio= life living organism, so biocaptial is life or organisms generating income. There are so many different aspects of biocapital introduced by Stefan Helmreich in his article Species of biocapital. Helmreich’s article tries to tell the history and the meanings of the term biocapital.
The four species of capital are economic, cultural, social and symbolic. These types of capital can all be transferred and morphed into another. “a classification could also manifest as a table of exchanges between different coinages” (Helm,463) All these types of capital are represented in biocapital. The symbolic capital can be expressed as the prestige of the scholarly community, the cultural capital is expressed as networking; the symbolic capital can be expressed as respect or a perception of power.
Helmreich mentioned a man by the name of Edward Yoxen. Yoxen said that biocapital is capitalizing life, not only using this technology to help us generate money but as the basis of technology. Yoxen said that it is now “technology controlled by capital” (Helm, 464).

To me the picture of the microscope and the money says it all. Recently the United States decided to issue a stimulus package to boost jobs. This surge of money was meant to give jobs to Americans. A substantial amount of capital went to the sciences to fund biotech. The number was about 10.4 billion. The idea was to create jobs and a foundation of biotech for the future. Rajan says “speculative finance often motivates and mirrors the speculations of biotechnology” (Helm, 464) Of course what was expected in return? Something was expected and that was a commodity, maybe a drug to help diseases, a cure for some new symptoms, or a plant that will save the world. What it comes down to is that the United States doesn’t just give money away. They want something that will make money in return (Timmer).
Rajan also states “the subjectivities in making –for scientists, doctors and patients advocacy groups- meanwhile, also tune to future looking landscapes”(Helm, 465) He is saying that the opinions and feelings, beliefs the framework that doctors and patients and scientists face are shaping what the future of biotech will be. Helmreich writes about “new subjectivities are in the making depends on the claim that biopower operates through conjuring new common sense around what will count as the truth of the biological” (Helm, 465). The term biocapital has been evolving and ever changing throughout history.
Helmreich speaks about the idea of hope and hype and that effect on the biological industry making it more capitalistic in nature. The sources of capital that are coming into the universities and companies are supported by Hope and hype. These companies and universities are using marketing techniques and excitement of the future possibilities to generate large amount of cash to fund their research. We see this analogy in the United States every day. The crash of the economy was the result of banks hoping for the future to be unlimitedly prosperous and hyping up people that they are eligible for low interest rate loans and a future house. They lent large sums of money to people on flexible rate mortgages thinking that the markets are stable and these people will be able to hold their own. However when interest rates rose people could not afford their very high payments so they lost their house or they lost their jobs. We see this in the research world and the scholarly world often also. The Bayh-Dole Act is a good example of that. The act that permits universities and their employees to keep rights and patent inventions developed with government money. “Permit the holding of intellectual property in biological matter and knowledge”(Helm, 464).

Helmreichs definition of what biocapital is to him is expressed in an equation based upon a Marx equation. B - C - B. B is biomaterial, C is a way of changing the biomaterial into a commodity by using laborites and legal instruments which equals B, biocapital (Helm,472). This is so simple. The equation is in our everyday lives, the capitalist idea. Take something and add a little, sell it for a profit. However biocapital involves so many things. The laboratory practices are easy enough to understand, engineering the material and making it into something new. However the legal side of it is where the capitalism comes in. The idea that you have to go thought legislation to legalize, patent, distribute, or sell something.
Another point Helmreich made was and the equation b - c - b is too subjective. The lines are being blurred between the neatness of categorizing and keeping species separate. Although the formula is good for showing what the inputs are of biocapital in most cases it is very hard to classify these aspects of life. Gordon talks about “more and more how biomedicine evolves through social choices” In Gordons article Biomedicine Examined (20). The definition of biocapital is the same evolving.
Helmreich really tried to show the classification of what biocapital is defined as. However it is such a controversial topic that encompasses social, economic, cultural classifications it is very hard to define. There are so many barriers that arise. Such as the many types of capital, the view that scientists have of what really biotechnology is. How can we put a definition to something that we can’t all agree on is one thing. I think that Helmreich is saying that biology and capital are so intertwined and are becoming more intertwined that it will be difficult to separate and define.
Citations

"A Brief History of Patent Law in the United States". Semestra. 1/12/2010 .
Gordon, Deborah. "Biomedicine Examined". Culture Illness and Healing 1988: 19-37.
Helmreich, Stefan. "Species of Biocapital". Science as Culture December 2008: 463-475.
Timmer, John. "Qualifying successes of science stimulus spend is challenging". ARS Technica. 1/13/2010 .