The Defetishization of the Human Body

By Aaron Parkhurst

In his reflections on Napoleon Bonaparte, Ralph Waldo Emerson considers his ‘unflattering’ insights for human motivation.  Emerson quotes Napoleon, “There are two levers for moving men, self-interest and fear”.  It is, as I see it, quite a cynical view of society, though, in light of many cultural practices, both historical and modern, political and social, it is not an unreasonably illogical conclusion. Professor and Anthropologist Nancy Scheper-Hughes from Berkeley University has spent a significant portion of her career studying the global organ trade as both an activist and an academic.  What she has found is a shadow of Napoleon’s cynicism.  In her 2002 publication Commodifying bodies, she sums up her perceptions of amoral self-interest.  “In all, the ultimate fetish … is the idea of life itself as an object of manipulation, a relatively new idea in the history of modernity.  The fetishization of life – a life preserved, prolonged, enhanced at almost any cost – erases any possibility of a social ethic (pg. 53).

Professor Scheper-Hughes spoke to the London academic community this month as the final guest of this season’s British Museum lecture series “Making Things Better”, hosted by the Medical Anthropology department at UCL in partnership with BioCentre.  The talk, Citizenship and Social Responsibility: Engaged Anthropology and Organ Trafficking in a Biotechnical Era, continued the season’s theme on bioethics and responsible regulation of medical technologies.  Professor Hughes does not ask her audience to question the development of transplant technologies, and indeed she seems to encourage both the contextually appropriate donation of organs from willing individuals as well as the development of innovations in organ transplantation that may improve the health outcomes of transplantation practice.  Rather, what she presses upon the audience is her forceful conviction that aristocratic groups, and those who reside on the upper tiers of global and social hegemonic hierarchy, cannot look to those who exist in social deference to supply their organs.  This includes groups from developing communities and the ‘third world’ as well as cases in the west when grandparents often demand kidney donations from their grandchildren.  “Often”, she writes, “when I speak of troubling issues in organ procurement, I am accused of risking or ‘taking a chance for life’ away from someone.  But what I am trying to underscore is that there is another ‘body’ of patients whose needs are being ignored or violated in the panicky search for organs and other body parts”.  

The results of laissez-faire procurement have allowed the modern development of ‘transplant tourism’.  This, as I understand it, is what Karl Marx, in Das Kapital referred to as the ‘fetishization of commodity’, in which goods within certain economic models gain deification and inherent magic and power outside of the people within a system.  In the case of human tissue and organs, some people seem able and willing to shift their understandings of organic goods to having value only to themselves.  The problem, as the professor presents it, is that cognitive shifts in perceptions of the body can happen so quickly for individuals who are ill, and it is understandably so.  Organ donations offer an only cure and the only escape from death.  The issue becomes magnified because of the scarcity of available organs in the world.  Unlike other commodities which require the sacrifice of labour, raw materials, and perhaps money, organ procurement requires a sacrifice of human life.  Organ banks in America and Britain require that people die in motorcycle accidents; transplant tourism requires that the worlds destitute give up their kidneys.  It becomes too easy of a thing, warns the activist, to deny an individual a new lease on life when there is someone apparently willing to offer it.  Dr. Scheper-Hughes, after many years of fieldwork, is all too aware that there are those in the world who will donate a kidney to feed their family, and there are those who take advantage of that.  The fallacy in philosophy is of organ trade as gift exchange.  The problem is that the relationship between the patient and the donor is not one of partnership, it is a form of structural violence.  A reflexive question we should be asking is, given the explained nature of organs, and the presupposed fetishization of the body, can society as a whole learn to control its desires?  In a case of life and death, can the world’s wealthy remove themselves from their own desperate self-interest to see the structural violence that pervades their intense ambitions for well-being?  Nancy Scheper-Hughes was twice asked at the end of the evening, “So, is there a silver bullet?  If so, what is it?”.  She honestly replied, “I’m afraid I don’t yet have an answer to that question”.

I believe that there potentially is a silver bullet.  It is, regrettably, a lazy solution, as it does not require any moral reflexivity, at least, not on the immediate themes of hegemony.  I’m speaking of organ and tissue production; facilities that develop and mass-produce organic human commodities.  Organs grown in a laboratory or factory do not actively participate in structural violence.  They do not require the same sacrifice of life, motorcycle accidents, and botched third world surgeries.  They also do not quite yet exist.  Activists for government interference in the organ trade and its corresponding human-trafficking warn that viable alternative options for organ and tissue procurement are many years away, but there seem to be many promising leads.  Scientists at Newcastle University have developed artificial liver cells.  Despite discrepancies in legalities for certain procurement practices between various nations, stem cell laboratories in research institutions across the globe are exploring the fundamental under-pinnings of controlled cloning and artificial tissue growth.  The Economist recently published an expose on organ ‘printers’ (Feb 2010).  The new technology transforms adult stem-cells taken from bone marrow into complex differentiated cells, and then structures them in a manner similar to a 3D printer.  The machine currently prints simple blood vessels, muscle, and skin, but the developing company, Organovo, aims to eventually print complex organ tissue, such as those that makeup kidneys and hearts, directly into a patient.  

The development of institutions capable of mass-producing cloned and/or manufactured organs begs both a bio-ethical and anthropological quandary.  What, if any, are the epistemological repercussions for a society’s perception of the body, the self, and well-being when we can de-fetishize the individual commodities that make up a bodily whole?  The relative scarcity of organs on the market helps maintain their sacred status.  In a system where new body parts are easily accessible, there are both exciting and frightening consequences for the transformation of the body from sacred to mundane.  The potential for therapy is revolutionary.  A cancerous or diseased lung or liver could simply be replaced, or repaired by a 3D printer.  Yet there are those who may ask, “why should I quit smoking or drinking?”  Burn victims could lose their scars, accident victims could repair a lost limb.  Yet there are those who may ask, “why must I be burned or disfigured to have new, young skin?”  The issues are not unique to organ replacement.  One example is the development of reconstructive surgeries that have helped countless individuals who, for whatever reason, are socially stigmatized due to their appearance.  Yet, the medical technology has quickly become pervasively prosaic.  For example, purely cosmetic procedures in Brazil, the “plastic surgery capital of the world”, are covered by national insurance and are free to society.  Ethnographers have commented that the wanton necessity for personal beauty in Brazil has created a society in which perceived flaws or perceived physically unattractive traits become a sort of intense social impoverishment that allows the government to consider cosmetic surgery as a medical necessity.  The phenomenon is not unique to Brazil.  What has happened is that rather than ameliorate an inherent problem in individual and social health, the development of medical technologies has in some ways come to define social perceptions of beauty.  This dilemma resonates among many presentations of emerging tech and bio-sciences; that is, the unique ethicalities of the political and social management of therapy vs. enhancement.  Social issues in innovations in tissue synthesis now echo that of local discussions on cybernetics, artificial intelligence, and other biotechnologies.  Is society effectively capable of taking advantage of the therapeutic possibilities of new technologies while ignoring the possibilities of personal enhancement?

One of the problems that Nancy Scheper-Hughes sees in society’s perceptions of organs, vis-a-vis the fetishization of life, is the ability to view organs as commodity in the first place: that we can calculate, seemingly empirically, the amoral fiscal value of our individual parts.  According to a survey from Wired magazine this year (Feb, 2011) eyes are valued at $24,000; female egg cells, $12,400 per IVF; a human kidney, upwards of $260,000; and human skin, a more affordable (monetarily speaking), $10 per square inch.  Those in need view the living individual as a husk of meat, with different cuts valued at different prices.  It seems many people are capable of maintaining this position without the modern influence of organs as mundane commodity.  New technologies have the potential to help socially re-deify the living human, and yet they have the potential to further reinforce social divide already too prevalent in the world.  The latter is a bit too cynical for me.  I encourage the position that scientific innovation is amoral in essence, and I do not push for politics to overly discourage the creative enterprises that lead to both therapy and enhancement; the two domains are inherently and philosophically intertwined.  Still, as a society we can try to be cognizant of the metaphors and values we place on the various instruments of our well-being.  Let us hope that Marx will be proven wrong, and we can remember that the sum of our parts make a unique cohesive whole.

Aaron Parkhurst is a PhD Candidate in Medical Anthropology at UCL.  His research includes humanity's struggles with modernity and changing perceptions of the 'self'. He can be contacted on this email address.

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