Blade Runners

>> Monday, January 12, 2009

No, not a reference to what you think; well, not exactly. The movie everybody knows was based on a Philip K. Dick novel, but what fewer people know (tho' I wouldn't say it's "uncommonly" known) is that the film's title was licensed from yet another writer, William S. Burroughs, regarded as a Beat although he was practically a science-fiction writer himself. And, actually, there's at least one more thing buried in the matryoshka: Burroughs' project was actually originally meant to be a proposal for adapting Alan E. Nourse's science-fiction novel about black-market medical providers in a dystopian future.

I haven't ever gotten around to reading Burroughs' or Nourse's books, though I like Burroughs and so it's the sort of thing where it's actually a little surprising I haven't read it. From what I've read about the Burroughs and Nourse versions of Bladerunner or Bladerunners or The Bladerunner (it seems to have gone by various titles in various incarnations, particularly when it was in development hell in the '70s until Ridley Scott bought the title and threw the rest of it out), the title actually makes sense in their context: to this day, I still have no idea why a bounty hunter would be called a "blade runner" (I mean, aside from the obvious badassness of it), but calling somebody who smuggles medical services a "bladerunner"--oh, yes, he has to smuggle his scalpels around, I totally get it.

It's real-life bladerunners, in the Burroughs/Nourse mold, who've prompted this post: Newsweek has a story up about organ trafficking, the allegation being that it's no longer just an urban myth that's sometimes gotten tourists beaten up or inspired a hysterical Venture Brothers episode, but rather a horrifying reality as donors are brought in from developing nations to sell off that gratuitous extra kidney or cornea, or maybe a piece of liver or chunk of marrow. We're informed that the World Health Organization estimates about fourteen thousand of the kidneys transplanted annually (one-fifth of the total) come from black-market sources. We read about organ brokers flying patients from around the globe to Mount Sinai for harvesting. And then there are real horror stories: UC Berkeley anthropologist Lawrence Cohen reports that husbands in India have been forcing wives to sell organs to contribute to family income or for the purposes of a dowry.

The medical community has responded: in May, at a global conference in Turkey, members of the medical community wrote and signed The Declaration of Istanbul on Organ Trafficking and Transplant Tourism, which has subsequently been endorsed by a number of medical organizations worldwide.

To the medical community's credit, if you read The Declaration, it's actually a bit more thoughtful and less-knee-jerk (or jerk of any kind) than the Newsweek piece.

See, here's the thing: the Newsweek article caters to the reflexive revulsion I suspect most of us feel when it comes to the subject of selling pieces of ourselves. That's the basis of the urban legends about organ harvesting, after all: dismemberment anxieties combined with fears of both theft and alienation of corpus (a phrase I'm making up because I can think of none better, though I suspect somebody else has already come up with a better expression), that is, the fear that part of your body might no longer be yours (c.f. all those horror movies where somebody's hand becomes an autonomous killer or comic books starring murderous hair). There's something fundamentally, intrinsically violating about the theft or vulgar sale of pieces of one's self (and conversely, the willing donation of an organ seems like an intimate gift, when one might reasonably conclude, bluntly, that's it's merely a transfer of meat, albeit a life-sustaining one and therefore noble in that regard, at least).

But let's assume, just for the moment, that equal bargaining partners are discussing the exchange of an organ for consideration--I have a healthy organ, you have money, I'm willing to part with my organ for money and I'm under no particular duress to do so: should that be illegal? It currently is illegal, apparently, in every part of the world except Iran, and while I hate to be on the side of the Iranians, I have to say that it seems that a belief in personal autonomy and freedom is inconsistent with a law telling me what I have to do with my body. Why shouldn't I be able to sell a kidney?

Granted, I might have seller's remorse later. I might find I need the kidney back, and selling it was a terrible idea. Then again, I might say the same thing about signing a contract to work on an oil rig or purchasing a ticket to fly on what turns out to be a poorly-maintenanced airplane. A lot of things are risky, but we allow consenting adults to do them: take flying lessons, join the army, have sex, the list of things which could be life-changing in a bad way or even fatal is nearly endless.

The problem, it seems to me, isn't with the nature of the transaction. It's with that deck-loading qualifier I used leading into my question: "equal bargaining partners". Much of economics, law, and all the philosophy behind contracts business and social can be boiled down to this presumption--that two (or more) people are on a similar and fair footing and can be expected to interact rationally as relative equals. If you and I are reasonable adults, it doesn't seem that problematic to me for you and I to negotiate the exchange of cash, goods, services and even other body parts for organs. (You need bone marrow, I need a cornea--hey, we'll both be under anesthesia anyway, right?1)

I have no problem with that arrangement, anyway, but I am revolted by the idea that husbands in India are selling their wives' bodies in this literal sense (or any other, for that matter; legalize prostitution and criminalize pimping, says I, but that's a subject for another time). And it strikes me as dire and unacceptable that the organ sellers also seem to be poor folks across the board; even the Newsweek example cited of an American would-be organ-seller appears to be a poor woman in rural Kentucky who needed money for dentures. The soundest argument one can make in favor of outlawing the organs market, I think, is that while one can imagine rational equals selling off their spare parts, it's not actually something a fiscally-comfortable person would actually ever do. The reality of duress--if not force--seems to be inseparable from the problem.

But then, it strikes me that the solution, in that case, isn't to outlaw the organ market as it is to remove the inequities that pervade it. That is, focus on poverty, the rights of women and children, and access to medical care. Reform those things, it seems to me, and the idea of a regulated organ market seems vastly preferable to an unregulated black market driven by poverty and feudal attitudes towards gender.

I was prepared by the Newsweek article2 to describe the Declaration Of Istanbul as a bit of well-intentioned paternalism, but then I read it, and actually the main thrust of the Declaration is sort-of-consistent with what I've written. That is, I think the doctors would be much happier if there was no organ market and they say so, but they seem to understand that the real issues are issues of poverty, class, gender, and access to treatment, and not just the general ickiness of people chopping off bits and auctioning them. There are prohibitions on advertising, but there's also a lot of nice stuff about equitable allocation of organs internationally. I might be a bit happier if there was something about equal rights for women, but then a statement like, "Because transplant commercialism tar-gets impoverished and otherwise vulnerable donors, it leads inexorably to inequity and injustice and should be prohibited," is one, as I sort of said above, that I have to accede to because of practice even if I think there's nothing wrong with organ sales in principle.

Because, like I said, selling organs doesn't seem like something comfortable people would generally do, making the idealized scenario a little ludicrous. I can afford not to sell you my kidney, so why would I? Conversely, if I need the money that badly, that's a major problem. I'm not entirely sure the Declaration Of Istanbul proposes adequate solutions even as it implicitly recognizes the real issues--outlawing organ sales only seems like it would make the black market more profitable--but trying to arrest organ brokers is also probably more feasible in the near-term than getting every man and woman a living wage, even if the latter is the long-term goal. Eliminate the incentives for selling organs, and I imagine most people will stop doing it.

Although in the meantime, don't be surprised if the blade runners make a killing.

1Hey, that line is funny. I know it's unlikely they'd do that much major surgery simultaneously.

2Also, I need to say this somewhere: I have no freaking clue whether the Newsweek article is accurate or more media scaremongering, or whether or not it's an accurate report of laughable research by the doctors and anthropologists cited, who may be wrong or mislead, etc.

I can see, for instance, where spooling out a long and horrific account of organ thieves and dying white millionaires would be a really, really funny--and maybe profitable--thing to do if I were a bored townie in some corner of the Third World; indeed, I have to admit that it's exactly the sort of thing I'd do if I was bored and some gringo from the yanqui university came up to me and started asking where she could purchase human kidneys. Have I told you about the time I told a newcomer to Charlotte that the reason he'd never seen anybody milling around the campus of Queens College was because it was a movie set that had been too expensive to knock down? That was pretty funny. And I was just being a dick, it's not like he was buying me lunch or something. Yeah. That's just how I roll, baby.


John the Scientist Tuesday, January 13, 2009 at 3:39:00 PM EST  

The problem is that not all countries would have a free market.

Although the Chinese took those websites down, Shenyang is still selling the organs of executed prisoners to wealthy Japanese, Filipinos, and Saudis (primarily).

In addition, with the condition of near-slavery in which Saudi domestic help is held, there is quite a potential for abuse there as well.

But I tend to agree about the free market in the West. Doctors want the control to be in their hands, it's quite paternalistic, in fact.

Post a Comment

Thank you for commenting! Because of the evils of spam, comments on posts that are more than ten days old will go into a moderation queue, but I do check the queue and your comment will (most likely) be posted if it isn't spam.

Another proud member of the UCF...

Another proud member of the UCF...
UCF logo ©2008 Michelle Klishis international gang of... international gang of...
смерть шпионам!

...Frank Gorshin-obsessed bikers.

...Frank Gorshin-obsessed bikers.
GorshOn! ©2009 Jeff Hentosz

  © Blogger template Werd by 2009

Back to TOP