thepeel
Joined: 08 Aug 2004
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 Posted: Sat Apr 28, 2007 1:34 am Post subject: Who Owns Your Body Parts? |
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Who Owns Your Body Parts?
Everyone's making money in the market for body tissue -- except the donors.
The Invisible Hand
The legal value of a human body, dead or alive, is zero dollars. "Under old English common law the body had no value at all," explains Ronn Wade, head anatomist for the state of Maryland. "Today if you look at not just transplantable tissue but the demand for body parts for medical research and training, and what the market will pay, the body certainly is valuable." The actual value of the body varies widely. A Brooklyn district attorney prosecuting the Mastromarino case says a single corpse can fetch $250,000, though most estimates are closer to a mere $100,000. One corpse can help heal 50 different people in the same number of countries; a tendon might be sent to Australia, a heart valve to India. Bones, skin, spines-all of it is worth something to someone.
The market is thriving and global demand has soared, but almost no one will cop to buying and selling body parts. The 1984 National Organ Transplantation Act outlaws the transfer of "any human organ for valuable consideration" for use in transplantation, a proscription generally taken to include tissues as well as organs. But the law does allow for "reasonable payments associated with the removal, transportation, implantation, processing, preservation, quality control, and storage of a human organ." Thus the tissue industry runs on what it deems to be "reasonable" terms. Those who strip skin for sales are "procurers," not vendors; their customers are "processors," not buyers. Tissues are not sold for prices based on demand but processed for a "reasonable price."
The first rule of the tissue market, in other words, is don't talk about the tissue market. Patients would be far worse off if the trade in tissue were stanched, goes this line of thinking. The supply of life-enhancing materials would become as scarce as organs are now, creating shortages and jacking up prices. But to admit that the market exists, that profits are being made, is to risk violating the law and the social norms from which it springs.
Some donors have found ways to play along and make a buck, engaging the language of donation even as they exact payment. Ova donors, for instance, can be "compensated" for their time at virtually any price the market will bear. (See "Ova for Sale," October.) Blood banks pay for plasma, sperm banks for semen. By contrast, the kin of deceased donors are never compensated, and they probably don't even know that their relatives' tissue will be sold.
Organs, unlike tissues, are not generally sold for profit, and the current donation regime suffers from severe and deadly shortages. In 1986 the Uniform Anatomical Gift Act imposed a highly regulated system for managing organ donation. Kidneys, hearts, and lungs are tracked, waiting lists maintained. But supply is scarce, largely because the circumstances in which organ donation occurs are so limited. Organ donors must be young and healthy; typically they die of a catastrophic event such as a motorcycle crash. The government has also designated a single designated procurement organization for every locality. If you die at home and donate, the government knows exactly what organization gets to take your organs.
Tissue donation, by contrast, is lightly regulated and totally unmapped. The government never designated organizations for each area, and a variety of organizations compete for available bodies. Almost anyone of any age can be a tissue donor, and tissue never enters the tightly controlled, heavily regulated system of organ distribution. This relative freedom has huge advantages for burn victims and other patients who benefit from donor tissue, but it has upset established procurement organizations that, for the first time, have to compete for parts.
In the Washington, D.C., area, the local organ procurement organization-the nonprofit with a monopoly on organs-also procures tissue. Hospitals notify the Washington Regional Transplant Consortium (WRTC) when someone is nearing death, and the nonprofit sends out family counselors to discuss donation with the next of kin. If consent is granted, WRTC sends a tissue recovery team to the hospital.
Where does the recovered tissue end up? According to Cindy Speas, WRTC's director of community affairs, the organization is "not involved in any way with anything that is not a not-for-profit." And it's true that the consortium doesn't send tissue directly to corporations. Instead, WRTC provides tissue to LifeNet, another nonprofit, whose mission is to "improve the quality of human life" and "serve the community." LifeNet posted $107 million in revenues in 2004 for "tissue/organ procurement, processing fees, and reimbursements."
From LifeNet, the tissue enters the for-profit system. LifeNet has contracted with LifeCell, the company that makes AlloDerm, along with other "alliance partners" such as Osteotech, the firm that makes bone putty. Standard and Poor's lists LifeCell's value at $888 million. From there, tissue can end up as replacement skin for a young burn victim or cosmetic filler for a thin-lipped socialite. |
http://www.reason.com/news/show/118517.html |
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