I ran across this scholarly paper the other day, compliments of my google scholar alert. I encourage everyone to read it in its entirety. Below are some excerpts:
The World Health Organization estimates that there is a kidney sold every hour illegally.
After the introduction of cyclosporine (anti-rejection medication) in the mid-70s and global distribution in the 1980s: the kidney took on new meanings; in a living donor, the kidney was now envisaged as a surplus object, an object that could serve wider uses for others…
In this clinical landscape, “the medicalized body” abstracts a person from their parts and made the distancing of the material body from the ‘self’ quotidian.
These new understandings of the body, especially the rhetoric of surplus of one’s other kidney, were quickly normalized and mobilized within medical and patient communities. With transplantation, the living donor’s other kidney was no longer seen as useful to them, but rather of better use elsewhere — in the body of a critically ill patient.
Kalindi Vora argues that the expendability of populations and persons is directly linked to their labour use-value; those who fail to be significant economic actors in the dominant society are not as useful as those who are.
Kidney traffic hinges on division of both the body and of the space in which the body is fragmented. No longer
a ‘gift’, the commercialized kidney renders social relationships through exchange irrelevant. With the division of space which renders donors anonymous, there can be mindful distance of the recipient taking one’s kidney for their own use; this mindful distance is bolstered by the act of monetary compensation to the seller as well as keeps the broker relevant.
Anne Griffin recently detailed the dubious parameters in the criteria used to define the [Iranian] waiting list as ‘eliminated’ in Ghods’s study. Griffin described that poor patients, who largely have to wait for cadaveric donation, since they cannot afford to compensate LRD or LUD’s, were still waiting on kidney transplants; the wait was only over for those with fiscal means.
Especially in the wake of publications from medical and ethnographic studies of kidney vendors in India, Bangladesh, Iran, and Moldova, variations of the same story were told: selling a kidney never made any significant impact on donor’s economic lives, despite what many economists, bioethicists, and medical professionals claim. What vendors did experience were lost wages, from the post-operative pain and sickness many vendors felt, feelings of deep regret, and societal expulsion in some grave cases. Thus, to promote the dismemberment of the economic underclass as a means of being economically ‘visible’ is both ethically and morally irresponsible. Moreover, rarely mentioned in literature advocating legalized markets (regulated and unregulated) are the risks of nephrectomy to donors or strategies focused on prevention of renal disease.
As Donald Joralemon and Phil Cox aptly state, “if society has a moral duty to rescue, the obligation surely is not limited to rescuing those of means.”