NPR News

Excerpt: 'The Red Market'

NPR | By Scott Carney

Published June 9, 2011 at 12:27 PM EDT

I weigh just a little under two hundred pounds, have brown hair, blue eyes, and a full set of teeth. As far as I know, my thyroid gland pumps the right hormones into the twelve pints of blood that circulate in my arteries and veins. At six feet two inches, I have long femurs and tibias with solid connective tissue. Both of my kidneys function properly, and my heart runs at a steady clip of eighty-seven beats per minute. All in, I figure I'm worth about $250,000.

My blood separates neatly into plasma, red blood cells, platelets, and clotting factor and would save the life of someone on an operating table or stem the uncontrolled spilling of a hemophiliac's blood. The ligaments that keep me together can be scraped from my bones and implanted in the wounded knee of an Olympian athlete. The hair on my head could be made into a wig, or reduced to amino acids and sold as a leavening agent for baked goods. My skeleton would make a striking addition to any biology classroom. My major organs — heart, liver, and kidneys — could go on to prolong the lives of people whose organs have failed, and my corneas could be sliced off to restore sight to the blind. Even after death a determined pathologist could harvest my sperm and use it to help a woman conceive. The woman's baby would have a value of its own.

Since I'm an American, my flesh sells at a premium; if I had been born in China, I would be worth much, much less. The doctors and brokers, no matter the country, who would move the pieces of my body through the markets stand to make a considerable sum — much more than I could as a seller — for their services. It turns out that the global laws of supply and demand are as fixed in organ markets as they are for shoes and electronics.

In the same way that a mechanic can swap out worn car parts for new ones and oil creaky joints to get an engine running again, a surgeon can prolong someone's life by trading broken pieces for newer ones. Every year the technology barriers get lower and the process cheaper. But there's no scrap heap for quality used human parts. Attempts to create artificial hearts, kidneys, and blood pale in comparison to the real thing. The human body is just too complex. At the moment the body can't be replicated in a factory or lab. Which means the only way we can meet the demand for body parts is to find sources of raw materials in the population of living and recently deceased people.

We need great volumes of human material to supply medical schools with cadavers so that future doctors have a solid understanding of human anatomy. Adoption agencies send thousands of children from the third world to the first to fill the gaps in the American family unit. Pharmaceutical companies need live people to test the next generation of superdrugs, and the beauty industry processes millions of pounds of human hair every year to quench a ceaseless demand for new hairstyles. Forget the days of grass-skirt-wearing cannibals on tropical islands, our appetite for human flesh is higher now than at any other time in history.

There is a strange alchemy that happens when we decide that a human body can be swapped on the open market. Most people instinctively know that what makes humans special is more than just our physical presence — from the electrons and quarks that give us mass to the complex biological structures that sustain our every breath; there is also a sense of presence, which only accompanies life. For the purpose of this book and to make sense of it as I write, I give the human body the benefit of a soul. Losing that soul transforms a body into a jumble of matter.

Though we like to think that our bodies are sacred and above the hardscrabble logic of the market, the sale of human parts is booming. Several billion dollars' worth of humanity changes hands every year. With almost six billion people in the world the supply is significant. There are just slightly fewer than six billion spare kidneys (or twelve billion if you are absolutely merciless) and almost sixty billion liters of blood in the global supply. There are enough corneas to fill a soccer stadium. The only thing stopping businesses from grabbing the potential profits are the rights to mine the resources.

Take, for instance, the market for adopted children. At the moment a family decides they want to bring in a needy child from a foreign country, they only have an abstract idea about that child's identity. In their search for the perfect baby they refine their expectations based on the available baby market. They troll through online menus issued by international adoption agencies, read newspaper articles about desperate children in orphanages, and make difficult decisions about what particular set of characteristics will trigger the adoption.

Sure, at some point the child will be a member of the family, but to actually obtain one they have to engage with an often shady supply chain of middlemen and corruptible government officials, many of whom see children as little more than bodies. It is only after they have brought the child into their home that the child transforms from an abstraction into someone real.

It doesn't matter what our moral position is on the subject, bodies are unquestionably commodities. And yet they are uncomfortable ones. As a product, bodies aren't assembled new in factories filled with sterile suited workers; rather they are harvested like used cars at scrap markets. Before you can write a check and pick up human tissue, someone needs to transform it from a tiny piece of humanity into something with a market value. Unlike scrap, the price of a human body isn't measured only in dollars. It is measured in blood, and in the ineffable value of lives both saved and lost. When we buy a body part, we take on the liabilities for where it came from both ethically and in terms of the previous owner's biological and genetic history. It's a transaction that never really ends.