In Body Shopping, medical ethicist Donna Dickenson gives a chilling account of the human body parts trade. Like a surgeon preparing her tools for an operation, she carefully unpacks troubling stories about organ selling, face transplants and furtive schemes to dupe patients and profit from their tissues. If there was any doubt whether the human body is a global commodity, Dickenson ably puts it to rest.

The book could not be more timely. Last month, Michael Mastromarino, a former oral surgeon, pleaded guilty to pillaging 1800 bodies for bones, ligaments, heart valves, organs and other valuable tissues. His New Jersey biotech firm was more like a human chop shop, paying funeral directors $1000 per pillaged corpse and later reselling the parts, earning at least $13,000 per body. After snatching the desired parts, Mastromarino stuffed the bodies with plumbing piping to deceive relatives. Body parts from diseased corpses with AIDS, cancer, hepatitis and other serious illnesses were sold for transplantation to unsuspecting hospitals, doctors and patients throughout the US and abroad. Among the more illustrious bodies to have been ransacked was that of long-time Masterpiece Theatre host and radio broadcaster, Alistair Cooke.

The challenge in parsing out the issue of trade in body parts is that it is wedged between two legal processes: altruistic donation and legalised tissue implantation. In between lies the troubling world that Dickenson describes as an international black market industry.

Every year over one million Americans undergo surgery involving soft tissues, skin, bones and tendons taken from cadavers, yet how these parts are obtained would shock most people. Tissueprocessing companies purchase parts from hospitals and other institutions to which bodies are altruistically donated, then sell them for profit. Some companies boast that one cadaver can reap over $200,000.

For Dickenson, body shopping is problematic not only because of the ghastly tales of deception – like those of doctors filing patents on cell lines derived from purloined tissues – but also because humans are led astray by their “dreams of infinite regeneration, immortality, and eternal youth – all in modern guise”. Encouraged by commercial blood banks, some parents, for instance, store umbilical-cord blood in the hope that it might later save their children from disease. For Dickenson, the blood banks should not shoulder all of the blame. The parents are complicit in allowing themselves to be duped by claims that hold little promise – a result, she says, of the human craving for biotech’s fountains of youth.

Hopeful parents aren’t the only ones subjected to the “emotional blackmail” of the biotech market. People with ailments ranging from multiple sclerosis to visual impairment fall prey to claims from unregulated biotech companies promising cures from stem cells that are unfit for clinical use in humans, and are sometimes derived from animal parts.

While some commentators argue that body shopping is ethically problematic because organs and other human parts are “moral” or community property and not commercial products, Dickenson offers a perspective that is courageous and more convincing. She argues that the body should never be a consumer good because it should never be “merely a thing”. To Dickenson, what is at stake is our dignity.

Body Shopping is ambitious and thoughtful. Dickenson’s claim that regulatory gaps in biotechnology can lead to coercion, misinformation and fraud is well substantiated. The challenge for scholars like Dickenson, however, is to offer alternative solutions. Black markets in human body parts will persist alongside transparent transactions so long as there is a demand for them. It may be more disempowering for the vulnerable to suggest that their biological materials should either be an altruistic good or withheld from medical research entirely. On this point, one thing is certain: body markets are here to stay.

Michele Goodwin is a visiting professor at the University of Chicago Law School and author of Black Markets (Cambridge University Press, 2006)

Copyright 2008 The New Scientist