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On the commodification of the black female body: the critical implications of the alienability of fetal tissue.

Recent scientific experimentation has revealed that fetal tissue yielded from abortions has remarkable therapeutic value. This Note posits that the demand for fetal tissue likely will expand to the point where the current supply no longer satisfies it. Therefore, in order to obtain tissue from women who would not otherwise donate their abortuses, should research organizations, pharmaceutical companies, and doctors be allowed to offer women a "financial incentive" for their fetal tissue? That is, should women be allowed to sell their fetal tissue? This Note explores the question from a Critical Race Theory perspective. It analyzes the impact that a market in fetal tissue will have on Black women, who are more likely to participate in such a market due to their precarious economic situation, their higher abortion rate, and the effects of internalized oppression. The Note concludes that because Black women will be disproportionately exploited, as well as disenfranchised from the benefits produced by a market in fetal tissue, fetal tissue should not be made market alienable.

Abortion, Legal↗

Commodifying the polyvalent good of health care.

This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. (1) How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? (2) If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"?

Commerce↗

What does it mean to use someone as "a means only": rereading Kant.

Debates about commodification in bioethics frequently appeal to Kant's famous second formulation of the categorical imperative, the formula requiring us to treat the rational (human) being as "an end in itself" and "never as a means only." In the course of her own treatment of commodification, Margaret Jane Radin observes that Kant's application of this formula "does not generate noncontroversial particular consequences." This is so, I argue, because Kant offers three different--and largely incompatible--interpretations of the formula. One focuses on the obligation to preserve rational willing; the second stresses respect for human (physical) dignity and integrity; the third views respect for others as "ends in themselves" as primarily involving a willingness to govern one's conduct by a procedure of impartial co-legislation. Only the third of these interpretations, I conclude, offers a reasonable and coherent approach to moral judgment about the limits of commodification.

Bioethics↗

Contested commodities at both ends of life: buying and selling gametes, embryos, and body tissues.

This essay examines the increasing commodification of the body with respect to tissues, games, and embryos. Such commodifcation contributes to a diminishing sense of human personhood on an individual level, even as it erodes commitments to human flourishing at the societal level. After the case for social harm resulting from the increasing commodification of the body is made, the question becomes whether that harm is best remedied by following any of three approaches by which government traditionally seeks to promote the flourishing of its citizens. The author concludes that it is not, and that what is needed is a pragmatic and somewhat casuistic approach to the regulation of contested commodities--that which legal scholar Margaret Jane Radin calls "incomplete commodification."

Altruism↗

The special case of property rights in umbilical cord blood for transplantation.

In this Article, Professor Stephen R. Munzer makes a case for limited property rights in umbilical cord blood. Professor Munzer proposes that the unique nature of cord blood distinguishes it from body wastes and qualifies it as a body part in which property rights vest. Employing a theory of property, based in part on the articulation of the principles of utility and efficiency, justice and equality, and "labor-desert," he explores legal and philosophical arguments that justify the acknowledgment of such rights. He also discusses concerns over alleged generous granting of patents in the area of cord blood stem cells in light of these principles. Significant aspects of health policy are explored with particular focus on the potential value of using cord blood to treat various diseases and disorders. Professor Munzer discusses various difficult cases involving the exercise of property rights in umbilical cord blood with respect to the interests and/or motives of newborns, parents, and other parties. He argues that some of the concerns associated with the commercialization and commodification of cord blood are not serious enough to warrant significant barriers to market exchanges of property rights in cord blood. In addition, he concludes that the particular nature and harvesting of cord blood do not make its commodification morally problematic. Finally, Professor Munzer reinforces his treatment of property rights in cord blood by addressing objections that view property as "propriety," as a pragmatic institution, or as social relations.

Blood Banks↗

Environmental economics reality check: a case study of the Abanico Medicinal Plant and Organic Agriculture Microenterprise Project.

This paper presents a case study of the Abanico Medicinal Plant and Organic Agriculture Microenterprise Project in the Arenal Conservation Area, Costa Rica. Microenterprise is the Sustainable Development and the Women in Development model for gender equity and environment of the World Bank, International Monetary Fund and large non-government organizations, like the World Wildlife Fund-Canada. The authors of this paper argue that debt-for-nature investment in microenterprise and ecological economic models are not distinct from neoclassical economic and development models that created the environmental, social and cultural crises in the first place. This case study shows that the world market accommodates only one model of development: unsustainable export-oriented production based on flexible labour markets, low wages, indebtedness and low cost production. Working standards in those micro-enterprises are eroded due to many factors,including indebtedness. What happened at a national level in non-industrial countries with the international debt crisis is now mirrored in individual indebtedness through microenterprise. Is current development policy creating a new form of indentured servitude? Medicinal plants, prior to commodification, were a source of women's power and upon commodification in international development projects, are the source of their exploitation.

Agriculture↗

The products of conception: the social context of reproductive choices.

This paper addresses the changing ideology regarding reproduction, an evolving American, and potentially worldwide, value system regarding children and parenthood. Children are increasingly being seen as products, and the new technology of reproduction, including the sale of reproductive material and services and especially prenatal diagnosis and selective abortion, encourage this commodification of the fetus. While the new technology does indeed offer new choices, it also creates new structures and new limitations on choice. In the contemporary American social structure, these choices are inevitably couched in terms of production and commodification, and thus do not offer individuals genuine choice or control.

Abortion, Induced↗

Prostitutes, workers and kidneys: Brecher on the kidney trade.

Brecher argues that the practices of selling blood and kidneys are akin to the practices of prostitution and wage-labour since they all involve commodification and, by implication, should be subject to legal prohibition. I suggest that these practices need not involve commodification and that they should only be condemned if people are forced into them because of their lack of power. Rather than these practices being prohibited, I suggest that it would be preferable if they were subject to state regulation in order to protect the weak from exploitation.

Commerce↗

The social life of genes: privacy, property and the new genetics.

With the advent of the Human Genome Project and widespread fears over human cloning and medical privacy, a number of states have moved to protect genetic privacy. Oregon's unique Genetic Privacy Act of 1995, which declared that an individual had property rights to their DNA, has provoked national and international interest and controversy. This paper critically reviews the literature on genetic privacy and gene patenting from law, philosophy, science and anthropology. The debate in Oregon, from 1995 to 2001, illustrates many of the key issues in this emerging area. Both sides of the debate invoke the property metaphor, reinforcing deterministic assumptions and avoiding more fundamental questions about the integrity of the body and self-identity. The anthropological critique of the commodification of the body, and the concept of 'embodiment' are useful in analyzing the debate over DNA as property.

Anthropology↗

Social and ethical aspects of in vitro fertilization.

In vitro fertilization (IVF) stands out as one of the contemporary period's most extraordinary technologies, and its social and ethical consequences among the most far reaching. Despite its uncertain effectiveness and medical consequences, IVF has contributed significantly to the medicalization of infertility and the increasingly imperative character of reproductive technology. New developments in IVF, particularly oocyte donation, have created new definitions of treatable infertility and new social needs for IVF; when the technology does not result in pregnancy or healthy babies, these developments have created profound new disappointments. IVF and the commodification of the extracorporeal embryo have also confused the social meaning and legal definition of parenthood. Ultimately the relationship between prospective parents, infertility specialists, and the embryos that they create is a highly ambiguous one. This ambiguity is likely to be a long-term characteristic of efforts to develop, use, and assess assisted reproductive technologies.

Commodification↗

Selling bits and pieces of humans to make babies: The gift of the magi revisited.

Reproductive medicine, a sector of a health care system increasingly captured by the demands of the marketplace, is enmeshed in a drive to sell certain human bits and pieces, such as gametes, cells, fetal eggs, and fetal ovaries, for reproductive purposes. The ethical objection raised by Kant and Radin to the sale of human organs - that this is incompatible with human dignity and worth - also applies to these sales. Moreover, such sales nullify the reproductive paradigm, irretrievably replacing it with a manufacturing paradigm. This represents a change in kind, not just of degree, in the way that we view our capacity to generate children and destroys our concept of reproduction as an essentially human activity. In the face of a struggle to retain those common ethical values at the foundation of reproductive medicine, this form of commodification of the human body should be viewed as ethically unacceptable.

Aborted Fetus↗

Regulating the market for human eggs.

This essay provides a rationale for a regulated market for human oocytes. Although the commodification of human oocytes raises important moral concerns, these concerns do not justify laws banning commerce in human eggs. Given the burgeoning ART industry and the growing oocyte market, the most prudent course of action is to develop regulations for the human oocyte market that are designed to protect and promote important social values, such as health, safety, liberty, and respect for human life. Other responses, such as banning the sale of eggs altogether or allowing donors to be compensated only for their services, would either create a black market or would lead to corruption and abuse. Society still needs to debate specific rules and policies that should govern the human egg market, but further discussion of that important task is best left to legislative bodies and other commentators.

Adult↗

Oocyte cytoplasm transfers and the ethics of germ-line intervention.

Author advances the discussion about positive genetic selection by looking at the use of oocyte cytoplasm transfers as a possible means to prevent disease and to overcome fertility, focusing on the issues of family and kinship, commodification of eggs and egg donors, and germ-line alterations.

Adult↗

Defending commercial surrogate motherhood against Van Niekerk and Van Zyl.

The arguments of Van Niekerk and Van Zyl that, on the grounds that it involves an inappropriate commodification and alienation of women's labour, commercial surrogate motherhood (CSM) is morally suspect are discussed and considered to be defective. In addition, doubt is cast on the notion that CSM should be illegal.

Commerce↗

Is life of infinite value?

It is possible and necessary to compare stretches of human life with other goods, such as the good of conserving resources for others. A minute of human life is not of infinite value; all else being equal, a minute of life is less valuable than 10 years of the same life. Nevertheless, this ability to evaluate human life does not necessarily lead to total commodification of human life.

Adult↗

Response: persistent perplexities.

This response to the preceding five articles highlights the stubborn persistence of the philosophical perplexities surrounding commodification in the realm of medicine and biotechnology.

Bioethical Issues↗

The kindness of strangers: organ transplantation in a capitalist age.

The topic of organ transplantation is examined from the perspective of three authors: Robert Bellah, Jeremy Rifkin, and Margaret Jane Radin. Introduced by reflections on the development of the justification of organ transplantation within the Roman Catholic community and the various themes raised by the historical study in Richard Titmuss's The Gift Relationship, the paper examines how and in what ways the possible commodification of organs will affect our society and the impacts this may have on the supply of organs.

Altruism↗