The movie The Island, The Legends of Dune Prequels, and a host of other fiction and science fiction works have dealt with a great fear which is part reality, part urban legend, and part possibility: The illicit organ transplant market.
The premise of The Island is that scientists trying to find ways to clone human organs discover that the organs die unless connected to a living, intelligent brain. This, of course, creates a moral dilemma, which is ultimately what most science fiction is really about. Are the clones subhuman enough to be sacrificed to provide organs for their originals? It is the same sort of moral issue that illuminates the debates over stem cells and abortion, but in this case it is made sufficient clear to be morally unambiguous by this "living brain" necessity. Biotechnologically, this is unlikely. We already grow all sorts of tissues in the lab and there has never been any indication that, for example, "cloned" skin requires a brain to function. There is no reason to anticipate that a "cloned" liver or heart or kidney or lung would need a living brain, or even of an entire human body, to be grown artificially in a lab either. And, the bottom line for even very morally cautious people, is that if there is no brain, there is no morally important life to preserve and protect.
But, at a deeper level, it also probes the theme recurrent in critiques of our economic system from slavery to Sinclair's "The Jungle". What moral responsibility do the beneficiaries of economic fruits bear for immorality in the way that the fruits they benefit from were made? And, what responsibility do we as a society have to not be willfully blind to how we received what we use in order to avoid moral responsibility? We already turn a blind eye to a great extent to the foreign sweatshops and polluting processes that generate our ordinary goods. This happens at a systemic level because our lawmakers have chosen to enter into free trade pacts that lack labor and environmental standards. The 19th century system developed to deal with the sacrifices of blood which went into our manufacturing processes, the worker's compensation system, continues to quietly exchange very modest amounts of cash for workplace deaths, in exchange for ending litigation over the matter with a strict liability regime. Few people realize how many people die to bring us the coal that makes electricity, or the agricultural goods and fish that we eat every day. As a character in The Island reminds us, people who eat hamburgers don't want to meet the cow.
The Legends of Dune series poses a more plausible scenario. Advanced technology has made it possible to clone or grow individual organs that can save lives in biofactories. But, this technology, while morally sound itself, is also extremely expensive, and the demand from wealthy powers (who are in this case at war) for more organs is intense. Stealing organs from innocent but impoverished people is morally bankrupt, but far cheaper, and the end users of the organs don't know the difference. The providers work hard to keep their methods secret. The recipients have no incentive to pry more than superficially.
Those who have looked into it claim that reports of kidneys stolen by deception or force are pure urban legend (the non-science fiction movie Dirty Pretty Things does a nice job of portraying that legend). But, plasma donations centers that pay people for their blood, surrogate mothers and egg donors who do what they do for money, and I suspect, people who receive financial inducements to voluntarily donate organs in the face of financial pressures (such of those from donors in India, more graphically described here), are more than myth. The process of obtaining morally questionable biological gifts that may even compromise or risk the donors' health is more akin to prostitution than it is to rape, at least right now. As in the case of sex, there has been an effort to limit donations to those rooted in love, but that has proved a difficult standard to maintain as more than blood ties have been permitted. See also here (funeral expenses for deceased organ donors). Science fiction author C.S. Friedman has written a short story called "Downtime", illustrating the harrowing conseqeunces of linking love to biological self-sacrifice. Against that backdrop world of the novel "Hopscotch" by Kevin J. Anderson where people pay others to inhabit their bodies during moments of foreseeable suffering seems almost humane by comparison.
This isn't really surprising. About 200,000 incidents of rape, attempted rape or sexual assault are reported each year in the crime victimize study conducted by the Department of Justice, about 15% of which lead to arrests. There are two and a half times as many arrests each year for prostitution, yet in the case of prostitution both parties try to avoid arrest and in parts of Nevada, prostitution is legal. Few people doubt that there are millions of prostitution transactions each year. The dirty side of the future of organ donation is likely to look more like the stories of Philip K. Dick, where desperate people in a criminal underground medical world do what they feel they must, than it is like "The Island.", where a murderous alternate reality that dozens of employees manage to keep secret without a leak, persists.
Post a Comment