In this harrowing, eye-opening account, investigative journalist Scott Carney goes inside the multi-billion dollar industry of human bodies, and studies the international market for organs, bones, genetic material, and even live human beings. As readers learn about murky international regulation, and the desperation that drives prospective buyers and sellers into a shady, and often dangerous underworld, they will discover that with these ethically complex issues, there are no easy answers.
Carney looks at the refugee village of Tsunami Nagar, largely populated by survivors of the 2004 earthquake and tsunami that killed tens of thousands. So many people here have sold a kidney on the red market - most for around $1000 - that the village is known as "Kidneyvakkam" or "Kidneyville." Most go through middlemen and organ brokers who seek out the most vulnerable and destitute as donors, then buy low and sell high to hospitals willing to overlook the possibly illegal sources of the organs they use.
Issues of transparency, privacy, and exploitation also cloud the business of international adoptions, egg donation, and surrogacy, and allow ethically suspect, and sometimes overtly criminal, enterprises to thrive. The most horrifying cases Carney investigates involve orphanages accused of kidnapping children from their parents and selling them to unsuspecting families abroad, but he also examines the ethical gray areas and questionable practices that exist with surrogacy and egg donation.
In some cases, greater regulation and transparency would help to correct the worst cases of criminal exploitation, Carney argues. And an altruistic system of pure "donation" is certainly preferable. Unfortunately, it's not always possible.
When the United Kingdom outlawed compensation to egg donors in 2007, the donor pools vanished almost overnight. The shortage drove women desperate to conceive to countries like Cypress, which boasts the highest number of fertility clinics per capita in the world. The same motivations drive people to other countries for organ transplants when the wait seems too long and the cost too high at home. And while blood donation is considered a civic good in the United States, in some countries, the only way to attract "donors" is to offer compensation - or kidnap them, as Carney discovers at an illegal "blood farm" in rural India.
It's difficult to point to solutions. Especially when, as Carney also points out, things so often go right. Organ and blood donations save lives. Adoption, surrogacy, and IVF have created countless happy families. But when things go wrong, there is a very real human cost. Carney argues that greater transparency would go a long way towards correcting the abuses that exist, as well as towards changing the way people think about what it means to put a price tag on a human being.
Carney's writing is nervy, his research fascinating, and the result is a book that is both thought-provoking and hard to put down. Interested readers might also enjoy White Coat, Black Hat: Adventures on the Dark Side of Medicine by Carl Elliott, a look at what happens at the intersection of medicine and commerce.