Why are you interested in medical ethics?
I think medical ethics is an interesting area for someone with a philosophical and legal background like me because it is an area in which you can actually make a difference. Marx’s dictum that ‘philosophers have analysed the world, but the point is to change it’ is relevant to people working in medical ethics. I also think that the dilemmas of medical ethicists very often highlight deep philosophical problems. In the example of body shopping, I was able to home in on the shocking point that you don’t actually own your body, either philosophically speaking or practically in law. People tend to think you do: they think it’s common sense that your body is yours, when it simply isn’t the case.
What is body shopping?
I coined this term to refer to what I think is the commercialisation of the human body. The term is trying to link together a number of instances like egg sales, the private banking of umbilical cord blood, kidney sales, the sale of sperm, and the patenting of the human genome (something like one in five human genes now have a patent, most owned by private firms). What I want to highlight is that we are lacking legal clarification about the relationship we have to our bodies, which is relevant in different ways in each of these cases. I don’t necessarily think that clarification means that we should change the laws so that we ‘own’ our bodies in the conventional sense of property. This materialist attitude creates a number of problems, exploitation for example.
“You don’t actually own your body, either philosophically speaking or practically in law. People tend to think you do.”
After the Asian tsunami in 2004, there were a whole series of reports where Indian women, mostly villagers whose husbands had lost their fishing boats, sold their kidneys for money. These people were left much unhealthier than they were before, and had in my view been grossly exploited.
Are there not good reasons for allowing people to sell their bodies if the industry is properly regulated?
Well, some people say that things like patenting the human genome are necessary for scientific research, which I think is debatable. There is a lot of evidence that the patents are actually blocking scientific research in cases where researchers can’t get hold of the patents, which are owned by a different company. This means that they can’t then do research on a particular gene, or on a drug which targets a particular gene.
Let’s talk about your first book by Henry David Thoreau, Walden.
Walden is a book that I have loved since I was 14 or 15. I actually grew up in New England, where Thoreau writes Walden from, so I suppose the book has a special resonance for me. Thoreau sets out as a young man to investigate how simply he could live. The book is about his awareness that, even in 1845, America was already becoming highly commercialised. He discusses how the original ideals that America was founded on were being compromised, and how massive industrial interests were starting to dominate. This is a trend which has continued to the present day, and is an important theme relating to my own interest in bioethics, with the commercialisation of the human body.
And what does he identify as the biggest problem with commercialisation?
Thoreau isn’t writing a political tract, but rather a pithily written and often humorous personal account. He is probably the greatest English prose stylist of his day, if not of ours, not least because many of his central points are expressed as epigrams, aphorisms or parables. His thinking about commercialisation is also put in that fashion, with a fantastical metaphor of a farmer neighbour whom he met walking down the road, pushing his barn before him. It encapsulates Thoreau’s strong sense that the once independent American character was being simultaneously overloaded and undermined by acquisitiveness and consumerism.
Your next book, The Shock Doctrine, is also a critique of American society. Tell us about the book.
Naomi Klein’s argument is that capitalism actually requires shocks to the economic systems. Economic management, she argues, is not about stabilising the economic system, but actually undermining it so that it can be ‘rescued’ by capitalist interests. It is the fact that she can apply her theory to such a wide range of areas that I admire, her weaving together of apparently disparate phenomena – this is what I try to do with the buzzing and confusing world of modern biotechnology, which I present as united by the process of the commodification of the human body.
What is the most interesting example she uses in the book?
It’s probably a bit predictable to choose her analysis of the Iraq war, but that is very telling. Klein argues that the war wasn’t caused just by what many critics saw as Bush’s monomania or Blair’s toadying. Nor was it merely a matter of ‘one-word answers’ like ‘oil’ or ‘Israel’. Instead, she sees the war as being about the deliberate destruction of the Iraqi economy and infrastructure so that Western firms could move in to win lucrative contracts and penetrate the closed economies of the Middle East. It was an entirely rational doctrine, she argues, the ‘shock doctrine’: just an evil one.
Your next book, Tissue Economies, is more directly about medical ethics. What does the book argue?
Waldby and Mitchell, like Naomi Klein, present a wide-ranging argument, which in their case applies to a number of areas in biotechnology. They produce an account of the way that tissue taken from a body can become a commodity, and look at the problems associated with this process. One example they focus on is private umbilical cord banking, where individuals pay for their child’s blood to be taken from the umbilical cord at birth and banked for a period of about 20 years. The theory is that you can provide some sort of personal spare-parts kit if stem cell research ever advances to the point where we can convert blood cells into tissues or organs. However, there have been criticisms of this practice on several bases. One is that there is something like only a one in 20,000 chance that the child is going to need it. Secondly, if your child did need it, that it would actually possibly be bad for the child to receive his or her own blood rather than blood from a public bank, for example if he or she had a genetically linked illness. Finally, there is another set of findings about the risk the child is in fact put at during childbirth when the blood is removed – umbilical cord blood is not waste blood, but is needed by the infant. The point is that, although there are documented medical reasons not to carry out this procedure, people do so. This is in a large part, Waldby and Mitchell argue, due to the economic influences.
And your next book, Shamans, Software, & Spleens, also looks in part at the economy for body parts.
The most interesting part of Shamans, Software, & Spleens for me is an analogy that James Boyle uses between the privatisation of the human genome and the privatisation of the agricultural commons (an analogy which has since been taken up by quite a lot of activist groups working in this area). This parallel is a useful one: in both cases, what was previously a common good and regarded as natural suddenly becomes private property. The analogy works also because enclosing the land in the case of the agricultural commons, which removed the peasants’ traditional rights so that they no longer could hunt for animals, collect wood and so on, is similar to the way that patenting individual genes by private firms has meant that researchers can be hampered in their own research.
Last book: Locke’s The Second Treatise on Civil Government.
I’m interested in the Second Treatise mainly because it is where we find Locke putting across the now very familiar idea about the relationship between labour and property. Basically his argument is that the way we establish a claim to an object of property is that we mix our labour with it. The classic example is the agricultural crop – if I planted it, weeded it and harvested it, then I have a claim to it, as I have laboured for it. This idea has influenced many people, including even Marx, with the idea that surplus value is seized wrongly by employers, because the labourers have mixed their labour with the product. But what has not been done yet is to apply Locke’s ideas to biotechnology and medical ethics.
And this is what you try to do?
I have been engaged in linking the two for about 12 years now. I wrote a book back in 1997 called Property, Women and Politics in which I argue that the Lockean idea could be very important in the area of reproductive ethics. For example, it could be argued that women who put effort into donating their eggs have laboured, and therefore have a right to them. I have recently been looking at whether it is possible to develop a full spectrum for what rights a patient should have in the products of biotechnology, in things like cell lines or bio-banks, or tissue banks, or organs or whatever, on this same basis.
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