15 August 2018

Organ Markets

'Still A Vexed Question: Postmortem Gamete Removal And Use', a forthcoming HLB article by Wendy Bonython and myself, considers questions about property and the parens patriae jurisdiction in Re Cresswell [2018] QSC 14 and Chapman v South Eastern Sydney Local Health District [2018] NSWSC 1231.

A different perspective is provided in 'Private parts: an interrogation of private property rights in cadaveric organs' by Christopher Smol in (2017) 4 Public Interest Law Journal of New Zealand 150, with Smol commenting
This paper makes a tentative case for a futures sales model for cadaveric donor organs, wherein individuals can contract out the right to harvest their organs for transplant following their death, in exchange for compensation. The law of the United Kingdom, New Zealand, Australia and the United States are generally adverse to the notion of property rights in human bodily materials, and this article criticises this paradigm as serving to disenfranchise materials’ originators. New Zealand’s framework for cadaveric donation under the Human Tissue Act 2008 does not fully address practical barriers to successful donations. This article advocates a tightly-regulated government-run futures scheme as having potential to overcome some of these barriers, while mitigating serious ethical concerns. Non-instrumental concerns around commerce in the human body can be reconciled with the proposed model.
Smol argues
Almost all jurisdictions agree that human organs should not be able to be bought and sold. Similarly, most agree that an increase in the supply of organs available for potentially life-saving transplantations is desirable. However, the former position, as reified in the legal principle that there is no property in the body, has impeded the latter objective. While organ transplantation training and technology in developed nations has grown affordable and accessible, the supply of donated organs for these operations remain vastly lower than demand. 
One explanation for this organ shortage is that attitudes to the body, living and dead, have not kept pace with technology. Most organs are procured for transplantation by altruistic donation. This article focusses specifically on cadaveric donation by the recently deceased or brain-dead, which can be done for various organs with high rates of success. The no property in the body principle forbids sales, thus limiting the supply of transplant organs to those donated (that is, without compensation). Unfortunately, this practice facilitates fewer transplantations than are needed to save the lives of all who suffer organ failure. In 2011, 477 New Zealanders began to receive renal replacement therapy, while replacement kidney transplants totalled only 118; patient deaths totalled 412; of these, 44 had undergone transplant surgeries, but the vast majority (368) died while on dialysis (an expensive and non-curative alternative), presumably waiting for a transplant. 
This article will analyse this organ shortage problem from a consequentialist perspective. The restriction of property rights over cadaveric organs under the current legal paradigm fails to efficiently incentivise and safeguard the retrieval of those organs for lifesaving procedures. Part II overviews domestic and international law regarding property rights in cadavers and organs. Part III provides an economic analysis of cadaveric procurement, and recommends a heavily regulated property right in cadaveric organs, exercisable through futures contracts for cadaveric procurement. Part IV assesses non- consequentialist opposition to property rights revolving around Kantian dignity and the commodification of the human body. Ultimately, a detailed and highly regulated monopsonistic system allowing the sale and purchase of futures contracts for the right individuals’ organs in the event of their death would efficiently increase organ procurement. With careful implementation it could save lives while negotiating and accommodating legitimate normative concerns.
'“Death is a disease”: Cryopreservation, neoliberalism, and temporal commodification in the U.S.' by Taylor R. Genovese in (2018) 54  Technology in Society 52-56 comments
In Darren Aronofsky's 2006 film The Fountain, the protagonist, Tommy—played by Hugh Jackman—proclaims to a laboratory colleague after his wife dies from brain cancer, “Death is a disease. It's like any other. And there's a cure… and I will find it.” While this re-framing of death as a medical diagnosis to overcome and in need of a “cure” may seem facetious—or perhaps, to some, horrifying—humankind's array of religions have spent at least a section of their scriptures trying to explain away death's finality. Until quite recently in human history, death has been less articulated to materialistic notions of the physical but instead has been coupled with discussions about the spiritual. 
Somewhat situated at the crossroads of the physical and the spiritual is the transhumanist movement. The transhumanists are a meliorist movement that hope to enhance human intellect and physiology by applying scientific and technological advances to “enhance” individual human bodies. The movement can be traced back to Nikolai Fedorovich Fedorov's “cosmist” movement at the turn of the 20th century whose goals consisted of: establishing universal immortality for human beings, resurrecting the dead, engineering the human body for spaceflight, and freedom of movement throughout the cosmos. One modern enactment of the transhumanist philosophy is that of cryopreservation, or freezing one's body after death with the hope of being reanimated in the future. 
In this article, I will be focusing specifically on cryopreservation and two of the American biotechnomedical tenets introduced by Robbie Davis-Floyd and Gloria St. John  in their technocratic model of medicine: the “body as machine” and “death as defeat.” These axioms are embraced by both the biotechnomedical establishment as well as the cryopreservation communities when they discuss the future of humankind. In particular, I will be focusing on the political economy of cryopreservation as an embodiment of American neoliberalism—as well as a Durkheimian death ritual—in the twenty-first century. Finally, I will theorize on a future populated by human beings from “the past” and the implications and consequences that may be caused by contemporary humans experiencing a temporal shift from traveling in deep time vis-à-vis cryopreservation