Copyright (c) 1997 First Things 38 (December 1993): 60-63.
The Human Body Shop: The Engineering and Marketing of Life. By Andrew Kimbrell. HarperCollins. 348 pp. $22.
Reviewed by Bernard N. Nathanson
What Ralph Nader did to the auto barons, what Rachel Carson did to the pesticide pirates, Andrew Kimbrell has now done to biotechnology. He has thrown himself against that remorseless machine and brought it to a shuddering stop—or at least he would do so if those who elect our lawmakers were to pay him the kind of attention he deserves. He has succeeded in dismantling the biotechnology myth: that Progress requires defining life down, and the more ruthless the biological reductionism the more benefits for mankind.
Kimbrell has been policy director of the Foundation for Economic Trends for eight years. The Foundation is a quirky but remarkably effective group operating in the Beltway Badlands that closely monitors the forces of biotechnology. It has been in the vanguard of those who oppose the patenting of life, genetic engineering without appropriate safeguards, cloning of animals and humans, and a bewildering variety of other kinds of biothaumaturgy. The Foundation’s reigning guru is Jeremy Rifkin, a man whose range of interests is truly of an epic order: he has published works on the physicochemical principle of entropy as applied to industrialized western society (Entropy); how to release ourselves from the strangulating harness of time and efficiency (Time Wars); on genetic engineering and its lethal incursion into Darwin’s principles (Algeny); on the necessity for a second Protestant Reformation (The Emerging Order). In short, Rifkin, Kimbrell and company have emerged as a maverick force constantly at war with the bien-pensant intellectuals.
Now, in The Human Body Shop, Kimbrell puts it all altogether. He begins with the blood transfusion cartel; sails from there into the entrepreneurs cornering the organ transplant and fetal tissue industries; and finally takes on the genetic engineers and their blood-freezing vision of our future on this planet. (Kimbrell merits an extra measure of admiration for having torn the smirking humanitarian mask off the biotechnology industry without once having invoked Aldous Huxley’s Brave New World—a neat trick in itself.)
Kimbrell’s overarching theme is the relentless commodification of the human body by people driven by the market ideology of self-interest. In his section on organ donation he cites the enormous demand for organs that fuels the engine of commerce in spare parts: by the end of 1991 over 23,000 Americans were on the waiting list for donated organs, and a new name is added to the list every thirty minutes (a new organ is not however transplanted every thirty minutes, and the list grows geometrically longer). When this reviewer was a medical student forty years ago, our anatomy instructor used to calculate for us the market worth of the human body reduced to its chemical components: ninety-eight cents. Now, with two corneas, one heart, one pancreas, two kidneys, two lungs, one liver, twenty square feet of skin (to cover burns), 60,000 miles of blood vessels, and ninety ounces of bone marrow—all available for transplant—each of us is viewed by the biotech entrepreneurs as a walking treasure trove of spare parts worth several hundred thousand dollars—with some products such as blood constantly replenishing themselves.
It is true that the National Organ Transplant Act (1984) prohibits interstate commerce in the U.S. in organs for transplant—though it exempts organs selected for research or replenishable tissues such as blood or sperm. Most countries, however, do not have comparable legislation, and there is at present a thriving industry in organ sales in India, Africa, Latin America, and Eastern Europe. Kimbrell sounds the tocsin: the forces of commercialization have not given up the struggle here in America, and he presents a strong and seamless case against caving in to them. After all, if we can sell a part or three, why not go the whole way and repeal the Thirteenth Amendment? Sell your whole body—or someone else’s.
Kimbrell lucidly discusses the issue of organ harvesting in the dying, and includes an illuminating section on the criteria for death and the concept of "neomorts," brain-dead patients kept alive by artificial means as whole-body storage systems for scarce organs. Oh death, where is thy definition?
The largely unregulated trafficking in sperm, ova, frozen embryos, surrogate motherhood (the uterus as bed and breakfast), and assisted reproductive technology comes in for its share of condemnation. Who, for example, can forget Dr. Cecil Jacobson in Virginia, who inseminated seven women with his own semen, pretending to them that he was obtaining the semen from a donor bank? Or Dr. Douglas Moss in New York City, who has been charged with inseminating twenty women, using the Jacobean pretext? What of the Mount Sinai Hospital in New York City, charged with violating the city’s Consumer Protection Law by fabricating the success rate of its fertility clinic and misleading infertile couples desperate for a baby? And IVF America which has already been disciplined by the Federal Trade Commission for also exaggerating its success rate in using such reproductive technologies as ZIFT (Zygote Intrafallopian Transfer), GIFT (Gamete Intrafallopian Transfer), PZD (Partial Zona Dissection), and plain old IVF in helping barren couples to have babies. The litany of villainy in this particularly intimate area of human activity is perverse, revolting, and ongoing. As Kimbrell points out, the sale of the elements of reproduction (or the commerce in the end-product of reproduction, i.e., the frozen "pre-embryo") is a blatant invasion of the market into our most intimate selves—our sexuality, our self-image, our marriages, and our families.
Genetic engineering has been the special focus of the Foundation for Economic Trends. Rifkin, Kimbrell and company have been active in opposing genetic engineers striving to patent their twisted creations: the geep, a goat-sheep combination with the face and horns of goats and the bodies of sheep; superpig, a pig with human growth hormone spliced into its genome so as to grow twelve feet long and manufacture human growth hormones on a large scale (this genetic lottery was an abysmal failure); mice with a copy of the AIDS virus in every cell of their body.
Rifkin and company in 1983 organized a scientific and religious coalition against genetic engineering on humans, and in 1989 filed suit in federal court against the National Institutes of Health, calling upon the court to restrain the NIH in its genetic engineering projects. After all, if the NIH is successful in its $3 billion genome project—the mapping out of the location of every one of our 50,000-100,000 genes on our 46 chromosomes—what will stop employers from using this genetic information to screen employees? Who will prevent insurance companies from denying health and/or life insurance to those with "defective" genes? Why should the military not use such information in assessing candidates for service? What of engaged couples—are they not entitled to see each other’s genomes, to see what each of them is getting? And when their child is conceived, why should they not run the genome of the child through the computer to see that he (or if desired, she) will be of the right height and weight, of outstanding intelligence, with blue eyes, blonde hair—a designer baby—and if not, discard the embryo?
A nightmare world? Absolutely, and the only thing standing between it and us is the courage and unflagging dedication to the sanctity of life of people like Rifkin and Kimbrell—not to mention Paul VI who predicted it all in his magnificent Humanae Vitae, who gave us the wisdom to recognize how life was being trashed, and supplied us with the moral and ethical means to oppose it.
Kimbrell touches upon the subject of fetal tissue transplant but regrettably fails to enlarge upon some of its potential ramifications. I have been inveighing for many years against the use of electively aborted fetuses for tissue and organ transplantation. Incidentally, the spontaneously aborted fetus is to all intents and purposes useless as a mine for tissue and organs in that it has usually been dead for several days and if the tissues are not alive and fresh they cannot be used; further, perhaps 65 percent of all spontaneously aborted fetuses are chromosomally abnormal (instead of 46 chromosomes they have 69 or 92, incompatible with life) and therefore must be discarded by the biogleaners.
Kimbrell correctly points out that if harvesting of the electively aborted fetus becomes a commercial commonplace (and Bill Clinton and his Rhodes-runners seem determined to bring this about), the ramifications of this technology will pose a myriad of knotty ethical questions: (a) Who is legitimately qualified to give consent to the cannibalizing of the fetus? Certainly not the pregnant woman who condemned her fetus to death. (b) How many additional abortions will there be if women who are having difficulty with the abortion decision are persuaded that the tissues and organs of the fetus will be used to save someone else’s life, e.g., a sufferer from Parkinson’s disease, or a severe uncontrollable diabetic? (c) The method of abortion will be dangerously altered, to suit the fetal tissue entrepreneurs. At present, only the pancreas of a fetus aborted between fourteen and twenty weeks is useful in the transplant treatment of diabetes. Mid-trimester abortions carry with them a fifteen-fold increase in maternal mortality. A great many women will die in this orgy of greedy profiteering. (d) The market forces driving this technology are so powerful as to be all but irresistible. Consider: it requires the specific brain tissue of five fetuses aborted in the first trimester to treat a Parkinson’s victim, assuming for the moment that fetal brain tissue is truly effective in the treatment of central nervous system disorders. (There are, in fact, many reputable neuroscientists who assert that the glowing reports of success with this technology reported in the November 1992 issue of the New England Journal of Medicine from the University of Colorado, Yale, and the University of Lund are attributable to the "placebo" effect, i.e., that invading the brain with a fine needle containing fetal brain cells injures the brain in the area of the putamen and substantia nigra, and in healing itself the brain manufactures more dopamine, the chemical substance lacking in Parkinson’s disease: once the injury is completely healed the dopamine source is shut down and the patient reverts to the frozen state.)
We now have 500,000 victims of Parkinson’s disease in this country, and 40,000 new cases are reported every year. There are four million sufferers from Alzheimer’s disease (another disorder for which fetal brain tissue has been touted as a cure) and 250,000 new cases annually. There are 750,000 cerebral palsy victims, two million stroke victims, thousands of paraplegics: to treat all these patients with fetal brain tissue transplant we will need at least 35 million fetuses aborted at 9-12 weeks. At present, there are 800,000 fetuses in the U.S. each year aborted during that period of pregnancy. How in the world is the demand to be met? (If we factor in RU-486, the French abortion pill, we will have perhaps half of that 800,000 figure, since the abortion pill causes a spontaneous abortion in the first trimester of pregnancy and the fetal tissues are useless for transplant.) Ergo, we have a demand for 35 million fetuses in the 9-12 week period and only 400,000 potentially useful ones. One does not have to be an astrophysicist to understand the attraction of recruiting Third World women by the millions to serve as fetal farms for those who need and can afford fetal tissue transplant therapy.
Who will pay for this technology? The x-rays required to guide the needle bearing the fetal brain cells into the appropriate area in the brain to treat the specific disorder (Parkinson’s, Alzheimer’s, etc.) cost at least $5,000. Add to that the surgeon’s fee, the nursing care costs, the immense outlay of money for physical therapy and other rehabilitative measures for these patients, and you have an astronomical bill—on the order perhaps of $60,000 per cure. With only one million patients being treated annually (and one can only shudder at the immense clamor for treatment raised by the enormous number of families of sufferers who have been denied or put on the waiting list for the treatment) the annual national bill will be on the order of $60 billion—10 percent of what we now spend on all of health care today. And we are now confining ourselves only to central nervous system disorders; we have not considered the 1.4 million diabetics who will undoubtedly seek fetal tissue treatment for their illness or the hundreds of thousands of chemotherapy patients who will demand fetal bone marrow transplants, to say nothing of leukemia victims and radiation therapy survivors who also will demand fetal bone marrow. Where will it all end?
Despite the formidable economic, medical, and ethical barriers to this practice, Kimbrell regrettably would offer only a rather timorous response: ban the sale of adult organs for transplantation, and "strongly support the ban on the sale of fetal parts and ensure that it is enforced." But even if commerce in organs and tissues themselves is interdicted, there remains an enormous satellite industry surrounding this technology: the person who collects and ices the tissue and organs gets paid; the laboratory personnel who process, culture, refine, and select out the tissue and organs—they all get paid. The surgeons, nursing staff, anesthesia personnel all get paid; the physical and occupational therapists, social workers, counselors—they all get paid. And to pretend that, with organs and tissues in such short supply and the demand so clamorous and heartrending, one can enforce a commercial ban without an immense black market springing up is quite simply unrealistic. No. The only satisfactory resolution is to ban the entire technology and look to infinitely less expensive, more effective, and ethically more acceptable pharmacologic solutions to these especially heartbreaking diseases and disorders.
Get this book and read it carefully: just a peek into the roaring inferno which yawns before us. Let Kimbrell-Virgil guide you through the trimillennial hell that awaits us patiently, voraciously . . .
Bernard N. Nathanson, M.D. is author of Aborting America and The Abortion Papers. He is presently serving as Visiting Fellow at the Kennedy Institute of Ethics at Georgetown University.