Q&A: 'The kidney is not a spare part'

Nancy Scheper-Hughes is a professor of medical anthropology at the University of California, Berkeley, and director of Organs Watch, which has conducted field research on organ trading in 13 countries.

Q. What would you say to someone who wants to buy a kidney from a willing seller?

A. If you're willing to ask a living person to help you out of your difficulty, just know you're entering a moral gray zone. You're putting them at risk.

The kidney is not a spare part. If you talk to kidney sellers the world over, within one to five years of selling their organ, they're not doing well. It's a far more invasive surgery to take a kidney out than to put one in. Sometimes doctors must take out a rib.

Economically, nearly everyone is worse off a year after selling their kidney. One reason is that almost all of them are manual laborers - stevedores, agricultural workers, etc. When they're told they can't lift heavy objects for a month after surgery, it excludes them from work. They tend to lose their niche.

So, if you're willing to pay someone for a kidney to save your life, it should be someone with whom you have an intimate relationship - someone you'll be able to give assistance to over the long term. But don't ask that of a stranger.

Q. What's wrong with making the human body - or parts of it - into a commodity?

A. It's the sense that body and soul are connected, and selling your body is chipping away at what gives you existence.

Also, we as a society say there are some things that are not candidates for commodification. Even if people are willing to be sex slaves, for instance, we say they can't be. We rightly have constitutional protections for people so needy that they think the best option is to sell themselves.

Also, commodification of body parts necessarily involves corruption of the medical profession, with doctors intentionally harming one population, normally the poor, and turning them into bags of spare parts.

Q. Some countries are moving toward regulated organ markets. Is there a way to do this and still protect all involved?

A. No. An organ market will necessarily exploit the desperation of both buyers and sellers. But if the world is determined to do this, we would need several things, including a "donors' bill of rights" and a national registry of living donors, which would involve a committee to authorize each donation. Also, you cannot leave it to hospitals to decide if a donor is acting freely and without the coercion of debt or extreme need. There should be an independent donor advocate - someone who has nothing to do with the medical or financial elements of the transplant. Finally, if you're going to plunge into the bodies of the healthy, they need medical coverage for anything related to that kidney sale - and they need it for life.