Beyond the market: a new approach to the ethical procurement of human biological materials

© 2011 Dr. Dominique Elizabeth MartinSupplies of human biological materials (HBM) for use in therapeutic procedures and research currently fail to meet global needs. Although the cause of shortages is multifactorial, the primary focus of ethical debate concerns strategies to motivate individual provision of HBM, in particular through the use of financial incentives. Despite the long history of trade in HBM from human teeth and bony relics to blood, organs, cells and tissues, contemporary ethical discussion is often fragmented, focusing on specific materials as representative of distinct issues. The approach of policy makers similarly highlights the apparent contextual differences of procurement and use of particular materials, producing multiple and often conflicting policies at the state, national and international levels. In contrast to the traditional orientation of debate, in which individual needs and choices are prioritized and the different features of procurement and use of particular materials are used to justify the adoption of different policies, I seek to outline a more consistent and comprehensive framework for policy making in this field by examining the commonalities of HBM procurement. Setting the detachment of HBM from living and deceased human beings within the personal and social context of embodied moral agency, I suggest that the commodification of these materials will impair our ability to express important values in our bodies and may undermine cooperative efforts in pursuit of important public goods such as health. Reviewing the ethical issues of markets in HBM, I argue that more effective and ethical policies regarding procurement of HBM will be developed using a framework that emphasizes community goals and solidarity rather than individual priorities in a market setting, at both the national and international levels. I outline how the self-sufficiency model may be used by governments to develop more responsible practices in procurement and distribution of HBM while encouraging public participation not only in donation but also in efforts to reduce needs for these materials. In short, I argue that markets in HBM fail to capture the way we value our biological materials and to reflect the ways we wish to treat materials in the social realm. We must look beyond the market for a broader vision of the role that our bodies play in our lives, recognizing that the treatment of HBM is a rich and complex component of human flourishing that market norms cannot express