Off #1 - T
Failure to specify beyond “legalize” makes the plan void for vagueness-it wrecks
negative ground and makes policy analysis impossible
Kleiman and Saiger 90 -lecturer public policy Harvard, consultant drug policy Rand- 18 Hofstra L.
Rev. 527. A SYMPOSIUM ON DRUG DECRIMINALIZATION: DRUG LEGALIZATION: THE IMPORTANCE OF
ASKING THE RIGHT QUESTION.
Defining Legalization Legalization, like prohibition, does not name a unique strategy. Perhaps the most
prominent inadequacy of current legalization arguments is their failure to specify what is meant by
"legalization ." Current drug policy provides an illustration of this diversity. Heroin and marijuana are
completely prohibited, 74 and cocaine can only be used in rigidly specified medical contexts, not including
any where the drug's psychoactive properties are exercised. 75 On the other hand, a wide range of pain-killers, sleepinducers, stimulants, tranquilizers and sedatives can be obtained with a doctor's prescription. 76 Alcohol is available
for recreational use, but is subject to an array of controls including excise taxation, 77 limits on drinking ages, 78 limits
on TV and radio advertising, 79 and retail licensing. 80 Nicotine is subject to age minimums, warning label requirements, 81
taxation, 82 and bans on smoking in some public places. 83 [*541] Drug legalization can therefore be thought of as moving drugs along a
spectrum of regulated statuses in the direction of increased availability. However, while legalization advocates do not deny that some sort
of controls will be required, their proposals
rarely address the question of how far on the spectrum a given drug
should be moved, or how to accomplish such a movement. Instead, such details are dismissed as easily
determined, or postponed as a problem requiring future thought. 84 But the consequences of
legalization depend almost entirely on the details of the remaining regulatory regime . The price and
conditions of the availability of a newly legal drug will be more powerful in shaping its consumption than the fact that the drug is "legal." Rules
about advertising, place and time of sale, and availability to minors help determine whether important aspects of the drug problem get better
or worse. The amount of regulatory apparatus required and the way in which it is organized and enforced will determine how much budget
reduction can be realized from dismantling current enforcement efforts. 85 Moreover, currently illicit drugs, because they are so varied
pharmacologically, would not all pose the same range of the problems if they were to be made legally available for non-medical use. They
would therefore require different control regimes. These regimes might need to be as diverse as the drugs themselves.
Vote neg –
Ground – forces the negative to read generic disadvantages and prevents debates over
the details of the plans legalization – PIC’s and disadvantage based off regulations are
key in the lit
Topic education – prevents having a debate over the heart of the literature – it’s not if
you legalize organ sales, but how you do it – key to clash
Off #2 – CP
The United States should decriminalize nearly all organ sales in the United States.
Legalization expands the black market
– legitimacy and awareness
Mendoza 2010 (Roger, PhD and Specialist in welfare economics, “Kidney black markets and legal
transplants: Are they opposite sides of the same coin?”. Health Policy. 94 (2010). pp. 262-3) [nagel]
One key implication we can gain from the foregoing analysis of the legal and regulatory framework is that
consensus does exist within government and among Filipinos concerning the need to eradicate kidney
trafficking. Yet, at the same time, there is considerable conflict within government agencies and hospitals,
and lack of sufficient public involvement, because various authorities benefit from ensuring that
kidney trafficking persists, as our surveyed vendors indicate. For these reasons, the black market is not effectively
regulated by law-enforcement agencies. The measures that we reviewed have done little to achieve
their policy objectives [48]. They have even paradoxically blurred the distinction between legal and
illicit transplantation and, in effect, conferred some semblance of legitimacy to black market trading for
the following reasons: 4.1. Lack of public awareness Policy implementation will be ineffective if existing rules and
prohibitions are not common public knowledge. Our survey of kidney vendors indicates that 75.3–83.3 per cent
either did not know it was illegal to sell their kidneys, or were unaware of the existence of such
measures, which are written in English and strict legalese (Table 11). In contrast, kidney trading assumes a public and open
character. Without a grassroots-based strategy, deliberate efforts at public education about health risks/hazards and health promotion,
trade participants will likely find it economically inefficient to distinguish between what is legal and
prohibited in kidney donation/transplantation.
Safeguards produce an underclass of rejected donors who supply the black market
Scheper-Hughes 2005 (Nancy, Professor at UC-Berkeley, “THE LAST COMMODITY: Post-Human
Ethics and the Global Traffic in ‘‘Fresh’’ Organs”. Global Assemblages: Technology, Politics, and Ethics as
Anthropological Problems. Ed. Aihwa Ong and Stephen Collier. Blackwell Publishing. Malden, MA. pp.
152-3) [nagel]
Bangon Lupa is a garbage-strewn slum built on stilt shacks over a polluted and feces-infested stretch of the Pasig River that runs through the
shantytown on its way to Manila Bay. In
Bangon Lupa, ‘‘coming of age’’ now means that one is legally old enough
to sell a kidney. But, as with other coming of age rituals, many young men lie about their age and boast of having sold a kidney when they
were as young as 16 years old: ‘‘No one at the hospital asks us for any documents’’ they assured me. The kidney
donors lied about other things as well – their names, addresses, and medical histories, including their
daily exposure to the general plagues of the third world – TB, AIDS, dengue, and hepatitis, not to
mention chronic skin infections and malnutrition. In this barangay of largely unemployed stevedores, I encountered
an unanticipated ‘‘waiting list,’’ comprised of angry and ‘‘disrespected’’ kidney sellers who had been
‘‘neglected’’ and ‘‘overlooked’’ by the medical doctors at Manila’s most prestigious private hospital, St. Luke’s Episcopal
Medical Center. When word spread that I was looking to speak to kidney sellers, several scowling and angry young men approached me to
complain: ‘‘We are strong and virile men, and yet none of us has been called up to sell.’’ Perhaps they had been rejected, the men surmised,
because of their age (too young or too old), their blood (difficult to match), or their general medical condition. But whatever the reason, they
had been judged as less valuable kidney vendors than some of their lucky neighbors, who now owned
new VCRs, karaoke machines, and expensive tricycles. ‘‘What’s wrong with me?,’’ a 42-year-old man
asked, thinking I must be an American kidney hunter. ‘‘I registered six months ago, and no one from St. Luke’s has called me . . . But I am
healthy. I can lift heavy weights. And my urine is clean.’’ Moreover, he was willing, he said, to sell below the going rate
of $1,300 for a fresh kidney. When one donor is rejected, another, younger and more healthy looking,
family member is often substituted. And kidney selling becomes an economic niche in some families
that specialize in it. Indeed, one large extended family Bangong Lupa supplied St. Luke’s Hospital with a reliable source of kidneys,
borrowing strength from across the generations as first father, then son, and then daughter-in-law each stepped forward to contribute to the
family income.
Legalization increases black market – empirics
Turner 2009 (Leigh, Associate Professor in the Center for Bioethics, School of Public Health, and
College of Pharmacy at the University of Minnesota, “Commercial Organ Transplantation in the
Philippines”. Cambridge Quarterly of Healthcare Ethics. 18:2. April 2009. pp. 192-196. DOI:
http://dx.doi.org/10.1017/S0963180109090318) [nagel]
Due to changes in legislation and regulatory enforcement, it is now much more difficult for foreign
patients to purchase kidneys in China and several other jurisdictions where commercial sales of
organs occurred. Pakistan and India now have legislation prohibiting buying and selling human organs.
Though legislative reforms have driven commerce in organs underground , commercial transplants still
occur in both countries . 7 In 2006, China curtailed the number of foreign patients purchasing organ transplants at Chinese medical
facilities. 8 In contrast, commercial organ transplantation persists in the Philippines.
Off – K
The aff explicitly sanctions the neoliberal commodification of the body – they reify
medical apartheid and social injustice
Scheper-Hughes 2002 (Nancy, Prof at UC-Berkeley, “The Ends of the Body: Commodity Fetishism
and the Global Traffic in Organs”. SAIS Review. 22:1. (Winter-Spring 2002), pp. 61-2) [nagel]
Amidst the neoliberal readjustments of the new global economy, there has been a rapid growth of
“medical tourism” for transplant surgery and other advanced biomedical and surgical procedures. A
grotesque niche market for sold organs, tissues, and other body parts has exacerbated older divisions
between North and South, haves and have-nots, organ donors and organ recipients. Indeed, a kind of
medical apartheid has also emerged that has separated the world into two populations—organ givers
and organ receivers. Over the past 30 years, organ transplantation—especially kidney transplantation—has become a
common procedure in hospitals and clinics throughout the world. The spread of transplant technologies has created a
global scarcity of viable organs. At the same time the spirit of a triumphant global and “democratic”
capitalism has released a voracious appetite for “fresh” bodies from which organs can be procured.
The confluence in the flows of immigrant workers and itinerant kidney sellers who fall prey to sophisticated
but unscrupulous transnational organ brokers is a subtext in the recent history of globalization. Today’s organ
procurement transactions are a blend of altruism and commerce; of science and superstition; of gifting, barter, and theft; and of voluntarism
and coercion. International Organ Markets, Bioethics, and Social Justice The problem with markets is that they reduce
everything —
including human beings, their labor, and their reproductive capacity — to the status of commodities
that can be bought, sold, traded, and stolen. Nowhere is this more dramatically illustrated than in the market for
human organs and tissues. The concepts of the integrity of the body and human dignity have given
way to ideas of the divisible body and detachable organs as commodities. The new field of bioethics has largely
capitulated to the dominant market ethos. 1 Conventional medical ethics obscures the ancient perception of virtue
in suffering and dying, while bioethics creates the semblance of ethical choice (e.g., the right to buy a kidney) in
an intrinsically unethical context. The transformation of a person into a “life” that must be prolonged
or saved at any cost has made life into the ultimate commodity fetish. This idea erases any possibility of
a global social ethic. In the rational choice language of contemporary bioethics the conflict between
non-malfeasance (“do no harm”) and beneficence (the moral duty to perform good acts) is increasingly resolved in
favor of the libertarian and consumer-oriented principle that those able to broker or buy a human
organ should not be prevented from doing so. In a market context, paying for a kidney “donation” is viewed
as a potential “win-win” situation that can benefit both parties. 2 Individual decision making has become the final
arbiter of medical bioethical values. Social justice hardly figures into these discussions because bioethical
standards have been finely calibrated to mesh with the needs and desires of consumer-oriented
globalization.
Their focus on subjective flashpoints of violence creates a stop-gap in thought which
distracts us from attempts to solve the root cause of all violence - Capital
Zizek, ’08 (Slavoj, senior researcher at the Institute of Sociology, University of Ljubljana, Slovenia and a professor at the
European Graduate School, Violence, p. 1-4)
If there is a unifying thesis that runs through the bric-a-brac of reflections on violence that follow, it is that a similar paradox holds true for
violence. At the forefront of our minds, the obvious signals of violence are acts of crime and
terror, civil
unrest, international conflict . But we should learn to step back , to disentangle ourselves from the
fascinating lure of this directly visible “subjective” violence, violence performed by a clearly identifiable agent. We
need to perceive the contours of the background which generates such outbursts. A step back enables
us to identify a violence that sustains our very efforts to fight violence and to promote tolerance. This is the
starting point, perhaps even the axiom, of the present book: subjective violence is just the most visible portion of a
triumvirate that also includes two objective kinds of violence. First, there is a “symbolic” violence
embodied in language and its forms, what Heidegger would call “our house of being.” As we shall see later, this violence is not
only at work in the obvious—and extensively studied—cases of incitement and of the relations of social domination reproduced in our habitual
speech forms: there is a more fundamental form of violence still that pertains to language as such, to its imposition of a certain universe of
Second, there is what I call “systemic” violence, or the often catastrophic consequences of the
smooth functioning of our economic and political systems . The catch is that subjective and objective
meaning.
violence cannot be perceived from the same standpoint : subjective violence is experienced as such
against the background of a non-violent zero level. It is seen as a perturbation of the “normal,” peaceful
state of things. However, objective violence is precisely the violence inherent to this “normal” state of
things. Objective violence is invisible since it sustains the very zero-level standard against which we
perceive something as subjectively violent. Systemic violence is thus something like the notorious “dark
matter” of physics, the counterpart to an all-too- visible subjective violence. It may be invisible, but it has to be taken
into account if one is to make sense of what otherwise seem to be “irrational” explosions of subjective
violence. When the media bombard us with those “humanitarian crises” which seem constantly to pop up all over the world, one should
always bear in mind that a particular crisis only explodes into media visibility as the result of a complex struggle. Properly humanitarian
considerations as a rule play a less important role here than cultural, ideologico-political, and economic considerations. The cover story of Time
magazine on 5 June 2006, for example, was “The Deadliest War in the World.” This offered detailed documentation on how around 4 million
people died in the Democratic Republic of Congo as the result of political violence over the last decade. None of the usual humanitarian uproar
followed, just a couple of readers’ letters—as if some kind of filtering mechanism blocked this news from achieving its full impact in our
symbolic space. To put it cynically, Time picked the wrong victim in the struggle for hegemony in suffering. It should have stuck to the list of
usual suspects: Muslim women and their plight, or the families of 9/11 victims and how they have coped with their losses. The Congo today has
effectively re-emerged as a Conradean “heart of darkness.” No one dares to confront it head on. The death of a West Bank Palestinian child, not
to mention an Israeli or an American, is mediatically worth thousands of times more than the death of a nameless Congolese. Do we need
further proof that the
humanitarian sense of urgency is mediated, indeed overdetermined, by clear political
considerations? And what are these considerations? To answer this, we need to step back and take a look
from a different position. When the U.S. media reproached the public in foreign countries for not displaying enough sympathy for the
victims of the 9/11 attacks, one was tempted to answer them in the words Robespierre addressed to those who complained about the innocent
victims of revolutionary terror: “Stop shaking the tyrant’s bloody robe in my face, or I will believe that you wish to put Rome in chains.”1
There are reasons for looking at the
problem of violence awry. My underlying premise is that there is something inherently mystifying in a direct
confrontation with it: the overpowering horror of violent acts and empathy with the victims inexorably
function as a lure which prevents us from thinking . A dispassionate conceptual development of the typology of violence
Instead of confronting violence directly, the present book casts six sideways glances.
must by definition ignore its traumatic impact. Yet there is a sense in which a cold analysis of violence somehow reproduces and participates in
its horror. A distinction needs to be made, as well, between (factual) truth and truthfulness: what renders a report of a raped woman (or any
other narrative of a trauma) truthful is its very factual unreliability, its confusion, its inconsistency. If the victim were able to report on her
painful and humiliating experience in a clear manner, with all the data arranged in a consistent order, this very quality would make us
suspicious of its truth. The problem here is part of the solution: the very factual deficiencies of the traumatised subject’s report on her
experience bear witness to the truthfulness of her report, since they signal that the reported content “contaminated” the manner of reporting
it. The same holds, of course, for the so-called unreliability of the verbal reports of Holocaust survivors: the witness able to offer a clear
narrative of his camp experience would disqualify himself by virtue of that clarity.2 The only appropriate approach to my subject thus seems to
be one which permits variations on violence kept at a distance out of respect towards its victims.
Must analyze the root social causes of organ sales – lack risks serial policy failure
Epstein 2011 (Miran, Prof at Queen Mary University of London, “If I were a rich man could I sell a
pancreas? A study in the locus of oppression”. J Med Ethics 2011; 37: 109-112.
doi:10.1136/jme.2010.039636) [nagel]
The assumption I have just discussed gives rise to a complex counterintuitive conclusion: the opponents and the proponents of organ vending
are both right and wrong at the same time. The
opponents are right in saying that it essentially involves
oppression, but they are wrong in confining their search for it to the sphere of exchange alone. This
sphere – the kingdom of transactions, the realm of buyer-vendor relations – may involve oppressive elements.
Perhaps it involves such elements more often than not. That having been said, it does not necessarily involve them. But whereas the
sphere of exchange is not essentially oppressive, its social context is! Conversely, the proponents of organ
vending are right in saying that its sphere of exchange is not essentially oppressive. However, like their rivals,
they are wrong in confining their search for any oppressive elements to that sphere alone. They
ignore the possibility that perfectly fair commercial transactions can easily take place in a perfectly
oppressive context. In the case of organ vending, this is presumably the rule. One might perhaps get the
impression that each of the parties has made nothing but a simple error here. There is another way of looking at it, however. Their joint
failure to spot the essentially oppressive context in which organ vending is taking place may not be
accidental. Rather, it may be a necessarily distorted (and distorting) product of that very context, or in other words, an
ideological façade that conceals and reaffirms the oppressive environment from which it has
emerged . This possibility sheds new light on the reciprocal effect of each of the sides of the debate on the context of organ vending, which
is at the same time their own constitutive context. The pro-vending camp reaffirms that context both by yielding to
its essential oppressiveness as well as by concealing it. In contrast, the anti-vending camp happens to fight its
oppressiveness, albeit indirectly and typically without even realizing that it does so, let alone intending to do so. Yet by ignoring its
oppressiveness, it undermines its own enterprise. Indeed, any attempt to the halt the commoditisation
of the body without explicitly tackling the conditions that give rise to its possibility cannot be taken
too seriously.
Cap’s unsustainable and causes extinction, but the alt solves
This is not a meaningless question – the structures of capitalism are driving multiple large-scale processes that are increasingly out of the
control of individuals living their lives. Global warming, multiple wars of accumulation, loss of land and income stratification: all of these are
making life unlivable.
Parr ’13 (Adrian, Assoc. Prof. of Philosophy and Environmental Studies @ U. of Cincinnati, THE WRATH
OF CAPITAL: Neoliberalism and Climate Change Politics, pp. 145-147)
A quick snapshot of the twenty-first century so far: an economic meltdown; a frantic sell-off of public
land to the energy business as President George W Bush exited the White House; a prolonged, costly,
and unjustified war in Iraq; the Greek economy in ruins; an escalation of global food prices; bee
colonies in global extinction; 925 million hungry reported in 2010; as of 2005, the world's five hundred
richest individuals with a combined income greater than that of the poorest 416 million people, the
richest 10 percent accounting for 54 percent of global income; a planet on the verge of boiling point;
melting ice caps; increases in extreme weather conditions; and the list goes on and on and on.2
Sounds like a ticking time bomb, doesn't it? Well it is.
It is shameful to think that massive die-outs of future generations will put to pale comparison the 6
million murdered during the Holocaust; the millions killed in two world wars; the genocides in the
former Yugoslavia, Rwanda, and Darfur; the 1 million left homeless and the 316,000 killed by the 2010
earthquake in Haiti. The time has come to wake up to the warning signs.3
The real issue climate change poses is that we do not enjoy the luxury of incremental change anymore.
We are in the last decade where we can do something about the situation. Paul Gilding, the former
head of Greenpeace International and a core faculty member of Cambridge University's Programme for
Sustainability, explains that "two degrees of warming is an inadequate goal and a plan for failure;'
adding that "returning to below one degree of warming . . . is the solution to the problem:'4 Once we
move higher than 2°C of warming, which is what is projected to occur by 2050, positive feedback
mechanisms will begin to kick in, and then we will be at the point of no return. We therefore need to
start thinking very differently right now.
We do not see the crisis for what it is; we only see it as an isolated symptom that we need to make a
few minor changes to deal with. This was the message that Venezuela's president Hugo Chavez
delivered at the COP15 United Nations Climate Summit in Copenhagen on December 16, 2009, when he
declared: "Let's talk about the cause. We should not avoid responsibilities, we should not avoid the
depth of this problem. And I'll bring it up again, the cause of this disastrous panorama is the metabolic,
destructive system of the capital and its model: capitalism.”5
The structural conditions in which we operate are advanced capitalism. Given this fact, a few
adjustments here and there to that system are not enough to solve the problems that climate change
and environmental degradation pose.6 Adaptability, modifications, and displacement, as I have
consistently shown throughout this book, constitute the very essence of capitalism. Capitalism adapts
without doing away with the threat. Under capitalism, one deals with threat not by challenging it, but
by buying favors from it, as in voluntary carbon-offset schemes. In the process, one gives up on one's
autonomy and reverts to being a child. Voluntarily offsetting a bit of carbon here and there, eating
vegan, or recycling our waste, although well intended, are not solutions to the problem, but a
symptom of the free market's ineffectiveness. By casting a scathing look at the neoliberal options on
display, I have tried to show how all these options are ineffective. We are not buying indulgences
because we have a choice; choices abound, and yet they all lead us down one path and through the
golden gates of capitalist heaven.
For these reasons, I have underscored everyone's implication in this structure – myself included. If
anything, the book has been an act of outrage – outrage at the deceit and the double bind that the
"choices" under capitalism present, for there is no choice when everything is expendable. There is
nothing substantial about the future when all you can do is survive by facing the absence of your own
future and by sharing strength, stamina, and courage with the people around you. All the rest is false
hope.
In many respects, writing this book has been an anxious exercise because I am fully aware that reducing
the issues of environmental degradation and climate change to the domain of analysis can stave off the
institution of useful solutions. But in my defense I would also like to propose that each and every one of
us has certain skills that can contribute to making the solutions that we introduce in response to
climate change and environmental degradation more effective and more realistic. In light of that view,
I close with the following proposition, which I mean in the most optimistic sense possible: our politics
must start from the point that after 2050 it may all be over.
Challenging global capital is the ultimate ethical responsibility. The current order
guarantees social exclusion on a global scale
Zizek and Daly 2004
(Slavoj, professor of philosophy at the Institute for Sociology, Ljubljana, and Glyn, Senior Lecturer in Politics in the Faculty of
Arts and Social Sciences at UniversityCollege, Northampton, Conversations with Zizek, page 14-16)
For Zizek it is imperative that we cut through this Gordian knot of postmodern protocol and recognize thatour
ethico-political
responsibility is to confront the constitutive violence of today’s global capitalism and its obscene
naturalization / anonymization of the millions who are subjugated by it throughout the world.Against the
standardized positions of postmodern culture – with all its pieties concerning ‘multiculturalist’ etiquette –Zizek is arguing for a
politics thatmight be called ‘radically incorrect’ in the sense that it break with these types of positions 7 andfocusesinsteadon the
very organizing principles of today’s social reality:the principles of global liberal capitalism. This requires some care and
subtlety. For far too long, Marxism has been bedeviled by an almost fetishistic economism that has tended towards political morbidity. With
the likes of Hilferding and Gramsci, and more recently Laclau and Mouffee, crucial theoretical advances have been made that enable the
transcendence of all forms of economism. In this new context, however, Zizek argues that the problem that now presents itself is almost that of
the opposite fetish. That is to say, the prohibitive anxieties surrounding the taboo of economism can function as a way of not engaging with
economic reality and as a way of implicitly accepting the latter as a basic horizon of existence. In an ironic Freudian-Lacanian twist, the fear of
economism can end up reinforcing a de facto economic necessity in respect of contemporary capitalism (i.e. the initial prohibition conjures up
the very thing it fears). This is not to endorse any kind of retrograde return to economism. Zizek’s point is rather that in rejecting economism
we should not lose sight of the systemic power of capital in shaping the lives and destinies of humanity and our very sense of the possible. In
particular we should not overlook Marx’s central insight thatin
order to create a universal global system the forces of
capitalism seek to conceal the politico-discursive violence of its construction through a kind of
gentrification of that system.What is persistently denied by neo-liberals such as Rorty (1989) and Fukuyama (1992) is that the
gentrification of global liberal capitalism is one whose ‘universalism’ fundamentally reproduces and depends upon a
disavowed violence that excludes vast sectors of the world’s populations. In this way,neo-liberal ideology
attempts to naturalize capitalism by presenting its outcomes of winning and losing as if they were simply
a matter of chance and sound judgment in a neutral market place.Capitalism does indeed create a space for a certain
diversity, at least for the central capitalist regions, but it is neither neutral nor ideal and its price in terms of social exclusion is exorbitant. That
is to say,the
human cost in terms of inherent global poverty and degraded ‘life-chances’ cannot be
calculated within the existing economic rationale and,in consequence,social exclusion remains mystified and
nameless(viz. the patronizing reference to the ‘developing world’). And Zizek’s point is thatthis mystification is magnified
through capitalism’s profound capacity to ingest its own excesses and negativity: to redirect(or
misdirect)social antagonisms and to absorb them within a culture of differential affirmation.Instead of
Bolshevism, the tendency today is towards a kind of political boutiquism that is readily sustained by postmodern forms of consumerism and
lifestyle.Against thisZizek
argues for a new universalism whose primary ethical directive is to confront the fact
that our forms of social existence are founded on exclusion on a global scale.While it is perfectly true that
universalism can never become Universal (it will always require a hegemonic-particular embodiment in order to have any meaning),what is
novel about Zizek’s universalism is that it would not attempt to conceal this fact or reduce the status of
the abject Other to that of a ‘glitch’ in an otherwise sound matrix.
Our alternative is to completely withdraw from the ideology of capital - this opens up
the space for authentic politics
Johnston ’04 (Adrian, interdisciplinary research fellow in psychoanalysis at Emory, The Cynic’s Fetish: Slavoj Zizek and the Dynamics of
Belief, Psychoanalysis, Culture and Society)
Perhaps the absence of a detailed political roadmap in Žižek’s recent writings isn’t a major shortcoming.
Maybe, at least for the time being, the most important task is simply the negativity of the critical struggle, the
effort to cure an intellectual constipation resulting from capitalist ideology and thereby to truly open up
the space for imagining authentic alternatives to the prevailing state of the situation. Another definition of
materialism offered by Žižek is that it amounts to accepting the internal inherence of what fantasmatically appears as an external deadlock or
hindrance ( Žižek, 2001d, pp 22–23) (with fantasy itself being defined as the false externalization of something within the subject, namely, the
illusory projection of an inner obstacle, Žižek, 2000a, p 16). From
this perspective, seeing through ideological fantasies
by learning how to think again outside the confines of current restrictions has, in and of itself, the
potential to operate as a form of real revolutionary practice (rather than remaining merely an instance of
negative/critical intellectual reflection). Why is this the case? Recalling the analysis of commodity fetishism, the social
efficacy of money as the universal medium of exchange (and the entire political economy grounded upon it) ultimately
relies upon nothing more than a kind of ‘‘magic,’’ that is, the belief in money’s social efficacy by those
using it in the processes of exchange. Since the value of currency is, at bottom, reducible to the belief
that it has the value attributed to it (and that everyone believes that everyone else believes this as well), derailing
capitalism by destroying its essential financial substance is, in a certain respect, as easy as dissolving the
mere belief in this substance’s powers. The ‘‘external’’ obstacle of the capitalist system exists exclusively
on the condition that subjects, whether consciously or unconsciously, ‘‘internally’’ believe in it –
capitalism’s life-blood, money, is simply a fetishistic crystallization of a belief in others’ belief in the
socio-performative force emanating from this same material. And yet, this point of capitalism’s frail vulnerability is
simultaneously the source of its enormous strength: its vampiric symbiosis with individual human desire, and the fact that the late-capitalist
cynic’s fetishism enables the disavowal of his/her de facto belief in capitalism, makes it highly unlikely that people can simply be persuaded to
stop believing and start thinking (especially since, as Žižek claims, many of these people are convinced that they already have ceased believing).
Or, the more disquieting possibility to entertain is that some people today, even if one succeeds in
exposing them to the underlying logic of their position, might respond in a manner resembling that of
the Judas-like character Cypher in the film The Matrix (Cypher opts to embrace enslavement by illusion rather than cope
with the discomfort of dwelling in the ‘‘desert of the real’’): faced with the choice between living the capitalist lie or
wrestling with certain unpleasant truths, many individuals might very well deliberately decide to accept
what they know full well to be a false pseudo-reality, a deceptively comforting fiction (‘‘Capitalist commodity
fetishism or the truth? I choose fetishism’’).
Our alt is more political than the plan – the plan is pseudo-activity that makes us feel
like we’ve done something when nothing has changed. Use your ballot to vote neg
and refuse to participate in politics-as-usual.
Zizek, ’08(Slavoj, senior researcher at the Institute of Sociology, University of Ljubljana, Slovenia and a professor at the
European Graduate School, Violence, p. 216-217)
In psychoanalytic terms, the voters’ abstentionis something like the psychotic Verwerfung (foreclosure, rejection/repudiation)
whichisamore radicalmove than repression (Verdrangung). According to Freud, the repressed is intellectually accepted by the subject,
since it is named, and at the same time is negated because the subject refuses to recognise it, refuses to recognise him or herself in it. In
contrast to this, foreclosure
rejects the term from the symbolic tout court. To circumscribe the contours of this radical
rejection one is tempted to evoke Badiou’s provocative thesis: “It is better to do nothing than to contribute to the
invention of formal ways of rendering visible that which Empire already recognizes as existent.”6 Better
to do nothing than to engage in localised acts the ultimate function of which is to make the system run
more smoothly(acts such as providing space for the multitude of new subjectivities).The threat today is not passivity, but
pseudo- activity, the urge to “be active,” to “participate,” to mask the nothingness of what goes on.
People intervene all the time, “do something”; academics participate in meaningless debates, and so on. The truly difficult
thing is to step back, to withdraw.Those in power often prefer even a “critical” participation, a dialogue, to silence—just to engage
us in “dialogue,” to make sure our ominous passivity is broken.The voters’ abstention is thus a true political act: it
forcefully confronts us with the vacuity of today’s democracies.
If one means by violence a radical upheaval of the basic social relations,then,crazy and tasteless as it may sound,
the problem with historical monsters who slaughtered millions was that they were not violent enough.
Sometimes doing nothing is the most violent thing to do.
ADV
General Solvency F/L
1. Scarcity artificially constructed – special interest corruption
Scheper-Hughes 2001 (Nancy, Prof at UC-Berkeley, “Commodity Fetishism in Organs Trafficking”.
Body and Society. 2001. 7:31. pp. 31-62. DOI: 10.1177/1357034X0100700203) [nagel]
The market in organs is driven by the simple calculus of ‘supply and demand’ and by the specter of
waiting lists, organ scarcities and organ panics. But the very idea of organ or kidney ‘scarcity’ is what Ivan
Illich (1992) would call an artificially created need, one that is invented by transplant technicians, doctors
and their brokers, and dangled before the eyes of an ever expanding sick, aging, desperate and dying
population. Newer and better technologies of organ retrieval and preservation and later generation immune suppression and
anti-rejection drugs (see Cohen, this issue) promise an extension of life or an improvement in the quality of life
through transplant surgery to an ever expanding pool of transplant candidates. In recent years, various
transplant centers have begun to offer, on an experimental basis, transplants to populations of previously
excluded patients – the elderly (over 65 years), the immunologically impaired, the difficult to match, HIV
serropositive and hepatitis C patients. These are high-risk, poor-outcome patients who were
previously denied a place on organs transplant waiting lists in most countries. Now, ‘guardedly optimistic’ reports on the outcomes of
such experimental programs in Western Europe were uncritically discussed at the annual meetings of Eurotransplant, which I attended in the
fall of 2000 in Leiden, the Netherlands. There was
almost no reflection on the effect that such marginal programs
might have in inflating the demands for already ‘scarce’ organs. Instead, an ethos of rugged market
individualism prevailed in place of a discourse on social medical ethics. One hesitant pediatric surgeon raised a
lonely voice from the convention hall. She rose to the microphone to ask the panelists the following question. Since the pool of available organs
was finite, and given that donation rates were flat or even declining in some Eurotransplant countries, wouldn’t these experimental transplant
programs further decrease the availability of organs for child and adolescent patients? The chair of the panel replied that the distribution of
organs would continue to be monitored by Eurotransplant with attention to the constantly shifting priorities that are accorded to different
classes of patients. ‘Yes, it is a bit like a balloon’, the chairman stated, ‘and demands and pressures from one group impact the expectations of
other, previously privileged groups. But this is part of the democratic process through which organ allocations are made.’ Here
‘democracy’ has been redefined as the contestations among special interest pressure groups, which
seems inappropriate in the medical context.
2. No shortage solvency – underlying fears
Neri 2002 (Rebecca M., Associate of Devorsetz, Stinziano, Gilberti, Smith & Heintz, NY Attorney, The
Digest, 10 Digest 67, p. 80-1) [nagel]
The corruption
lies not in the potential for market abuses, but rather in the existing social
consciousness of the population. As mentioned above, the six [*81] most popular reasons people give for not
donating organs are: "hastiness of organ retrieval and a feeling that declaration of death and
immediate subsequent removal of organs interferes with the family's expression of grief; mutilation;
fatalism and superstition; religion; age and ignorance." n67 If the greater social value of organs is to
prevent their being interred without harvesting and to save lives, then the market must arrange itself around
enabling people to weigh their cost or fear concerning donation. But how is a market to do this when,
in fact, the incentive is merely valued in fiscal terms? How can a market theory, which relies on the wealth of its
participants more so than the social justice of its actors effectively push social mores towards weighing the benefits of
giving over the cost of facing ones personal fears? It simply cannot. Though any market incentive might push people
towards realizing that money is preferable in exchange for needed organs, the
market incentive simply fails to account for
the underlying fears of the people concerning donation. The market cannot provide a structure in which ordinary people
can rationally weigh costs and benefits of organ donation, because the market lacks sufficient grounding in the irrational
fears concerning donation. A pure incentive program that replaces altruism with cash, or other necessities is
inadequate as it falls short of effectively replacing existing social fears connected with donating
organs after death. If there really is to be any increase in the organ supply, the answer lies in reshaping society not
through a free market and property system, but rather, through structuring discussion around
changing social values at their core.
3. Squo solves – 3D printing
Griggs 4/3/2014 (Brandon, Senior Contributor to CNNTech Online, “The next frontier in 3-D printing:
Human organs”. CNN Online. DA: 8/10/2014. http://www.cnn.com/2014/04/03/tech/innovation/3-dprinting-human-organs/) [nagel]
Bioprinting works like this: Scientists harvest human cells from biopsies or stem cells, then allow them
to multiply in a petri dish. The resulting mixture, a sort of biological ink, is fed into a 3-D printer, which is
programmed to arrange different cell types, along with other materials, into a precise three-dimensional shape. Doctors hope
that when placed in the body, these 3-D-printed cells will integrate with existing tissues. The process
already is seeing some success. Last year a 2-year-old girl in Illinois, born without a trachea, received a windpipe built
with her own stem cells. The U.S. government has funded a university-led "body on a chip" project
that prints tissue samples that mimic the functions of the heart, liver, lungs and other organs. The
samples are placed on a microchip and connected with a blood substitute to keep the cells alive, allowing doctors to test specific treatments
and monitor their effectiveness. "This is an exciting new area of medicine. It has the potential for being a very important breakthrough," said
Dr. Jorge Rakela, a gastroenterologist at the Mayo Clinic in Phoenix and a member of the American Liver Foundation's medical advisory
committee. "Three-D
printing allows you to be closer to what is happening in real life, where you have
multiple layers of cells," he said. With current 2-D models, "if you grow more than one or two layers, the cells at the bottom suffocate
from lack of oxygen." To accelerate the development of bioprinted organs, a Virginia foundation that supports
regenerative medicine research announced in December it will award a $1 million prize for the first
organization to print a fully functioning liver. One early contender for the prize is Organovo, a California start-up that has
been a leader in bioprinting human body parts for commercial purposes. Using cells from donated
tissue or stem cells, Organovo is developing what it hopes will be authentic models of human organs,
primarily livers, for drug testing.
4. Effective regulation impossible
Rothman and Rothman 2006 (S.M. and D.J., Profs at Columbia University, “The Hidden Cost of
Organ Sale”. American Journal of Transplantation. 6:7. July. 1524-1528. DOI: 10.1111/j.16006143.2006.01325.x) [nagel] We disagree with the Ableist language used.
Whatever the proposed system, regulation may not be readily accomplished. Once a market is lawful, halfway measures that allow for sellers but not for buyers might prove inoperative. Effectively regulated
markets typically involve so-called ‘natural monopolies’ wherein entry points can be effectively policed.
(Think of electric power, telephone service and railroads.) By contrast, in kidney sale, with almost everyone eligible to
enter the market, oversight [regulation] will not be easily established or maintained. So too, as most students of
regulated markets are quick to admit, change almost inevitably carries unintended consequences. Deregulate the
market in energy trading and Enron scandals occur; deregulate the telephone market and the
communications industry is transformed; deregulate the savings and loan business and corruption breaks
out. Hence, the question must be asked: since practices may develop in ways that cannot be predicted or
controlled, are we ready to live with a system that makes kidneys a commodity?
5. Legalization bad – 5 reasons
-altruism decrease, increase poverty, consent coerced, legal safeguards fail, health decline
Goyal et al 2002 (Madhav, and Ravindra L. Mehta, Lawrence J. Schneiderman, and Ashwini R. Sehgal,
Department of Internal Medicine, Geisinger Health System, State College, Pa (Dr Goyal); Department of
Nephrology, University of California, San Diego (Dr Mehta); Departments of Family and Preventive
Medicine and Medicine, University of California, San Diego, School of Medicine (Dr Schneiderman);
Division of Nephrology and Center for Health Care Research and Policy, MetroHealth Medical Center,
and Departments of Medicine, Biomedical Ethics, and Epidemiology and Biostatistics, Case Western
Reserve University, Cleveland, Ohio (Dr Sehgal). “Economic and Health Consequences of Selling a Kidney
in India”. Journal of the American Medical Association. 2002; 288(13):1589-1593.
doi:10.1001/jama.288.13.1589.) [nagel] We disagree with the gendered language used.
Our quantitative findings, along with those of previous qualitative studies,9,16,31,32,34,35 undercut 5 key
assumptions made by supporters of the sale of kidneys. First, although paying people to donate may have increased the
supply of organs for transplantation, the financial incentive did not supplement underlying altruistic motivations.
Only 5% of participants said wanting to help a sick person was a major factor in their decision to sell.
Second, selling a kidney did not help poor donors overcome poverty. Family income actually declined by
one third, and most participants were still in debt and living below the poverty line at the time of the survey. Third,
regardless of these poor economic outcomes, sellers arguably have a right to make informed decisions about their own bodies. However,
most participants would not recommend that others sell a kidney, which suggests that potential
donors would be unlikely to sell a kidney if they were better informed of the likely outcomes. Fourth,
safeguards such as eliminating middle [persons]men or having an authorization committee did not
appear to be effective. Middlemen and clinics paid less than they promised, and the authorization committees did not ensure that
donations were motivated by altruism alone. Fifth, nephrectomy was associated with a decline in health status.
Previous qualitative reports suggest that a diminished ability to perform physical labor may explain
the observed worsening of economic status.31- 35 Persistent pain and decline in health status have not been reported in
previous long-term follow-up of volunteer donors in developed countries.47
Morality/Justice Turn
Turn – the only true justice and moral stance is to reject organ sales
Shalev 2003 (Carmel, Lawyer-Ethicist Gertner Institute, Tel Hashomer, Israel, “Organs, justice and
human dignity”. Debate - Controversy: An ethical market in human organs Charles A Erin, John Harris J
Med Ethics 2003; 29:3 137-138 doi:10.1136/jme.29.3.137) [nagel]
Justice is at stake, because the moral question that the shortage of organs raises is one of fair distribution. Globally, it is clear that
the need for organs for all persons suffering renal failure throughout the world will not be satisfied.
The rich will benefit from a market in human organs and not the poor. There are many sick persons
facing risk of death in the world. Most live in countries that do not have the professional capacity and technological infrastructure for either
dialysis or transplantation. Only
some are fortunate enough to have access to medical services that can save
their lives, and the ability (or insurance) to pay for their costs. In countries that have public medical facilities with
transplantation capability, the poor will wait on dialysis for organs from cadavers while rich people will buy
transplantation services with living donors. The argument for human dignity is a moral intuition, which Margaret Radin
articulated several years ago. To put it simply, there are certain things that money can’t buy and that are not for
sale. Once upon a time medicine was a calling, but now it is becoming a business. Despite the vagueness of the idea
of human dignity, it is an intuitive value that resists the notion of a contract for a pound of flesh.
Freedom of contract is not an absolute. Many legal systems refuse to recognize the validity of contracts that are
illegal, immoral or contrary to public policy. In 1991 the World Health Organization published guiding principles on organ
transplantation. Guiding Principle 5 is crystal clear: “The human body and its parts cannot be the subject of
commercial transactions. Accordingly, giving or receiving payment (including any other compensation or reward) for
organs should be prohibited.” Nothing has changed since then except for the flourishing of an
international black market of profit -seeking private practitioners and institutions pandering to
“consumer demand”. Considerations of distributive justice and of human dignity are sufficient
justification to restrict the liberty of individuals . It is true that all we need is an organ, but there are also moral
limits on the means that we may employ for the end of saving our own lives. The value of saving life
does not give a sick person a right to an organ from a living other at all costs. If saving lives is such an important
value, we should be encouraging altruistic donations and an ethic of solidarity, care and compassion.
Suffering Turn
Kidney donation creates a life of suffering – medical, economic, social
Scheper-Hughes 2005 (Nancy, Professor at UC-Berkeley, “THE LAST COMMODITY: Post-Human
Ethics and the Global Traffic in ‘‘Fresh’’ Organs”. Global Assemblages: Technology, Politics, and Ethics as
Anthropological Problems. Ed. Aihwa Ong and Stephen Collier. Blackwell Publishing. Malden, MA. pp.
162-3) [nagel]
Transplant surgeons have disseminated an untested hypothesis of ‘‘risk-free’’ live donation in the
absence of any published, longitudinal studies of the effects of nephrectomy among the urban poor living anywhere in the
world. The few available studies of the effects of neprectomy on kidney sellers in India34 and Iran35 are
unambiguous. Even under attempts (as in Iran) to regulate and control systems of ‘‘compensated
gifting’’ by the Ministry of Health, the outcomes are devastating. Kidney sellers suffer from chronic pain,
unemployment, social isolation and stigma, and severe psychological problems. The evidence of strongly
negative sentiments – disappointment, anger, resentment, and even seething hatreds for the doctors and
the recipients of their organs – reported by 100 paid kidney donors in Iran strongly suggests that kidney selling there
represents a serious social pathology. Our research with 22 kidney sellers in Moldova and 20 sellers in the Philippines, which in
several cases included diagnostic exams and sonograms, found that kidney sellers face many post-operative
complications and medical problems, including hypertension and even subsequent kidney
insufficiency, without access to medical care or necessary medications. On returning to their rural villages or urban
shantytowns, kidney sellers often find themselves weakened, sick, and often unemployable, because they
are unable to sustain the demands of heavy agricultural or construction work, the only labor available
to men of their skills and backgrounds. Kidney sellers are most often alienated from their families and coworkers,
excommunicated from their churches, and, if single, they are even excluded from marriage. The children of
kidney sellers are ridiculed as ‘‘one-kidneys.’’ In my sample of 22 kidney sellers in Moldova, my assistants and I found that not one
had seen a doctor or been treated at a medical clinic following their illicit operations in Istanbul and Georgia (Russia). I had to coax the young
men to agree to a basic clinical examination and sonogram at the expense of Organs Watch. Some
said they were ashamed to
appear in a public clinic, as they had tried to keep the sale a secret; others said they were fearful of
learning negative results from the tests. All said that if serious medical problems were discovered, they were
unable to pay for follow-up treatments or necessary medications. Above all, they said, they feared being
labeled as ‘‘weak’’ or ‘‘disabled’’ by employers and coworkers, as well as (for single men) by potential girlfriends and
brides. ‘‘No young woman in the village will marry a man with the tell-tale scar of a kidney seller,’’ the
father of a village kidney seller said sadly. ‘‘They believe that he will be unable to support a family.’’ Sergei, a married man from Chisenau,
revealed that his mother was the only person who knew the reason for the large, saber-like scar on his abdomen. Sergei’s young wife believed
that he had been injured in a construction accident while he was away in Turkey.
1NC Ethics Turn
Legalizing organ sales creates a violent racial and economic system that collapses
ethics into management
Scheper-Hughes 2005 (Nancy, Professor at UC-Berkeley, “THE LAST COMMODITY: Post-Human
Ethics and the Global Traffic in ‘‘Fresh’’ Organs”. Global Assemblages: Technology, Politics, and Ethics as
Anthropological Problems. Ed. Aihwa Ong and Stephen Collier. Blackwell Publishing. Malden, MA. pp.
164) [nagel]
In his 1970 classic, The Gift Relationship, Richard Titmuss anticipates
many of the dilemmas now raised by the global
human organs market. His assessment of the negative social effects of commercialized blood markets in the U.S.A. could
also be applied to the global markets in human organs and tissues: The commercialism of blood and
donor relationships represses the expression of altruism, erodes the sense of community, lowers scientific
standards, limits both personal and professional freedoms, sanctions the making of profits in hospitals and clinical
laboratories, legalizes hostility between doctor and patient, subjects critical areas of medicine to the laws of
the marketplace, places immense social costs on those least able to bear them—the poor, the sick, and the
inept—increases the danger of unethical behavior in various sectors of medical science and practice, and results
in situations in which proportionately more and more blood is supplied by the poor, the unskilled and the
unemployed, Blacks and other low income groups.36 The goal of this project is frankly adversarial in its attempt
to bring social justice concerns to bear on global practices of organs procurement and transplant. This
chapter has been an attempt to delineate some of the contradictions inherent in a market-driven solution to the problem of ‘‘scarcity’’ of
human organs; as well as an attempt to recapture the original biosociality inherent in the once daring proposal to circulate human organs as a
radical act of fraternity; and, finally, to bring a critical medical anthropological sensibility into the current debates on the commodification of
the body.
Yes Coercion/No Consent
No empirics for free consent – all ev goes negative
Scheper-Hughes 2007 (Nancy, Vera N. Schuyler Institute Fellow and Professor at Harvard University,
“In Defense of the Body from the Queen of Hearts to the Knave of Hearts:”. J Med Ethics. 4/27/2007.
DA: 7/31/2014. http://jme.bmj.com/content/33/4/201.full/reply#medethics_el_1538) [nagel]
Taylor makes the leap from my discussions of tissues harvesting from the dead to living, voluntary sale of organs. As these cannot be subsumed
under the same heading, I have supplied one. I have only one question: What
is Taylor evidence for the blanket assertion
that "voluntary trades in human organs that take place between consenting adults, untainted by force
or fraud, make all parties to them better off". Where are the empirical studies to support his claim? It is, I fear,
the philosopher's speculation that in the best of all possible worlds this would or could possibly be the
case. To date, however, all empirical studies of living kidney donors indicate varying degrees of coercion,
deception, feelings of exploitation, shame, and resentment following arranged kidney sales. In
addition to my research are studies conducted by Lawrence Cohen, Sheila and David Rothman, Goyal,
Schneiderman and Sehgal and Zargooshi. There are also as yet unpublished doctoral dissertations by
medical anthropologists working in Iran, Turkey, Egypt, and the Philippines with similar findings. While
selling a kidney means different things and has different medical, social, and psychological consequences, depending on many factors (including
access to medical after care, attitudes toward the body, religious and cultural beliefs about gifting, sales, and reciprocity, living and work
conditions, and so on) thus far the data show negative consequences. Most
kidney sellers report lower wages and
decreased income in the first years after the sale. Since the sale of one kidney per family is never
enough, the temptation is strong in many areas where kidney selling has almost become routine (as in
Manila) for families to pass along the role of kidney seller from father to his sons. Would regulation of black
markets in organs solve matters? The only test case we have to draw on is Iran. Iran's government regulated
system of kidney sales for transplant surgeries is highly contested within the Iranian medical profession. Internal medical critics of the system
say that easy access to the bodies of poor people has prevented the development of a deceased donor system in Iran and has eroded living
kidney donation among loving family members. They report that kidney sellers are often treated, like deceased donors, as anonymous suppliers
of medical material. There is in Iran today no medical registry of paid donors and no medical accountability, mandatory reporting of mishaps, or
seller follow up. Regulation
in Iran has not ended the black market, it has simply made it an official policy.
Living donors are still recruited by middlemen and payments are negotiated behind the scenes. More
affluent transplant patients demand healthier, better-off donors, and are willing to pay an additional
price for a 'higher quality' kidney. While regulation is generally preferable to an underground black
market, it is contradictory for governments and Ministries of Health to weaken one previously healthy segment of
the population in the interest of a sicker and wealthier section.
Consent impossible – “autonomy” violates ethical practice and exploits the poor
Scheper-Hughes 2005 (Nancy, Professor at UC-Berkeley, “THE LAST COMMODITY: Post-Human
Ethics and the Global Traffic in ‘‘Fresh’’ Organs”. Global Assemblages: Technology, Politics, and Ethics as
Anthropological Problems. Ed. Aihwa Ong and Stephen Collier. Blackwell Publishing. Malden, MA. pp.
161-2) [nagel]
Bioethical arguments about the right to sell an organ or other body part are based on Euro-American
notions of contract and individual ‘‘choice.’’ But the social and economic contexts make the ‘‘choice’’ to
sell a kidney in an urban slum of Calcutta, or in a Brazilian favela or Philippine shantytown, anything
but a “free” and “autonomous” one. Consent is problematic with “the executioner” – whether on death row
or at the door of the slum resident – looking over one’s shoulder. Putting a market price on body parts – even a
fair one – exploits the desperation of the poor, turning suffering into an opportunity. Asking the law
to negotiate a fair price for a live human kidney goes against everything that contract theory stands
for. When concepts such as individual agency and autonomy are invoked in defending the ‘‘right’’ to sell an organ,
anthropologists might suggest that certain “living” things are not alienable or proper candidates for
commodification. And the surgical removal of nonrenewable organs is an act in which medical
practitioners, given their ethical standards, should not be asked to participate. The problems multiply
when the buyers and sellers are unrelated, because the sellers are likely to be extremely poor and
trapped in life-threatening environments where the everyday risks to their survival are legion, including exposure to urban
violence, transportation- and work-related accidents, and infectious disease that can compromise their kidney of last resort. And when that
spare part fails, kidney sellers often have no access to dialysis, let alone to organ transplant. While
poor people in particular cannot “do without” their ‘‘extra’’ organs, even affluent people need that
“extra” organ as they age, and when one healthier kidney can compensate for a failing or weaker kidney.
No legal consent
Adair and Wigmore 2011 (Anya and Stephen, Edinburgh Transplant Unit at the Royal Infirmary of
Edinburgh, “Paid Organ Donation: The Case Against”. Ann R Coll Surg Engl. Apr 2011; 93(3): 191–192.
doi: 10.1308/147870811X565061a) [nagel]
Sadly for
the majority of donors, selling a kidney does not result in the significant economic benefit of
which they dreamed. Often it is associated with a decline in general health. Many fall back into debt, often
compounded by the inability to work following donation due to ill health.8 Supporters of paid donation argue that
a person should have the basic right to choose the fate of his or her organs. In the setting of paid donation, informed consent is often
of dubious quality, with the risks of surgery often not being properly explained or understood.
Furthermore, many individuals are pressured to donate by family members, with the outcome of any
‘balanced discussions’ about wishing to proceed with organ donation predetermined.8 In the UK, our society believes that we
have a responsibility to protect individuals from harm. This principal applies even when harm may be
self-inflicted. That is why we have motorcycle helmet and seatbelt laws. Why should this statebrokered paternalism be overturned to allow paid donation?
Coercion inevitable – market dynamics and destruction of bioethics
Caplan 2004 (Arthur, Prof at UPenn, “Transplantation at Any Price?”. American Journal of
Transplantation. 4:12. 1933-1934. December. DOI: 10.1111/j.1600-6143.2004.00686.x) [nagel]
Matas focuses his ethical analysis of kidney markets on the claim that sellers will be exploited. He rejects this argument noting that the poor are
capable of rationality when it comes to sales and the inequity he sees when only those who supply parts among all involved with transplants
are asked to go without compensation. On ethical grounds, however, his argument is wanting. The
issue is not the rational
capacity of the seller, but the likely absence of real alternatives. It is hard to imagine that there will be
numerous persons in wealthy Western nations eager to sell a kidney unless their compensation were
significant. That has been the experience with markets in egg sales and paid surrogacy in the United States (9,10). Choice is
imperiled by high compensation, not because the sellers are rendered irrational by the prospect of
money, but for those in need of money certain offers, no matter how degrading, are irresistible (10–12).
Those who are in need of money might rationally decide to sell their children, but the sale of babies is
not permitted because this is seen as a gross exploitation of the poor if they have no options but to resort to child sales.
It is precisely for this reason that severe restrictions are in place on what can be paid to subjects who ‘volunteer’ themselves or their children
for medical experiments and toxicity testing (12). The
possibility of making a lot of money relative to one's means
also creates enormous pressure from third parties on the prospective seller to ‘choose’ to sell. Those
in severe debt with no alternatives cannot truly be said to choose to become organ vendors if those to
whom they are in debt force them into sales. Choices require options as well as the ability to reason about them. Matas has
not, however, grasped the real ethical nettle with his focus on exploitation. The debate about whether exploitation is
inevitable in markets in rich or poor countries misses the two most important reasons why allowing the sale of
kidneys is unethical. Participation in sales, even in a tightly regulated market, violates the ethics of
medicine. And markets will prove next to impossible to implement in North America and Europe on ethical grounds. Medicine has
long held that the core ethical norm of the profession is the principle ‘Do no Harm’. Taking organs
from living persons is in direct violation of this moral norm. The only way in which it seems morally
defensible to remove an organ from someone is on the grounds that the donor chooses to undergo the harm solely
to help another and that there is sufficient medical benefit to the recipient. The creation of a market puts medicine in
the position of removing body parts from persons solely to abet their interest in securing
compensation for themselves. Is this a role that medicine can ethically countenance? What would such a role do to public trust in
physicians? The goal of medicine is the alleviation of illness, disability and suffering not finding ways to permit
persons to make a profit for themselves by interventions that cause them permanent and significant harm. A key moral
problem with markets in kidneys and other body parts is what it does to the ethics of the medical
profession. In a market, even a regulated one, doctors use their skills to help people harm themselves for money and solely for money.
1NC Poverty
No poverty solvency – compensation is too small
Greasley 2012 (Kate, Prof of Law at Oxford University, “A legal market in organs: the problem of
exploitation”. J Med Ethics. 2012; 0: 1–6. doi: 10.1136/medethics-2012-100770) [nagel] We disagree
with the Ableist and gendered language used.
When it comes to the usefulness of research into the kidney trade in countries such as India it is, of course, important to keep in mind a realistic
picture of what a regulated UK system would look like. Yet to this end, it should be stressed that the
problems of advantage taking
which I have underscored in the Indian context are not primarily matters of reliable payment or
arbitrary pricing (though for many this is, naturally, a related problem). The main issue is that there is no material
improvement to the vendors’ conditions even where full payment is reliably made. Unless, then, what is
envisioned in a regulated system involves truly transformative sums of compensation (which clearly it does not),
there is no reason to think that this persistent feature would not be replicated. And it is a reasonable
assumption to make that anyone desperate enough to sell [their] his kidney is not in a position to invest the
proceeds in such a way as to make them, eventually, transformative. In other words, there is nothing in the
notion of a well-regulated, fairly priced UK market which casts the common Indian story of the urgent
sell to pay off debts which only continue to accrue in a parochial light.
Donation locks in poverty and social isolation long term
Delmonico et al 2008 (F.L. and D.A. Budiani-Saberi, Prof at Harvard Medical School and Prof at
University of Pennsylvania, “Organ Trafficking and Transplant Tourism: A Commentary on the Global
Realities”. American Journal of Transplantation. 8:5. pp. 925-929.
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2008.02200.x/full) [nagel] CLD = commercial
living donors
Egypt is one of the few countries that prohibits organ donation from deceased donors. In
the absence of an entity to govern
allocation or standards for transplants, the market has become the distribution mechanism. Egypt is also
one of the countries in which COFS has conducted extensive field research and long-term outreach service programs for victims of the organ
trade. In-depth longitudinal interviews conducted by Budiani reveal that 78%
of the CLDs (n = 50) reported a deterioration
in their health condition. This is likely a result of factors such as insufficient donor medical screening for a
donation, pre-existing compromised health conditions of CLD groups and that the majority of employed CLDs
reported working in labor-intensive jobs. A kidney sale does not solve the most frequently given reason for being a CLD, 81%
spent the money within 5 months of the nephrectomy, mostly to pay off financial debts rather than
investing in quality of life enhancements. CLDs are not eager to reveal their identity; 91% expressed social isolation
about their donation and 85% were unwilling to be known publicly as an organ vendor. Ninety-four percent
regretted their donation (13). The studies in Pakistan and Egypt are consistent with findings in India
(14), Iran (15) and the Philippines (16) that revealed deterioration in the health condition of the CLDs. A
long-term financial disadvantage is evident following nephrectomy from a compromised ability to generate a
prior income level. The common experience also entails a social rejection and regret about their
commercial donation. These reports are consistent with the COFS experience in the CLD interviews; a cash payment does not
solve the destitution of the vendor.
We control uniqueness – legalization net increases poverty and exploitation
Greasley 2012 (Kate, Prof of Law at Oxford University, “A legal market in organs: the problem of
exploitation”. J Med Ethics. 2012; 0: 1–6. doi: 10.1136/medethics-2012-100770) [nagel]
In addition to this, the
single purchaser system would do nothing to combat another logical corollary of a free market in
organs, this being an added incentive on behalf of the wealthier community to maintain the supply of
organs by keeping the conventional source of sellers from improving on their socioeconomic status.
Indeed, it was a further finding of Cohen’s study in Chennai that the relatives of a patient who needed a
kidney would now ask themselves why they should assume the risks of donating when they could
simply go out and buy one. As Rothman puts it, ‘a market in organs stimulates a market in organs’.
Health Turn
Donation causes massive health decrease
(also in TT DA)
Goyal et al 2002 (Madhav, and Ravindra L. Mehta, Lawrence J. Schneiderman, and Ashwini R. Sehgal,
Department of Internal Medicine, Geisinger Health System, State College, Pa (Dr Goyal); Department of
Nephrology, University of California, San Diego (Dr Mehta); Departments of Family and Preventive
Medicine and Medicine, University of California, San Diego, School of Medicine (Dr Schneiderman);
Division of Nephrology and Center for Health Care Research and Policy, MetroHealth Medical Center,
and Departments of Medicine, Biomedical Ethics, and Epidemiology and Biostatistics, Case Western
Reserve University, Cleveland, Ohio (Dr Sehgal). “Economic and Health Consequences of Selling a Kidney
in India”. Journal of the American Medical Association. 2002; 288(13):1589-1593.
doi:10.1001/jama.288.13.1589.) [nagel]
Participants rated their health status before and after nephrectomy by using a 5-point Likert scale
ranging from excellent to poor (Table 3). Forty participants (13%) reported no decline in their health after nephrectomy, 117 (38%)
reported a 1- to 2-point decline, and 147 (48%) reported a 3- to 4-point decline. Of all participants, 50%
complained of persistent pain at the nephrectomy site and 33% complained of long-term back pain.
Advice for Others Participants were asked what advice they would give someone else with the same reasons they had for selling. Of 264
participants who answered this question, 79% would
not recommend selling a kidney, while 21% would.
1NC Exploitation DA
Organ selling causes targeted exploitation of the poor
Park 2012 (Alice, Senior Contributor to Time and CNN, “Should people be allowed to sell their
organs?”. CNN Online. DA: 7/30/2014. http://www.cnn.com/2012/07/03/health/allowed-sell-organstime/) [nagel]
Of course, certain
body parts are already up for sale. Aside from sperm and plasma, donors can also be
paid for their eggs and hair. But by expanding that list, the court's ruling reopens the long-standing
ethical debate over the commercialization of human tissues. For now, legally "sellable" human body
parts aren't ones that could be used to cure fatal diseases, which prevents a market frenzy. But if the bonemarrow case starts changing that -- and experts say it could -- it might jump-start a dangerous trend in which lowerincome groups were disproportionately targeted or incentivized to give up their marrow and people
with rarer blood types demanded more money for their valuable cells.
Our ethical responsibility precedes everything – failure to resist exploitation for
organs makes life disposable
Scheper Hughes 2000 (Nancy, Prof at UC-Berkeley, “The Global Traffic In Human Organs”. Current
Anthropology. 41:2. April 2000. http://www.jstor.org/stable/10.1086/300123) [nagel] We disagree with
the Ableist language used.
I will argue that transplant surgery as it is practiced today in many global contexts is a blend of altruism and commerce, of science and magic, of
gifting, barter, and theft, of choice and coercion. Transplant
surgery has reconceptualized social relations between
self and other, between individual and society, and among the “three bodies”—the existential lived
body‐self, the social, representational body, and the body political (see Scheper‐Hughes and Lock 1987). Finally, it
has redefined real/unreal, seen/unseen, life/death, body/corpse/cadaver, person/nonperson, and
rumor/fiction/fact. Throughout these radical transformations, the voice of anthropology has been relatively muted,
and the high‐stakes debates have been waged among surgeons, bioethicists, international lawyers, and economists. From time to time
anthropologists have intervened to translate or correct the prevailing medical and bioethical discourses on transplant practice as these conflict
with alternative understandings of the body and of death. Margaret Lock's (1995, 1996) animated discussions, debates, and difficult
collaborations with the moral philosopher Janet Radcliffe Richards (see Richards et al. 1998) and Veena Das's (n.d.) responses to the latter and
to Abdullah Daar (Das 1996) are exemplary in this regard. But perhaps what is needed from anthropology is something more akin to Donna
Haraway's (1985) radical manifesto for the cyborg bodies and cyborg selves that we have already become. The
emergence of strange
markets, excess capital, “surplus bodies,” and spare body parts has generated a global body trade
which promises select individuals of reasonable economic means living almost anywhere in the
world—from the Amazon Basin3 to the deserts of Oman—a miraculous extension of what Giorgio Agamben (1998)
refers to as bios—brute or naked life, the elementary form of species life.4 In the face of this late‐modern dilemma—
this particular “end of the body”—the task of anthropology is relatively straightforward: to activate our
discipline's radical epistemological promise and our commitment to the primacy of the ethical (Scheper‐
Hughes 1994). What follows is an ethnographic and reflexive essay on the transformations of the body and the state under conditions of
neoliberal economic globalism.
Impact is the erosion of all morality
Leyton 2000 (Elliot, Professor of Anthropology, Memorial University of Newfoundland, St John’s
“Comments” from “The Global Traffic In Human Organs” by Nancy Scheper-Hughes. Current
Anthropology. 41:2. April 2000. http://www.jstor.org/stable/10.1086/300123) [nagel]
But this
erosion of all morality follows most naturally from the assumptions and expectations
associated with the utterly unleashed industrial world order. If human beings are both philosophically and
economically reduced to mere commodities, then it follows as night follows day that their parts—their eyes, livers,
lungs, hearts, kidneys, and so on—also be offered for sale in the trading houses. And, once commodified, their
living tissue provides the basis for a new world market that offers the wealthy and the well‐connected
an indefinite extension of life, limited only by the abilities of current medical technology—the end of the
body indeed, and the double end of death, too, for not only can the rich now live forever (at least in theory) but the
diagnosis of death must be pushed farther and farther back into active life if we are to be provided
with the juiciest and most vital organs.
Black Market
Demand for organs drives international black market – government and military ties empirics
Scheper-Hughes 2005 (Nancy, Professor at UC-Berkeley, “THE LAST COMMODITY: Post-Human
Ethics and the Global Traffic in ‘‘Fresh’’ Organs”. Global Assemblages: Technology, Politics, and Ethics as
Anthropological Problems. Ed. Aihwa Ong and Stephen Collier. Blackwell Publishing. Malden, MA. pp.
158-9) [nagel]
Israel, for complicated reasons having to do with moral, political, and institutional obstacles to the procurement and distribution of
cadaver organs, is a major player in the global market for ‘‘fresh’’ (living donor) organs. The search by Israeli
surgeons and patients for living donor organs began in the West Bank and Gaza, and then moved to Turkey, India,
and Iraq, and, later to Moldova, Romania, and Russia. When these options closed down, the Israeli
market for kidneys moved to Brazil30 and South Africa. Thus, today, one half of all Israelis who have a
transplanted kidney purchased that kidney abroad. Caught between a highly educated and medically conscious public and
a very low rate of organ donation, the Israeli Ministry of Health has expedited the expansion of transplant tourism
by allowing Israeli patients to use their national insurance to pay for transplants conducted elsewhere,
even if illegally. The cost of the transplant ‘‘package’’ increased from $120,000 in 1998 to $200,000 in 2001. The cost includes the air travel,
bribes to airport and customs officials, ‘‘double operation’’ (kidney extraction and kidney transplant), the rental of operating and recovery
rooms, and hotel accommodation for accompanying family members. The donor fee of between $3,000 and $20,000 (depending on the status
of the donor) is also included. Well
known Israeli businessmen and their associates have formed
‘‘corporations’’ (including the firms of Kobi ( Jacob) Dyan and Ilan Perry) with ties to illicit medical centers and rogue
transplant units (public and private) in Turkey, Russia, Moldova, Estonia, Georgia, Romania, South
Africa and the U.S.A. The specific sites of the illicit surgeries are normally kept secret from transplant patients until the day of travel,
and the locations are continually rotated to maintain a low profile. The surgeries are performed at the dead of night in rented operating rooms.
In one scenario, Israeli
patients and doctors (a surgeon and a nephrologist) fly to a small town in Turkey, where the
kidney sellers sometimes include young Iraqi soldiers or guest workers. In another scenario, the Israeli and Turkish
doctors travel in tandem to a third site in eastern Europe, where the organ sellers are unemployed locals or guest workers from elsewhere. In a
third scenario, living kidney
donors are recruited from the slums and favelas of Recife, Northeast Brazil (by
brokers who include a military police officer) and sent by plane to Durban and Johannesburg in South Africa, where
they are met by South African brokers, who will match these unfortunates up with Israeli patients arriving from Tel Aviv. In this instance,
South African surgeons operate alone, without the presence of Israeli surgeon accomplices. The
collaboration of the Israeli government and Ministry of Health in this multimillion dollar business , which
is making Israel something of a pariah in the international transplant world, requires some explanation. Between 2001 and 2003, medical
insurance programs under Israel’s national health care system (Kupot Holim) funded 319 foreign kidney transplants with living unrelated donors
who were paid. According to government tax investigators looking into the illegal trade, each Israeli transplant tourist was paid prior to, or
reimbursed following, kidney transplant abroad $120,000 plus an additional $25,000 for pre- and post-op testing, treatment and care of the
living donor and the patient. In
the absence of a strong culture of organ donation and under the pressure of
angry transplant candidates, each person transplanted abroad is one less demanding and angry client
with which to contend. More troubling, however, is the support and involvement of the Ministry of
Defense in the illicit transplant tourism. Israeli patients who traveled on the transplant junkets to Turkey
and eastern Europe recorded the presence of military officers accompanying their flights.
Incompetence, corruption, and line-blurring
Mendoza 2010 (Roger, PhD and Specialist in welfare economics, “Kidney black markets and legal
transplants: Are they opposite sides of the same coin?”. Health Policy. 94 (2010). pp. 263) [nagel]
Inefficient monitoring due to resource constraints and lack of coordination remains a challenge for
government agencies [40], especially in developing countries like the Philippines. Credibility issues appear to be part of
this ineffectiveness. To illustrate, not long after the 2008 Revised National Policy was enacted, a Department of Health’s undisclosed
exemption of 8 Israelis from the foreigners’ ban “because of humanitarian considerations” provoked public indignation [49]. Inefficient
compliance monitoring renders the kidney commerce tolerable at minimum, emboldens its
participants and subverts policy intent. 4.3. Duplicate participants and functions The dividing line between the
underground and legal transplant systems becomes razor-thin when several participants (matching
agencies, foundations, hospitals, doctors and law-enforcers) in one system consciously or unconsciously perform the
same roles and functions in the other with relative ease. “Non-directed” kidney donations to governmentapproved foundations, for one, help unscrupulous brokers and criminal syndicates to circumvent the
prohibition against unrelated donations. The Philippine Society of Nephrology also discovered that recipients pay huge
sums for new kidneys, but most of them go to brokers, including some licensed doctors and medical facilities,
who locate many poor donors for the “non-directed” program [10,50]. Corruption within government
offices, hospitals, and law-enforcement agencies also need to be addressed. Effective law enforcement helps
connect legislation to the regulation of economic behavior.
Gratuities, deep markets, lack of broker penalties
Mendoza 2010 (Roger, PhD and Specialist in welfare economics, “Kidney black markets and legal
transplants: Are they opposite sides of the same coin?”. Health Policy. 94 (2010). pp. 263) [nagel] LNRD
= Live Non-Related Donor
While regulatory measures may prohibit kidney selling, self-contradictory provisions and policy
loopholes create reverse incentives (to trade illicitly). Both National Policy and Revised National Policy allow
“gratuities,” which could stimulate kidney selling. A foreigners’ cap or ban, as the Secretary of Health
acknowledged, may not suppress organized kidney crimes and could have the opposite effect, as syndicates are forced
to go deeper in their covert operations [10]. Crafting legislation or public policy cannot be restricted to textual provision but
need to address opportunities (demonstration effects) that may arise to subvert its own intent. 4.5. Relative insulation of commodity brokerage
A prevailing issue concerns the legal burden disproportionately placed on poor and vulnerable donors
in their role as kidney vendors. Conversely, brokers who stand to profit the most are relatively shielded from a law
enforcement standpoint in the absence of broker-specific penalties. Without brokers, it is doubtful if
most LNRDs will find kidney buyers, as our survey has indicated. Without incentives (e.g., cash rewards) to report
these brokers and their vast patron–client network, and swift government action, the underground
kidney trade will continue to flourish, entrench market injustices based on ability-to-pay and dent reform efforts.
Grey areas, low broker costs, inflexible enforcement
Mendoza 2010 (Roger, PhD and Specialist in welfare economics, “Kidney black markets and legal
transplants: Are they opposite sides of the same coin?”. Health Policy. 94 (2010). pp. 263) [nagel]
Unlike most developed countries, the Philippines permits kidney donations to emotionally related as well as unspecified recipients out of
consideration for socio-cultural values (e.g., extended family, altruism). How
to distinguish genuine emotional ties from
those that are brokered overnight (e.g., short-term marriages to obtain a Filipino spouse’s kidney have
reportedly increased since the foreign recipients total ban took effect [51,52]), or how to address
genuine but paid kidney donations to related recipients, underline grey areas in legal compliance that
may require a case-by-case approach. They arise in many developing countries where reward-based, patron–client ties can be cemented within
a short period of time and are crucial to individual goal achievement. 4.7. Minimal transaction costs in brokerage trading Low
transaction
costs to kidney buyers and sellers owe to the ease of information exchange (e.g., extended family ties, word of
mouth), speed of (brokered) transplant arrangements, broker price-fixing, nephrectomy in top-quality
private and state-run hospitals, and direct involvement by politicians and law-enforcers. Despite government
pronouncements to the contrary, they help make the Philippines a favored destination for medical/ transplant tourism [53]. Compliance
monitoring is insufficient and costly without the benefit of effective law enforcement. That, in turn,
demands creative policing and prosecution (e.g., with adequate and objective media coverage) to cope with everchanging trade environments (e.g., online and sham marriages) and rules (e.g., contracting by scouts).
Governments intentionally overlook criminal organ harvesting – this practice corrupts
the medical profession and allows atrocities to be praised as heroic acts of altruism
Scheper-Hughes 2003 (Nancy, Prof at UC-Berkeley, “Rotten trade: millennial capitalism, human
values and global justice in organs trafficking” trans. by ProQuest from Spanish, Journal of Human
Rights. June, Vol 2:2) [nagel]
Anyway, how
is a national government able to put price to a healthy part of the body of a human being
without the democratic essential commitment and the ethical principles that guarantee the
equivalent value of all the human lives? Some system national regulator would have to participate in the
global black markets, wece the value of the human organs with arrangement to the consumer's prejudices, until the point that at the
moment in the market of kidneys an Indian kidney is sold for only 1.000 dollars, a Philippine kidney 1.300, a kidney moldavo or Romanian
reaches those 2.700, while a Turkish salesperson can be won 10.000 and an urban Peruvian can perceive until 30.000. The
circulation of
kidneys already transcends the national frontiers and the international markets can coexist and to
compete aggressively with any national regulated system. Putting a market price - even equal - to the
parts of the body, you exploits the poor person's desperation, translating their suffering in an
opportunity. Also, the surgical transplanting of non-renewable organs is an act in the one that the medical
technicians, because of its ethical referents, they should not be invited to participate. The surgeons whose
fundamental responsibility is to propitiate care, they should not plead for the paid car-mutilation, even with an eye toward
saving lives. The bio-ethical arguments on the right to sell an organ or another part of the body are based on euro-American notions on the
contract and the individual "election." This believes the
appearance of an ethical election - for example, the right to
buy a kidney – is in context intrinsically not ethical. The social and economic contexts make that the "election" of selling a
kidney in a suburb of Calcutta or in a Brazilian favela or in the Philippine shanties it is all less "free" and "autonomous" one. The idea of the
consent is the ideology of "the executioner" - either in the hall of the death or to the door of the shanty - that looks above the shoulder to the
salesperson that doesn't have another option that to sell an organ. I insist: to
even being this equal - it exploits
put a market price to the parts of the body the desperation of the poor ones and he/she makes of their suffering an
opportunity. To interpellate to the law to negotiate a fair price for the kidney of an alive human goes against all that the theory of the
contract sustains. When concepts like those of individual agency and autonomy are invoked to defend the right to sell an organ, the
anthropologists should suggest that certain "alive" things are not alienable neither convenient candidates for mercantilism. And the
surgical transplanting of non renewable organs is an act in the one that the doctors, because of their
ethical approaches, they should not be invited to participate.
Organized Crime
Organ sales expands the black market – funds organized crime
Scheper-Hughes 1998 (Nancy, Prof at UC-Berkeley, “The New Cannibalism”. New Internationalist.
.300 (Apr. 1998): p14-17) [nagel] We disagree with the Ableist language used.
But nowhere more openly and flagrantly than in India has the `shortage' encouraged a sale of kidneys. There a veritable organs bazaar is
operated out of private clinics, especially in Bombay and Madras. Until
a new law last year prohibited the sale of living
donor organs, patients from the Gulf States - Kuwait, Saudi Arabia, Oman and the United Arab Emirates - travelled to India to
purchase a kidney. Now that market has been driven underground. Recent reports by human-rights activists,
journalists and medical anthropologists indicate that the international kidney trade has declined but left in its wake
an even larger underground market controlled and organized by cash-rich crime gangs expanding out
from the heroin trade into the organs trade. In some cases they have the backing of local political leaders. Organ
`donors' are recruited by `agents' to sell a spare organ in order to cancel crippling debts, to pay for a necessary
operation, or to cover large family expenses. And where there is an illegal market there are likely to be other
criminal practices as well. Professor Veena Das of the University of New Delhi has come across stories, from reliable
sources, of `organ theft'. She told the story of a young woman with stomach pains who went to a small clinic where she was told by
the doctor: `It looks like you have a bladder stone and we had better remove it.' But in fact the doctor used it as a pretext to
operate and remove a kidney which he had contracted to deliver to an intermediary for an
undisclosed third party.
Fetish
Organ sales construct a fetishized desire around “freshness” that creates an increasing
underground demand
Scheper-Hughes 2002 (Nancy, Prof at UC-Berkeley, “The Ends of the Body: Commodity Fetishism
and the Global Traffic in Organs”. SAIS Review. 22:1. (Winter-Spring 2002), pp. 72) [nagel]
The idea of the organ as fetish conjures up the magical energy that is invested in the “fresh” organ
purchased from a living donor. Averham, a 71 year old kidney buyer who flew from Jerusalem to Georgia in Eastern Europe
where he purchased a kidney from a young peasant, explained to me why he would never tolerate a cadaveric
kidney: “That kidney is practically dead. It was probably pinned down under the wheels of a car for several hours and then it
was put on ice for another several hours. Then you expect it to go right back to work for me? It’s really disgusting to think about putting that
dead man’s organ inside you. So
I chose a better way. I was able to see my donor [in a small town in Eastern Europe]. He
was young, strong, healthy. Just what I was hoping for.” As Averham’s preferences show, cadaver organs are no
longer the primary organs of desire. In the last decade, there has been a dramatic shift worldwide toward
the procurement and use of organs from living donors who can give one kidney, half a liver, or the lobe of one lung. The
move to living organ donation is seen as the only solution to the chronic scarcity of organs for
transplant and a means to increase the viability and longevity of transplanted organs. In the United
Sates live donor kidney transplants account for 50 percent of all transplants, and live donor liver transplants for
10 percent. 12 Similarly, in Israel, an experimental program of live, unrelated kidney donation was
established to screen and select purely “altruistic” donors. But the head of the screening committee stated that: “Of the 40-some
applications we reviewed and approved, it is possible that two were truly altruistic. All the others were paid. ”
Scarcity
The rhetoric of organ scarcity artificially constructs a fake need to drive medical racism
and exploitation – this ethical utilitarianism creates garbage populations for
destruction
Scheper-Hughes 2002 (Nancy, Prof at UC-Berkeley, “The Ends of the Body: Commodity Fetishism
and the Global Traffic in Organs”. SAIS Review. 22:1. (Winter-Spring 2002), pp. 67-8) [nagel]
Sadly, however, the
discourse on scarcity conceals the actual existence of excess and wasted organs that
end up in hospital dumpsters on a daily basis throughout those parts of the world where the
necessary infrastructure to use them is lacking. Indeed, the ill will and competitiveness of some hospital
workers and medical professionals also contributes to the production of organ “wastage.” For example,
transplant coordinators in public hospitals in many developing countries are often told to dispose of
usable organs rather than allow the competition to “get their hands on them.” The very idea of organ
“scarcity” is what Ivan Illich would call an artificially created need, invented by transplant technicians and
dangled before the eyes of an ever-expanding sick, aging, and dying population. The resulting
artificially created organs scarcity is “misrecognized” as a natural medical phenomenon. 4 In this
environment of “survivalist” utilitarian pragmatics, the ethics of transplantation is modeled after classical “lifeboat”
ethics. 5 With ethical presumptions of scarcity, there appears to be clear choices to be made, namely
who gets into the lifeboat (“getting on the waiting list”); who will be shoved off the boat when it gets
overcrowded (getting triaged while on the waiting list); and who will, in the end, be “eaten” so that others may
live (race and class disparities in organs procurement and distribution practices). A new kind of organ
trade has emerged out of the global economy: transplant tourism. Along with it, a group of self-defined
transplant outlaws — doctors, patients, brokers, and kidney sellers — has emerged. They short-circuit national waiting
lists and make a mockery of national and international codes of ethics prohibiting the sale of organs,
from either living or dead donors. The key actors are a new class of entrepreneurial organs brokers,
who take advantage of questionable organs scarcity panics and the desperation of both the organs buyers and
the organs sellers. The sellers are recruited from populations that are suffering from economic transitions.
These include displaced rural populations, guest workers, refugees, and young soldiers.
Eurocentrism
Organ sales promote a privileged and Western ideology that maintains poverty and
violence – regulation inevitably fails and expands corrupt market practices
Scheper-Hughes 2002 (Nancy, Prof at UC-Berkeley, “The Ends of the Body: Commodity Fetishism
and the Global Traffic in Organs”. SAIS Review. 22:1. (Winter-Spring 2002), pp. 77-79) [nagel]
In the developing world, poor people cannot really “do without” their “extra” organs. Transplant
surgeons have disseminated an untested hypothesis of “risk-free” live donation in the absence of any
published, longitudinal studies of the effects of organ removal on the poor. Organs Watch has found that living
kidney donors from shantytowns, inner cities, or prisons face extraordinary threats to their health and
personal security through violence, accidents, and infectious disease that can all too readily
compromise their remaining kidney. As the use of live kidney donors has moved from the
industrialized West, where it takes place among kin and under highly privileged circumstances, to areas of high risk in the
developing world, transplant surgeons have become complicit in the needless suffering of a hidden
population. In all these transactions, the body, as we know it, is radically transformed. The integration of the body and its
parts as naturally given is exchanged for a divisible body in which individual organs and tissues can be
detached, isolated, and sold. This juncture points to the demise of classical humanism and holism and to
the rise of what Lawrence Cohen refers to as “an ethics of parts”— part histories, part truths, and now, it seems,
divisible bodies in which detached organs emerge as market commodities, as fetishized objects of
desire and consumption. Bioethical arguments about the right to sell an organ or other body part are based on
Western notions of contract and individual “choice.” But the social and economic contexts that make
the “choice” to sell a kidney in an urban slum of Calcutta, a Brazilian favela, or a Filippine shantytown is anything but a “free”
and “autonomous” one. The idea of consent is problematic when one has no other option but to sell an
organ. Putting a market price on body parts — even a fair one — exploits the desperation of the poor,
turning their suffering into an opportunity. Asking the law to negotiate a fair price for a live human
kidney goes against everything that contract theory stands for. When concepts like individual agency
and autonomy are invoked in defending the “right” to sell an organ, anthropologists might suggest that certain
“living” things are not alienable or proper candidates for commodification. And the surgical removal of
non-renewable organs is an act in which medical practitioners, given their ethical standards, should
not be asked to participate. The argument for regulation is out of touch with the social and medical
realities operating in many parts of the world but especially in developing nations. The medical
institutions created to “ monitor ” organs harvesting and distribution are often dysfunctional, corrupt,
or compromised by the power of organs markets and the impunity of the organs brokers and of
outlaw surgeons willing to violate the first premise of classical medical bioethics: above all, do no harm. Amidst the tension
between organ-givers and organ-recipients, between doctors and patients, between North and South,
between individuals and the state, between the illegal and the “merely” unethical, clarity is needed
about whose values and whose notions of the body and embodiment are being represented. In fact, the values of bodily integrity
and dignity are more widespread in the poorer parts of the world than they are in the more affluent
and more secular parts. The values of bodily integrity and dignity lie behind “First Peoples” demands for the repatriation and reburial
of human remains warehoused in museum archives. They lie behind the demands of the wretchedly poor for
dignified death and burial. 20 And they certainly lie behind rumors of organ theft and popular resistance to
presumed consent laws.