Bioethics Beyond Altruism Donating and Transforming Human Biological Materials

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11 Valued Matter: Anthropological Insights ... 267

studies that have sought the ways in which organs-for-transplant are
understood as extensions of gift and/or commodity relations (Kierans
2011 , 2015 ; Sharp 2006 ). This can include the quantifiable value
expressed in extending life years, the economic value generated within
related and expanding healthcare markets or indeed how the specific
strategies bound up with the medical practicalities of organ exchange
depend on calculated attributions of value to bodily matter (e.g. blood
components, genes, cells, proteins and so on). Thus, we might, for
instance, turn to the codification and equivalence work that goes into
tissue typing and antigen matching so that organs can be appropriately
allocated and made to work when exchanged—the biostatistical values
that give organs differential human value at a functional genetic level.
This orientation to value is less an outcome of the biotechnical pro-
cesses themselves, but instead owes much to the ways in which organs
are problematised as “scarce resources”, a defining characteristic of
transplant medicine that ensures that organs-for-transplant are things
of value. Said another way, organs are not scarce (and hence of value)
in and of themselves, they are scarce relative to the ways in which
they become and are made available for “use” under different socio-
political arrangements. In fact, it is the trope of scarcity which can
be said to be the discursive-organisational fulcrum upon which the
transplant project hinges (Sharp 2006 ). Depicting and orienting to
organs as scarce resources has given rise to the diverse ways in which
organs are procured and allocated, practices which, in turn, as oth-
ers have shown, generate all manner of inequalities of access, enti-
tlement and outcome (Cohen 2002 ; Crowley-Matoka 2005 , 2016 ;
Hamdy 2012 ; Kierans 2015 ; Scheper-Hughes 2000 ). These concerns
are part of the political ground upon which transplant medicine oper-
ates, a politics which has been further complicated by the expanded
range of body parts, tissues, cells and genetic material which are today
routinely exchanged between bodies (Copeman 2009 ; Waldby and
Mitchell 2006 ).
These interrelations between forms of value and the body emerg-
ing in the context of contemporary biotechnologies have generated a
substantive body of thinking on the topic of “biovalue” (Novas 2006 ;
Waldby 2002 ) and its correlate “biocapital” (Helmreich 2008 ; Rajan


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