282 C. Kierans
able to do so (Polayni 1944 ). The “benign” practices of valuation associ-
ated with an older political economy of state-led care survive the trans-
lation to the new market-led one but take on a rather different cast
under such conditions, with “value” acquiring newly monetised and
monetisable implications. The Mexican case, therefore, stands in close
relation, rather than in comparison, as a sober forewarning of the cata-
strophic harm that extends itself as public goods, like health, are not
only transformed into commodities, but are increasingly used to pro-
vide the material basis for generating capital. Moreover, it affirms Marx’s
prophecy that “... the increasing value of the world of things proceeds
in direct proportion the devaluation of the world of men” (Marx 1970
[1844]), and, in these circumstances, of life itself.
Conclusion
Almost by definition, we could say that the production of value
is intrinsic to the transplant project. Without it donors cannot be
matched to receivers and systems of access cannot be put into play.
Inequalities of access and outcome are also inherent to the transplant
story, as they are fundamentally vulnerable to the conditional depend-
ence of technologised medicine on the bodies of others. However, these
integral systems of value take on greater salience and urgency when
seen in the context of the political economies of health care they are
grounded in. Attending to the situated political and moral-economic
conditions of resourcing provides an important way of considering
how transplant medicine produces its effects: whether good or bad. In
a comparative and relational rather than relative mode, it also requires
us as social science researchers to pay close attention to the instructional
significance of the ethnographic case, to ask how such cases provide a
view to what is happening elsewhere. If the Mexican case is indeed a
harbinger, a setting where the logic of the arrangements we collectively
live under can be seen in a clear-cut way particularly in terms of the way
transplantation links life, labour and value, perhaps all our futures are at
risk.