The Sciences November/December 1997 [antikvár]

Initial Conditions EDITOR'S NOTEBOOK The Organ Trade ! ; : ; ! i y '!' 1/i ' ¦ ! ! ; I j i ; I. .1,-' 11", '. . Fans of Monty Python will li^member this skit from the 1983 movie I The Meaning of Life. The Browns, a nondescript English family, are enjoying an evening together when the doorbell rings. Two men stand on the threshold. "Hello," says one. "Uhh, can we have your liver?" Pause. "It's a large, ehh, glandular organ in your abdomen. You know, it's, uh, it's reddish brown." Mr. Brown, regaining his wits, replies, "Yeah, I know what it is, but . . . I'm using it, eh." "Come on, sir," says the second man. The two visitors scuffle briefly with Brown until they manage to fmd his liver donor's card. "Need we say more?" says the first man triumphantly. "Listen!" says Brown, now clearly alarmed. "I can't give it to you now. It says, 'in the event of death.'" The first man replies with unassailable logic: "No one who has ever had their liver taken out by us has survived." And the second man chimes in: "Just lie there, sir. It won't take a minute." And in fine, gruesome Monty Python style, the two proceed to butcher him and carry off the bloody liver to their waiting van. Cool heads will dismiss this grotesquerie as comic license, but one wonders what Monty Python might make of the organ-transplant business in China, where the circumstances can be just as grisly as the ones in the movie. As David J. Roth-man describes in his essay "Body Shop" (page 17), the vital organs from the freshly killed bodies of condemned prisoners have for years been "harvested" for transplant (the euphemism is far more appalling than any movie gore offered up by Monty Python). Well, what's wrong with that? The demand is legitimate enough: sick people need replacement organs. The condemned prisoners will die anyway. And Chinese hospitals need hard currency, provided by organ recipients (many of them non-Chinese) only too eager to pay for a new kidney, cornea or heart. But that, notes Rothman, is precisely what is wrong with the practice. It offers financial incentives that cannot help but subvert the justice system. One need not buy into the sensational inventions of the latest thriller, such as Tony Chiu's novel Positive Match (reviewed by Laurence A. Marschall on page 46 of this issue), to imagine the kinds of corruption those incentives can engender. Indeed, according to Rothman, the latest fear is that the rapid rise in the number of death sentences in China (the number handed down in 1996 alone was roughly equal to the total in the two preceding years) is being driven by the growing worldwide apperite for organ transplants. As an opponent of the death penalty, I would argue that the mere existence of capital punishment in China, in the United States or anywhere else in the world is a barbarism that lends the full credibility and moral authority of the state to murderous and premeditated violence against a subdued individual. But even a staunch supporter of the death penalty must be appalled by the link between state justice and the marketplace. Where, more than in capital cases, should justice be blind to "extracurricular" considerations? Even the appearance of such a link undermines the credibility of the justice system; the mere fact that China admittedly tolerates the link is blameworthy, whether or not the financial value of the prisoners' organs has actually led to subversions of the justice process. And physicians, as the American Medical Association has recognized, cannot ethically participate in the removal of organs from executed prisoners. If they do, they not only join a system that must undermine justice, but they also violate their own most sacred professional creed: First, do no harm. We are pleased to report that The Sciences has won the annual Folio Editorial Excellence Award for consumer magazines in science and technology. —Peter G. Brown 4 the sciences ¦ Novemhcr/Decembcr 1997