Tissue Economies: Blood, Organs and Cell Lines in Late Capitalism (review)

Tissue Economies presents several important questions of our time: "What does it mean to give blood and other human tissues today and what does it mean to receive them? What values and what kinds of embodied power relations are constituted by the exchange of human tissues and what kind of social space does their circulation describe" (181)? Examination of the increasing circulation and commodification of human biological matter is an urgent task, because much of it is proceeding in an unregulated and uncharted manner. The term "tissue economies" is defined here as a system for maximizing the productivity of donated tissues in sustaining the life and health of others through "strategies of circulation leverage, diversification and recuperation" (30). It is offered as an analytic frame to help think through the political economies of tissue exchange, much as Richard Titmuss suggested the gift as a way to understand blood donation and society in the early 1970s. Now classic, The Gift Relationship: From Human Blood to Social Policy (London: Allen & Unwin, 1970) argued that in the United Kingdom the system of voluntary blood donation was superior to practices in the United States of paying donors, by showing that there was less wastage and less risk of infection in the British system. Moreover, Titmuss argued that the circulation of the gift of blood was essential to the formation of a sense of social responsibility and trust amongst strangers, and the prevention of individual alienation.

The observation that the material exchange of bodily matter helps constitute the shape of society is where Tissue Economies begins, but it departs from Titmuss in several ways. The change in conditions for the human in biomedical research makes such a departure necessary: tissues are radically fragmented and distributed in processes far more complex than the transfer of whole blood from one individual to another. Tissues often gain commercial value after being donated. Revisiting the case of John Moore, whose spleen was used to make a patented cell line, the authors argue that the commercial value gained by tissue fragments in "biocommerce" should dispel any lingering beliefs that the human body can exist beyond relations of commerce or that its value is intrinsic and unquantifiable. In addition, a strict dichotomy between gift and commodity is misleading in assessing the ways tissue is exchanged today. The book considers the interpenetration of gift and commodity systems in a variety of examples, from "autologous donation," in which parents bank their children's umbilical cord blood for their own potential future use or patients store their own blood ahead of time for use in surgery, to patient advocacy groups who fund research on their own diseases and patent the outcomes, to biotechnology corporations calling for a biomedical commons to prevent the patenting of gene sequences. The authors also develop an analytic of the "technicity" of tissues, arguing that the particular shape of tissue economies is formed at the intersection of the biology of bodily tissues (their location and function in the body, their immunogenic specificity) with the kinds of technologies available to procure and study them.

While thought-provoking and insightful as to the changes that have occurred in the distribution of the human body's constituent organs, tissues, and fluids since 1970, this analysis feels premature. This is in part because the analytic arguments are not matched in sophistication by the empirical examples offered to illustrate them.

The materiality of contemporary tissue exchange, although the subject of some promising work in anthropology, sociology, and economics, remains understudied. In the face of rapidly changing phenomena of enormous scale and scope, this volume's revisiting of the case of John Moore or the attempted auction of a human kidney on E-Bay is particularly disappointing. We simply do not know enough about tissue circulation in the world, and it urgently needs to be studied. Here, the authors would have done well to follow Richard Titmuss more...