Boston Globe Q&A: Our system of donating body parts may be costing lives, says Northeastern’s Kara Swanson

"The enormous success of volunteer blood banking has shaped the way we now think about body products in general, writes Northeastern University law professor Kara Swanson in a new history, “Banking on the Body: The Market in Blood, Milk, and Sperm in Modern America” (Harvard University Press). Today, we divide body products into “commodities” and “gifts”—roughly speaking, options and necessities. Sperm and eggs are perfectly legal to sell and buy, while lifesaving products like bone marrow and organs follow the blood model, and are considered beyond the market."

"But Swanson argues that for all the success of blood banking, the model can have deadly consequences when it comes to other body products. Thousands of people die each year waiting for organ transplants. The solution, Swanson says, might be to realize that this dichotomy is basically a quirk of history, and start paying kidney or bone marrow donors just as we do men who donate their sperm. She spoke with Ideas at a cafe near her home in Cambridge."

Excerpts...

IDEAS: There was once a huge amount of anxiety surrounding the idea of transferring body products from one person to another.

SWANSON: When blood transfusion was being developed, we didn’t know about DNA, so blood was it. “It runs in that family.” Where does it run? It runs in the blood....Before people were transfusing blood, people were using wet nurses, and there was that same kind of socio-cultural anxiety. What might this woman who is different than myself and my family transmit to my baby? Personality traits? Religion? Preference for odd, spicy foods?...That tension was resolved in part because of the bank. If you have it sitting there in a fridge, lined up bottles of milk, bottles of blood, or vials of sperm, it doesn’t feel as personal.

Skipping down...

IDEAS: Just as we learned to distrust paid blood, we’ve also come to think of organs as being beyond money. Was that influenced by how we handle blood?

SWANSON: The transplantation of organs sourced from nonrelatives came to be more successful around the same time that Americans were learning to fear the paid supplier—formerly respected as the “professional donor,” now characterized as a skid-row bum. When one doctor announced he was going to establish a supply of organs the same way his predecessors had established supplies of human milk, blood, and sperm—that is, by offering money—Congress and the medical profession moved quickly to outlaw such a practice [with the federal National Organ Transplant Act] in 1984. Harvesting kidneys from living donors is of course more risky to suppliers than selling renewable body products, which also played into the decision to ban sales.

IDEAS: Do we know paying organ donors would increase supply?

SWANSON: I’m a historian, not a fortune teller! What history has told us is that not paying organ donors has correlated with a situation of scarcity....History has also shown that Richard Titmuss’s theory that payment will diminish gifting also is not always borne out by the facts. It makes a great deal of difference how the act of supplying a body product is framed by all participants.