The Sociology of Blood and Guts

by Kieran Healy on March 9, 2004

The director of “UCLA’s Willed Body Program”:, Henry Reid, has “been arrested”: for “illegally selling human body parts”: from perhaps as many as 800 cadavers. A second man, Ernest Nelson, has also been arrested and charged with receiving stolen goods. Nelson “claims”: that he routinely showed up hacksaw-in-hand at UCLA, with the full knowledge of the Program, and left with knee joints, hands and other body parts. UCLA officials describe Nelson and Reid as a pair of criminals operating without the knowledge of the University. The practice came to the attention of other administrators when Nelson wrote a letter to UCLA demanding $241,000 compensation for body parts he had been forced to return after UCLA banned transfers of cadavers to people or organizations unaffiliated with the University.

Exchange in human goods is a topic “near and dear”: to all my major organs. At the moment, I’m trying to write the conclusion to a book about some aspects of it. Over the past twenty years or so in the United States, a very large and complex system of tissue procurement and distribution has grown up, mostly to service the demand created by new medical technologies. Some of these, like heart and kidney transplants, enjoy broad public support. Others, like the use of “processed cadaveric skin”: for “lip enhancement”: and “penis enlargement”:, “bone screws”: for orthopedic surgery or “cadavers in automobile crash tests”: are less well known.[1] With the exception of the plasma market in the U.S., almost all solid organs and human tissues come from voluntary donors. The increasing demand for body parts has led to a lively debate (going back to the 1970s) on whether some kind of market in human body parts is a good idea. Although this is a very important question, in my view debate about it misses a lot of what’s really interesting about actually-existing systems of exchange. The wide range of empirical variation in rates of blood and organ donation across countries, and within the U.S., for example, complicates the simple contrast between giving and selling that underpins arguments about markets for organs. So does the terrific amount of cultural work that goes into maintaining the viability of organ donation, on the one hand, and real markets for things like human eggs, on the other.

Demand for organ transplants now outruns the supply of organs by a factor of about ten, and bioethicists and many “medical professionals”: have come around to the view that some kind of financial reimbursement might increase the supply of organs. The main thing standing in the way is the terrific success of their own efforts, since the 1970s, to convince people that organ donation was a morally worthwhile practice rather than a ghoulish reprocessing of the dead. Central to this effort was the idea that organ donation is the “gift of life,” a way for a person to go on doing good after their own death and a means for grieving families to see their loved ones live on in a quite literal way.

Now, it is important not to romanticize gift-giving. The obligation to return a gift with something of equal or greater value can keep power relations ticking along nicely. There is nothing like an exchange of gifts for insulting someone to their face. But gifts do tend to be very particular. They are for someone special. They are not given at random. Even anonymous gifts, such as the gift of a human heart or liver, tend to take on this character. Both donor families and recipients tend to have an ideal picture of the other partner in the exchange. Much of the early media coverage of organ transplants encouraged this tendency, focusing as it did on particular people — often children — desperately in need of a transplant. The wrinkle in this idea is that, as “Viviana Zelizer”: has shown, similar processes can be found at work within market exchange. Egg donors are really egg sellers, for instance, but much of the exchange in this market takes place in an atmosphere of gift-giving. The money is still there at the center of it all, of course, but it won’t do to say that the associated gifts and other features of the transaction are simply window-dressing for a simple sale.

The key interface is not the individual-to-individual transaction (largely a myth anyway, in this area) but the transition into the secondary exchange of human goods — the world where donated hearts go, where donated skin is rendered, and where knee joints and heart valves and tendons are processed. This organizational layer does not have the (even fictively) particularized quality that individual decisions to donate or sell may possess. It is concerned with maintaining a reliable supply of homogenous products to cope with a generalized demand. It shouldn’t be a surprise that UCLA’s program has been in trouble before for mixing donated bodies “with medical waste and animal remains”: and dumping them in a landfill. That sort of tendency is built into complex organizations, and it persists whether or not the raw materials are sourced via markets or gifts. It’s a consequence of the industrialization of exchange in human goods, not its commodification.

fn1. I hope that link won’t get us banned by filtering software.



Mrs Tilton 03.09.04 at 2:33 pm


have you any thoughts, then, on Gunther von Hagens’s purchases of the corpses of executed Chinese criminals to be ‘plastinated’ for his Body Worlds exhibit? Or on v. Hagens more generally?

Or perhaps you posted these back when the permanent atmosphere of semi-scandal surrounding v. Hagens spiked into real scandal a few weeks back, and I simply missed them.


Ben Hyde 03.09.04 at 3:02 pm


Tor 03.09.04 at 3:47 pm

What scares me about organ donation is not what happens to my organs, but what they do to me while still alive to facilitate the transfer. My understanding, based on tv and articles – so therefore biased towards the ‘they’re going to KILL YOU’ end of the spectrum – is that there are certain chemicals which are often injected that help ease the transfer, but aren’t very good for the donor. So if you were in a coma, life support was about to be withdrawn, you would receive the injections – and if you were about to make a sudden recovery, well, you’re out of luck. Hospitals can have a tendency to do what is best or easiest for them, rather than what is best for you – something I learned watching my wife give birth, and why I don’t trust hospitals enough to be a donor.


Russell Arben Fox 03.09.04 at 5:17 pm


This is why God (or the Dialectic) created the blogosphere–so I can read (and spend about 40 minutes tracking down links associated with) posts like this. Fascinating stuff. I doubt I’d ever spent more than 15 minutes thinking about organ donation previously in my whole life. Good work, and good luck with the book. Your point about the difference between industrialization and commodification is one that I could probably make good use of in many different contexts.


Eric Russell 03.09.04 at 8:05 pm

Harper’s magazine had a long report by Annie Cheney about the human-remains trade just this month. It’s been a couple of weeks since I read it, but as I recall the gist of it was that while it is technically prohibited to profit from the brokering of human remains, brokers are allowed to recoup their expenses, and by padding those expenses they can make a very good living. So good that many, like Mr. Reid, are tempted to stretch the bounds of legality. I think one of the figures cited was that you can buy a body for $20,000 and, if you have an anatomist that knows how to “disarticulate” bodies, sell off the parts for as much as $200,000.

Unfortunately, the article’s not available online, but you can look at the cover of the issue here:


Zizka 03.10.04 at 12:38 am

Here in Oregon the state medical examiner was fired for selling organs after autopsies. As I recall, he “harvested” very small organs such as thyroids that wouldn’t be missed at a funeral. he used the rather small amount of money earnedm on staff parties, etc.

From a positive point of view, the interesting thing is the large number of cadaver body parts which are capable of being helpful to surviving people. The problems that have emerged weren’t there when cadavers were only good for skeletons and anatomy dissection.


politicaobscura 03.10.04 at 1:25 am

A couple of thoughts:

It is important to recognize that the donation of organs is different from the donation of tissue or body parts for research (as in UCLA). Organs are recovered from a brain dead patient who is on a ventilator (the patient is dead, but the organs are being profused with oxygenated blood). The organs are allocated based on scientific, computerized formulas to those who have been waiting longest (in the case of lungs and kidneys) or who are the sickest (as for hearts and livers). These organs do not need to be processed and are generally used “as is”.

Almost all donated tissue, on the other hand, is take from folks who have suffered cardiac death and have been already brought to the morgue or medical examiners office. Almost anyone can be a tissue donor (unlike organ donation which reguires a very specific kind of head injury to occur). Tissue is always processed before use (sterilizations, freeze drying, reshaping, etc.) As this becomes more and more expensive and complicated, most of the patents on the processes are owned by for-profit companies. Unless the US government is interested in spending $35 million to create a tissue processing lab, all advances in the future are likely to continue to come from the for-profit arena. That might sound bad in the abstract, but wait until your child needs a heart valve transplant and then decide if you want a valve preserved with a process 25 years old or one that is state of the art.

As for whole body donation, almost without exception the types of people who make a whole body donation don’t care one bit what happens to their physical parts so long as it helps someone. It appears the lawyers involved on behalf of some of the families in the UCLA scandal might be claiming families being traumatized by bodies being “cut up”, but it is unlikely that those who actually donate themselves to science cared much if they were cut up by first year medical students or if their joints were used to help orthopedic physicians learn more about their trade.

As for the person who posted above that they were afraid what might happen to them in a hospital if they became an organ donor, I say, “grow up”. The idea of people in comas being killed for their organs is Hollywood foolishness, watching someone waste away with liver disease or Cystic Fibrosis is REAL life…


Kieran Healy 03.10.04 at 4:59 am

Mrs T –

no strong thoughts on von Hagens, beyond the feeling that while he’s clearly a showman, it’s a pretty good show. I missed the allegations that he’d sourced some bodies from Chinese executions.


des 03.10.04 at 12:13 pm

Hagens appears to have just been descandalled

Gunther von Hagens was accused in several press reports last year of using bodies from China and Kyrgyzstan.

But prosecutors in Heidelberg, Germany, said the corpses had been sold legally by institutions such as hospitals.

This is in the Beeb’s “entertainment” section…

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