Same as it ever was

26 07 2015

Medical research is gross.

No, wait, scratch that: biological research is gross.

There’s blood, and guts, and sawed-through bones. There are transgenic creatures, creatures which have been induced to glow, and shall we discuss fecal transplants?

Terribly useful, yes. But also gross.

And you’ve all seen the photo of the mouse with the ear on its back, right? Mother Jones helpfully compiled a list of weird experiments with mice, and while the naked ear-ed mouse doesn’t bother me, I cannot look at that last picture.

I just, I can’t, and you can’t make me. (This is me squinching my eyes tight.)

I find it profoundly disturbing.

So, on some level, I can empathize with those who are profoundly disturbed that Planned Parenthood donates fetal tissue for research. It sounds terrible.

Of course, much of the uproar deals with the alleged sale of said tissues and organs—an act which, if true, would be terribly illegal—but there is little evidence to indicate that Planned Parenthood has or does sell tissue.

They do charge for storage and maintenance, which fees are quite legal. The whole business is quite legal.

See Public Law 103-43, passed into law in June, 1993, in particular, Part 498A (a):

(1) IN GENERAL – The Secretary may conduct or support research on the transplantation of human fetal tissue for therapeutic purposes.

(2) SOURCE OF TISSUE – Human fetal tissue may be used in research carried out under paragraph (1) regardless of whether the tissue is obtained pursuant to a spontaneous or induced abortion or pursuant to a stillbirth.

There are important sections on the conditions of a licit donation, auditing of procedures, research and state law, and then:

PROHIBITIONS REGARDING HUMAN FETAL TISSUE SEC. 498B.

(a) PURCHASE OF TISSUE– It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce.

Some statutes can be written in such a way as to obscure their meanings, but this one is not: fetal tissue sales are illegal.

(In fact, the sale of any human organ or tissue (with the exceptions of gametes, blood, and plasma) are illegal in the United State; only Iran (currently) has a legalized organ trade. It is a matter of serious ethical debate whether such sales should be allowed, but, again, under the current Uniform Anatomical Gift Act, they are prohibited.)

But what of the prices discussed? Scroll down to subsection

(d) DEFINITIONS – For purposes of this section:

. . .(3) The term valuable consideration’ does not include reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue.’.

Et voilà: charging for fetal tissue is not illegal.

Again, this might be disturbing to those who are generally unaware of how biomedical research is conducted in this country (or around the world), or of the bloodiness of medical practice generally.

Jen Gunter, an OB/GYN and pain specialist, responded bluntly to the alleged wrongs revealed in that Center for Medical Progress sting video:

Hearing medical professionals talk casually about products of conception may seem distasteful to some, but not to doctors. Medical procedures are gory by nature. Surgeons routinely cut skin, saw bones, and lift the uterus out of the abdominal cavity and then put it back in. We stick our hands inside people and it is messy. We handle broken limbs, rotting flesh, and cancers that smell. We talk about this calmly because this is what we are trained to do. It doesn’t mean that we are heartless; it means we are professionals and this is our norm for a clinical conversation. There is no reason a conversation about products of conception requires more or less reverence than one about a kidney or a biopsy specimen.

Furthermore,

Hearing medical professionals negotiate with a private buyer over the price for collecting tissue may also seem distasteful, but there is indeed an expense involved for the donor (in this case, Planned Parenthood). FactCheck.org contacted several researchers who work with human tissue, and the price range mentioned in the videos—$30 to $100 per patient—is on the low end. “There’s no way there’s a profit at that price,” Sherilyn J. Sawyer, the director of Harvard University and Brigham and Women’s Hospital’s Biorepository, told the website.

Again, anyone could reasonably be put off by all of this, just as anyone outside of a particular field may be put off by the behaviors and standards of those in the field. I don’t want to see what happens in even an humane slaughterhouse, and I regularly avert my eyes (when not otherwise avoiding) depictions of animals being killed. I find it distressing.

But just because it is distressing does not mean it’s unethical. Some proponents of the “yuck factor” theory of ethics believe that our reactions of distress and disgust can be signals of a deeper moral response, but I think it more a matter of unfamiliarity and cultural taboo, and thus a rather unsteady guide to moral behavior.

In other words, insofar as I accept that biomedical research and medical treatment are in general both good, and that such practices depend at least in part on research on human body parts, I accept that something that sounds terrible—legal trade in human body parts—may not be terrible.

That said, I do think the tissue market as it currently exists, legal though it may be, is also problematic, largely because it pushes the process of commodification ever further into our bodies. That tissue banks aren’t always upfront about the destination of donated tissues, e.g., that skin may be used for a cosmetic surgery rather than burn patient only adds to the murk of this market.

Most of those reacting strongly to the discussion in the video, however, are less concerned about the legal tissue market (and in fact are convinced that Planned Parenthood is breaking the law) than that this somehow reveals something extra-unsavory about both Planned Parenthood and abortion.

They don’t want to overturn PL 103-43 or the UAGA, aren’t calling for changes to the regulation of the tissue markets, or going undercover at tissue banks. They aren’t concerned about how gross it is to skin a cadaver.

No, this is about abortion, not fetal tissue, not alleged illegal activity, but about how abortion in general and Planned Parenthood in particular are terrible.

In other words, while the issue of fetal tissue donation may be new to some, the message overall is same as it ever was.

~~~

Also worth reading: James F. Childress on the Human Fetal Transplantation Research Panel of 1988. It was the report of this panel which provided the ethical argument in favor of research using fetal tissue.

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They’re clouding up the images of my perfect day

27 07 2009

Two things.

One, I don’t much like how much morality infects politics. The rules, the norms, the players, the goals, are not the same.

Yes, I’ve read Foucault (oy, have I read Foucault), and I don’t think he’s in the main wrong about the creative repression of power in all spheres of life. That said, the  circulations of power are distinct, and even amidst such power moves, there are phenomenon which manage to corral meanings to themselves counter or even indifferent to dominant narrative. Thus, morality and politics each generates its own terms of existence.

Geek-speak out of the way, I am therefore bumfuzzled by my reaction to the question of whether a legal market in solid organs (kidneys, mainly, tho’ perhaps also partial livers) ought to be set up.

I have long opposed organ sales, oppose the sale of blood and plasma, and give the hairy eyeball to the sale of human eggs and sperm. (I’m also not crazy about the patenting of biological material, nor of whole creatures, as, for example, genetically engineered mice.)

But is this due to a general skepticism toward capitalism, a critique which begins in the sale of a person’s labor and which can, by logic, extend to the sale of a person’s parts? If so, the opposition is grounded in the ontological claims of socialism and would therefore be, politically speaking, acceptable.

(Never mind that the ontological claims of any political or economic theory are likely to be shot through with moralisms. That’s another post.)

No, my problem is that while I am generally skeptical of capitalism, I think my opposition to the sale in body parts can be—dammit!—traced to an unspecified moral unease.

Even this wouldn’t be problematic were I not also—or at least, until very recently—adamantly opposed to legislation to legalize organ sales.

You see the problem: impermissible moral/political comingling!

I have a wide anarchistic streak (which at various points runs parallel to various libertarian arguments), but I also don’t trust capitalist-markets to protect and promote the basic conditions of existence necessary to a human life.

But what of a regulated market? Or even a socialist market? Could such a regulated social market perhaps avoid the problems associated with the current system (organ shortages, black market sales, exploitation of organ sellers) without amplifying or otherwise legitimizing the horrors of those black market sales?

(There’s also the question of whether those (as a class) in need of an organ in any way deserve or have rights to organs—but, again, another post.)

I’d still be leery of even a well-run regulated social market (which could be configured in a variety of ways), but the leer would be merely moral; as a political matter, I don’t know that I could oppose it.

Dammit. My biases are clashing. I hate that.

Two. On the uselessness of most political and social commentary.

(I know, given what I just wrote, this is rich.)

I was laying in bed this morning listening to NPR and a promo aired about US policy and China and India and . . . *click*

Like it fucking matters, I thought. This group says jump UP and that one DOWN and then SIDEWAYS and DIAGONALLY and then someone suggests perhaps we should discuss this in terms of diving rather than jumping and everyone goes Oooh, how contrarian or revisionist or just plain crackers.

The Chinese & Indian leadership will do what it will do and the people will do what they will do and we’ll all occasionally look at one another and say So that’s what’s going on and be utterly and completely wrong—or maybe even utterly and completely right—and we’ll never know, one way or the other.

It’s not that I think political analysis or political action is useless—my heretical side has not yet overtaken its orthodox counterpart—but that for it to be of any use, it must be specific, oriented in a particular direction, and always always always aware of its own limits.

Natural scientists work off the null hypothesis, and statisticians build error into their calculations. Politics is a hell of a lot more complicated and unstable than physics (except, perhaps, in its quantum form, and even then. . . ), but pundits are a hell of a lot more arrogant than physicists in describing their reality.

Oh, christ, I’m about to go off on a digression on scientism and the misguided adoption of physical models of knowledge by the social sciences and the wretched belief that to understand is to control, but, y’know, it’s late and I’d really just wrap this all up.

So a shortcut: By all means, try to understand. By all means, share that understanding. But fer the love of pete, don’t think this means anything beyond the understanding itself.

But I don’t suppose one gets to be a pundit by regularly declaring, ‘But I could be missing something. . . .’