Sharp - LAH

The Commodification of the Body and Its Parts Author(s): Lesley A. Sharp Source: Annual Review of Anthropology, Vol.
29 (2000), pp. 287-328 Published by: Annual Reviews Stable URL: http://www.jstor.org/stable/223423 . Accessed: 05/05/2013 19:08
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Annu. Rev. Anthropol.2000. 29:287-328 Copyright? 2000 by AnnualReviews. All rightsreserved
THE COMMODIFICATIONOF THE BODY
AND ITS PARTS

LesleyA. Sharp
New York 10027, Departmentof Anthropology,BarnardCollege, New York, e-mail: LSharp@barnard.edu
scienceand Key Words embodiment, magicandsorcery,biomedicine, technology,medicalethics for commodi* Abstract Thehuman body-and its parts-has long beena target that ficationwithinmyriad cultural settings.A discussionof commodification requires one consider, of thebodywithinanthropology first,the significance and,second,what definesa body"part." Afterexploring theseinitialquestions, thisarticleoutlinesdominanttheoretical to commodification within withMaussand approaches anthropology, Marxfiguring Thediscussionthenturnsto historically well-documented prominently. forms of body commodification: These include slaveryand other oppressivelabor and the realmsof sorceryand endocannibalism. An practices;female reproduction; here uncovers dominant established that continue to drive current analysis approaches studies. The remainder of this articleconcernsemergent whose apbiotechnologies, shift in plicationin clinical and otherrelatedscientificarenasmarksa paradigmatic of the commodified, anthropological understandings fragmented body. The following contextsareexplored withcare:reproductive costechnologies; organtransplantation; meticandtranssexual thecategory of and,finally, surgeries; geneticsandimmunology; thecyborg.The articleconcludeswithsuggestions foran integrated theoretical vision, cross-fertilization of analytical andthe inclusionof an advocating greater approaches ethicsof body commodification withinanthropology.
INTRODUCTION
I have somethingof a problemwith borders....They constituteirresistible lures. Keller (1995) and commodificationare troublingthemes within anthropolBody fragmentation each definition, ogy. By challenges an often assumed human desire to protect boundaries and personal guard body integrity. Yet how are such concepts understoodwithin the discipline? What do cross-culturaland historicallyinformed approachesreveal aboutthe exploitativeuse of the humanbody? As initially proposed, the intendedfocus of this article was specifically the commodificationof
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SHARP body parts. This promptlyexposed a host of questions, for an analysis of body fragmentsmustinevitablyconsiderwhatthe body is. Only thenmight one explore how (literally and symbolically) fragmentation and commodificationoccur. The cross-cultural so intrinsic to the fact that approach anthropologyalso foregrounds universalistthinkinghampersanalysis. Thus, this projecttakes a highly particularist approachto the myriadforces that shape, augment,mediate, or undermine that cultural,social, economic, body integrity. Crucial,too, is the understanding and political frameworksgenerate varying (at times complementary,at others contradictory) readings;that gender,class, age, and faith, for example, play their as and that specialized realms of knowledge and power-including the well; part nation-state,the military,magic, clinical biomedicine, and scientific knowledge andresearch-expose diverseconstructionsof the body, its potentialfor fragmentation,and, ultimately,its commodification.Althoughthe primarypurposeof this articleis to examineanthropological of body commodification, the understandings of this necessiastonishingarray pertinentquestionsgeneratedby topic inevitably tates an interdisciplinary Thus, this analysisfrequentlyventuresbeyond approach. anthropologyand into the realms of history, philosophy, bioethics, society and technology studies, and culturalstudies. Inherentin such a projectis an underlyingtension between topical and theoretical concerns. In light of this predicament,this article is divided into several sections, which togetheroffer an integratedapproach.More specifically,it is organized as follows. Following an overview of anthropologicalunderstandings of the body, the discussion turns to the question of commodification.A spatiotemporalapproach proves especially helpful, uncoveringa rich arrayof examples for understanding body commodificationacross cultures and epochs. Thus, the thirdsection offers a brief historicalreview of well-documentedexamplesof body commodification:slaveryandotherquestionable laborpractices;female sexuality; and magic, sorcery,and endocannibalism.The primarygoal here is to highlight establishedtheorieson the exploitativeuse of the body and its parts. The essay's fourthandlargestsection marksa shiftto whatI referto as medicoclinical contexts,beginningwith a historicalreview of medicine's demandfor caconcerns. davers,followed by a detaileddiscussion of contemporary ethnographic I must stress that I use the terms "medico-clinical" or simply "clinical"throughout as a form of shorthand,designed to encompass-and thus underscore-the inseparable relationshipthatexists betweencontemporary cosmopolitan,biomedical practicesand associatedforms of scientific researchand knowledge. Recent and biotechnologieshave generateda host of new forms of body commodification often areeven essentialto this process. The following topics definethe foci within this section: reproductive cosmetic and gentechnologies;organtransplantation; der reassignmentsurgeries;genetics and immunology; and, finally, the category of the cyborg. As I argue,certaindomainsgeneratespecific theoreticalresponses. for example, drawheavily on (post-) feminist theoryand Studies of reproduction, the frequentlyinvestigate shifting natureof kinship; those on organ transplantation often privilege discussions of personhoodand propertyownershipvis-a-vis
COMMODIFICATION OFTHEBODY
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the body; and cyborgs dominatethe burgeoningfield of science and technology studies. A final goal is to offer an integratedvision by advocatinggreatertheoretical cross-fertilizationand the inclusion of an ethics of body commodification within anthropology.
(DE)CONSTRUCTING THE BODY

A vast arrayof incursionsinto the body ultimatelycommodifiesit eitheras a whole or in fragmentedform. In an attemptto delineateboundaries,I offer a few qualifications. First,this articledrawsmost heavily on socioculturalanthropology.Thus, its primaryfocus is the humanbody, althoughbrief forays into realms inhabited and cyborgs underscorethe immediacy and potential of by xenotransplantation forms. a centraltheme is that of body fragmentation.A key conSecond, hybrid cern is what constitutesa "bodypart"?Further,what do specific contexts reveal about cultural-or perhapsmore appropriately, economic-(de)constructions of the humanbody? How is the body fragmentedor deconstructed?The body may be fragmented both metaphorically andliterallythroughlanguage,visual imaging, or the actual surgicalreconstruction, removal,or replacementof specific parts. In turn,what do such (de)constructionssay about body boundaries,the integrityof the self, and the shifting social worthof humanbeings? As revealedbelow, scientific forms of knowledge currentlyfragmentthe body with increasingregularity. Medico-scientificrealms in particular expose expandingdesires for cadaversand skeletons, blood, organs and other transplantable tissues, microscopic ova and most material. This and, sperm, recently,genetic spectrumof examples uncovers not only a proliferation in the marketability of humanbody parts,but also the ever increasingatomizationof the medicalizedbody. In thislight, the themeof body integritymustbe addressed in bothsubjectiveand objectifiedterms. Here, cross-culturaldiscussions of self and personhoodas they andanthropology pertainto the body areespecially important, providesuseful theoreticaltools. Thebody has long been a favoredsite of interestthroughout the discipline's history,with concernsrangingfromvariationsin body size andphysiology, the aesthetics of comportment,and body decoration,enhancement,or mutilation to the potency of effluvia and other tangible as well as invisible body fragments. More particularly, and especially within medical anthropology, a relativelyrecent theoreticalinterestin embodimentregularlyquestionsor problematizesCartesian mind-bodydualism. Here the body, self, and personhoodemerge as inextricably linked. As Lock (1993a) has arguedin this journal, anthropologyhas frequently aboveothers.Theoristshavedrawnespeprivilegedphenomenologicalapproaches cially from Merleau-Ponty(1962) and, more recently,employ Bourdieu's(1977) of habitus,as derivedin partfromearlieressays on the "techniques of configuration the body" and personhoodby Mauss [1973 (1935), 1985 (1938)]. Questions frequently focus on the natureof being-in-the-world,where illness foregroundsthe sense of the body-as-self. As the phenomenologicalphilosopherLeder argues
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from aware(1990:69, 80), whereas wellness may allow the body to "disappear ness and action," pain and disability are often accompaniedby "a heightened thematizationof the body" (see also Fine & Asche 1988, French 1994, Murphy 1987). A focus on embodimentthus ultimatelyforegroundsthe dualistic separation of body and self. This dualism, so rampant in medicalpractice,facilitatesthe depersonalization-and, thus, dehumanization-of persons-as-bodies,a process thatultimatelyallows for the commodificationof the body and its parts. As a result, commodificationexposes the limitations of embodiment theory because this process inevitablybrings to the foregroundthe objectificationof the body over subjective experience. This is not to say that the subjective is irrelevant. As we see below, individualpatients and other medical or research "subjects" often struggle to reassert their selves-as-personswhen faced with forms of body fragmentation.Put anotherway, the very sense of self-as-body is frequently obscuredby commodification,so that an analysis that reclaims the subject must inevitably first wade throughthe mire of objectification. For instance, in Taussig (1980), one encountersan especially detailed and now classic exemplary analysis of this very process. Nevertheless (and as Taussig similarly asserted), other theoreticalapproachesto the body often emerge as more fruitful where commodificationis concerned. These include the following: epistemological and ontological frameworks;a concern for emotions and the senses; symbolic constructionsof the body, which may, in turn, inform how the world is thatunderscoreeximagined(and vice versa);andpolitical-economicapproaches violence (Csordas 1994, ploitative practicesor the everyday effects of structural & Farmer1997, Kleinmanet al 1997, Lock 1993a, Martin1992, Scheper-Hughes Lock 1987, Turner 1994). Within these frameworks, anthropology has much to offer to other disciplines' discussions of commodificationbecause these frequently focus (at times exclusively) on rights of control or ownership of one's own body. As Turner(1994) furtherasserts, danger lies in the tendency both to depoliticize the body and to deny its sociality. This pairing cannot be underscored enough. Pertinentalternativequestions frequentlyposed within anthropology address, for instance, how the body is fragmented, for what purpose, and by whom; how such processes may obscure, augment, or alter constructions of personhoodand/or the social worthof humanbodies; and the victimization vs the agentialpowers and activist concerns of persons in referenceto their bodies. also exof the body within a medicalizedCartesianframework The breakdown Keller reminds As of the boundaries. the biologist body's poses potentialfluidity us above (1995), such breakdownsor boundarybreachingsmay in fact define the richest analyticalterrain. The marginsof life delineate a favored anthropological territory because within the discipline the body offers a compelling analytical tool with radicalvariationsemergingfrom cross-cultural analysis [Douglas 1970, & Lock 1987]. At times the fluidityof boundMauss 1973 (1935), Scheper-Hughes aries may threatenthe integrityof the body and self; at others it may heraldnew and celebratedforms of transformation.
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COMMODITIES
Commodities,like persons, have social lives. Appadurai(1986a:3) Anthropologyhas been especially effective in generatingdynamicmodels of comin the disciplineis theimplicitunderstanding thatcommodimodification.Inherent or objects whose worthlies ties often are not simply things-in-and-of-themselves, merely in theirexchange value. Rather,as Mauss (1967) argued,exchange goods are frequentlyentangledin a host of meaningsframedby sociopoliticalconcerns, and thus they are symbolically chargedby their sociality as well as by their links to hierarchyand power. Exchange is furthershaped by spatio-temporalforces, whereby commodities may confirm the social embeddednessof a sequence of owners or embody individual or collective histories. Within such a framework, kula the carefully studiedreciprocaland redistributive institutionsof Trobriander and Kwakiutlpotlatch emerge as quintessentialexamples (Mauss 1967). Thus, as Appaduraiasserts above, exchange goods do indeed have social lives (Appadurai 1986a), so much so that we may conceive of them as having biographiesof their own, a point arguedwith force by Kopytoff(1986). When viewed in such terms, commodities clearly are not static objects. Rather,they quickly emerge as emblematic of transformative processes. Transformative processes are, nevertheless, often ambiguous in nature, and here Marxproves especially helpful in expandingthe Maussianframework.Marx (1978) likewise recognized the social characterof commodities, defined specifically as those goods producedunderthe alienatingconditions of capitalistlabor. Albeit brief, his commentaryon fetishism (Marx 1978) underscoresthe significantly enigmatic quality of commodities. In his frequentlyquoted introduction to this section of Capital, he states that "a commodity appears,at first sight, a very trivial thing, and easily understood. Its analysis shows that it is, in reality, a very queer thing.... So far as it is a value in use, there is nothing mysterious about it." As he asserted,it is the origin of commodities-that is, the processes that generatethem-that so often remainsobscure. The mystery of commodities lies in the fact that "Value... does not stalk about with a label describingwhat it is"; insteadit "convertsevery productinto a social hieroglyphic. Lateron, we try to decipherthe hieroglyphic,to get behindthe secret of our own social products" (Marx 1978:319-322). Laborrelations,too, are not what they seem-that is, "direct social relationsbetween individualsat work";rather,they comprise"material relationsbetween persons and social relationsbetween things"(Marx 1978:321). As we see, deciphermentlies at the very heart, so to speak, of this discussion of body commodification. As Appadurai(1986a) has noted, anthropologicalwritings tend to oppose Maussianand Marxistapproaches,where precapitalistversus capitalistmodes of productiondivide respectivetheoreticalinterests.Yet both theoristsin fact recognized "thesocial life of things"(Appadurai1986b), a concernparticularly apropos
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SHARP to this essay, in which the commodificationof the body offers an arenain which to integratethese supposedly disparatemodels. In those contexts framed especially by technocraticmedicine (Davis-Floyd & St. John 1998), the language of gift exchange may obscure capitalistforms of commodification. In other words, two models of commodificationmay be at work simultaneously, one more akin to of the symbolicallychargedgift andreciprocity, Mauss'sunderstanding the otherto Marx'snotionof commoditiesas goods producedunderthe alienatingconditionsof capitalism.Thus, differentpartiesmay offer competingreadingsof variousgoods of humanorigin. Whereas,for example, medical professionalsmay insist on the of bodyparts,nonprofessionals understandobjectification mayinsteadforeground of and all of which be embodied within selfhood, ings kinship,body integrity, may an organ or other body fragment. Thus, Mauss and Marx can work in tandem, togethergeneratinga dialecticalmodel of commodificationas a social process. further on the enigmaticqualFollowingMarx,criticPietz (1985) has elaborated of African ity of the fetish. Althoughhe writes specifically of the transformation ritualmaterialsinto artobjects of monetaryvalue desiredby Europeans,his arguments are neverthelessapplicableto humanbody partsas well. Pietz assertsthat the fetish must be analyzedon both subjectiveand objectivelevels of psychological experience. As he explains, readingsof the object are intensely personaland generatedfrom within the self; these in turnareprojectedonto the fetish, granting it meaning. Yet also intrinsicto this process is the fact that the fetish inevitably inhabitsborderzones (definedgeographicallyand culturally),ambiguousterrains characterizedby the disjunction of competing cultural readings of the object. Thus, the fetish is at once a sacredritualobject and an artcollector's prize (Pietz (1976) on (1986a) commentson art,drawnfrom Graburn's 1985) [cf Appadurai's processes similarly characterize Maquet]. Shifting meanings and transformative the fetishizationof humanbody parts:Forexample,a deadwoman'stransplantable heartmay simultaneouslyembody the essence of a lost loved one, be transformed into a gift for a recipient in need, and be the coveted object of a surgeon's desires. The theme of ambivalence,and of borderzones andtheircrossings, are thus centralto this article'sconcerns.
HISTORICIZING
THE COMMODIFIED
BODY
The studyof the commodifiedbody is hardlya new proposition,given thatthe body in its entirety or fragmentedform has long been an object of economic, social, and symbolic use in a host of societies. A historical analysis uncovers several dominant themes that reemerge within medico-clinical contexts. I offer here a cursory review of well-documented examples in order to spotlight established theoreticalconcerns. First, historically,the body frequentlyemerges as a site of production,where living persons may be valued solely for their labor power. The associatedtraffic in humanbeings has many antecedents,characterized by a wide range of rights
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and obligations. Myriad forms of slavery emerge as obvious examples of one party owning or purchasingtemporaryor permanentrights to another(Kopytoff 1982, 1986; Meillassoux 1975, 1991; Miers & Kopytoff 1977; Patterson1982; Watson 1980). As Patterson(1982) has argued, dehumanization-as a form of objectification-is intrinsic to enslavement, often characterizedby a profound sense of "socialdeath."Slaveryis also the point of departure for otherexploitative labor practices: Domestic service and child labor, for example, are frequently described as legalized forms of enslavement. In these and other contexts, the labor process may, in turn, fragmentthe body. Thus, in English, workershave long been referredto as "hands"[Dickens 1994 (1854)]. The social worth of these and other categories of persons depends heavily on their economic value, so they may also fall prey to forms of body trafficking.Withinthe United States, slaves have been marketedas breeding stock, and athletes and their teams are frequentlybought and sold by elite clients. More subtle forms of body trafficking drive a transnationaltrade in adoptablechildren (Anagnost 1995, Comaroff & Comaroff 1999:282). Further,a related theme that emerges in conjunctionwith discussions of enslavementis thatof colonization. Colonialpower,laborpolicies, and medical practices have frequently worked together to discipline colonized bodies (Butchart 1998, Comaroff & Comaroff 1992, Packard 1989). Even the local desires of colonial subjectshave been targetsof commodification,so thatthe body is transformed throughthe consumptionor use of foreign goods that shape localized constructions of the self (Burke1996). As Kleinman& Kleinman(1997) reveal, sufferingitself may be commodified: Media images may quickly reduce the weak and disenfranchised to little more than objects of pity and exploitation. The theme of objectificationis clearly centralto all these examples. Thus, we must pause to consider its relevance to commodification.Commodificationinsists upon objectificationin some form, transformingpersons and their bodies from a human category into objects of economic desire. Thus, the presence of objectificationin a host of forms is significantbecause it flags the possibility that commodificationhas occurred: The medicalizationof life, the fragmentationof the body, andthe subjectification of colonized subjectsall potentiallydehumanize individualsandcategoriesof personsin the name of profit.It is for this reasonthat slavery and colonization so frequentlyemerge as metaphorsfor a host of commercializedand exploitativepractices. Consider,for example, cosmetic surgery: Withinfeminist critiques,women who opt for elective forms of body transformation may be described as enslaving themselves to the surgeon'sknife, a process that ultimatelytransformsthem into subjects of medical colonization, anchoring their social worth in a fragmented,malleable, and highly idealized model of the humanbody (Basalmo 1992, Morgan 1991, Turner1987:88). Clearly anthropologists must be alert to the use of such metaphorsbecause these offer clues to of the commodificationprocess. objectificationas an intrinsiccharacteristic In this vein, women consistently emerge as specialized targets of commodification, where the female body is often valued for its reproductivepotential. Such bodies may, in turn,requireregulation.Prostitution is one site wherethemes
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SHARP of production, reproduction,enslavement, and colonization frequently merge (Brownmiller1975:391-92, Rubin 1975). As White's (1990) work from colonial Nairobi illustrates,prostitution(like slavery)may assume a varietyof forms, and thus we should be wary of monolithic argumentsaboutcommodifiedbodies. Yet anotherpervasivetheme is thatwomen's bodies are fragmentedin a host of ways throughtheir reproductive potential,so that they are reducedto vaginas, wombs, or breasts. Consider,for example, wet-nursingas a legitimized exploitative,often class-basedsocial practice(Hrdy 1992, 1999), or the elaborate,long-standing debate on the exchange value of women-as-wives in anthropology[the literature is extensive; for recent reviews see Ensminger & Knight (1997), Filer (1985), Kresselet al (1977), Strathern (1985), Tambiah(1989)]. The process of commodification may also rendersome categories of bodies invisible, a theme that arises frequentlyin the literatureon reproduction. Although female bodies dominate scholarlydiscussions, male bodies may also fall prey to exploitativepractices. As Ebron (1997) explains, however, men (as prostitutesand clients) are frequently omittedfromdiscussionsof sex trades. Commodifiedmale virilityis also an object in anthropology of desire, but oddly,it, too, has been less carefullyproblematized [for discussions of the culturalrelevanceof semen, see Alter (1994, 1997), Herdt (1997)]. When set against discussions of women's bodies (1987), Papagaroufali as highlightedhere, far less concern is voiced, for example, over the militaryuse of soldiers' bodies, or the commercial status of sperm donation. This theme of power of visual invisibilityreemergesbelow in a discussion of the transformative technologies. Of final concern is the far more literal-that is, physical-fragmentation of the body. Body fragmentscan harborthe ability to harm or heal, chargedwith powersthatexceed those of the bodies fromwhence they came. As the intertwined realms of magic, sorcery,and healing attest, bodies are frequentlytargetsof agand subsequentcommodification. Certaincategories of gression, fragmentation, children,virginalorfertilewomen, laborers,or others persons-whether strangers, consideredhardyor otherwiseaccomplished-may be viewed withintheirrespective societies as possessing morepowerthanothersin particular contexts, andthus their body partsmay be highly prized. School youth, for example, who embody their nation'spotential,may fall victim to ritualmurder,theirbody partscoveted by politicians or others on the rise (Comaroff& Comaroff 1999, Sharp 2000a; Burke 2000:241ff). In warfare,a man's power can be forcefully underminedby a foe throughthe deliberatedestructionof his body and his humanitythrough, for example,decapitation(Rosaldo 1980). Concernswith male political power or economic success may focus specifically on the phallus, a targetfor aggressive forms of "penissnatching"[a topic of intense debateat a recentconference(Fisiy et al 1997)]. In othercontexts, impotenceassociatedwith the demandsor dangers of capitalist productionrenderslaboring men so vulnerableas to warrantritual intervention(Nash 1973, Taussig 1977). As assertedby Comaroff & Comaroff (1999; cf Geshiere1997, Masquelier2000), suchpost-colonial"occulteconomies" transactionin the the "not-quite-human herald intensified anxieties surrounding
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such seemingly exotic concernsparallelresponsesto gefurthermore, corporeal"; netic mutationsandcyborgsin postindustrial settings,foci thatareexploredbelow. not sites of dangerouslonging; they may are Finally, body fragments simply also be cherished and publicly valued goods. In both senses they are inevitably emotionally charged objects of intense desire. The blurredboundariesof sorcery and healing underscorethe magical-that is, transformative-propertiesof fetishizedbody fragments,wherehair,nails, sputum,blood (includingmenstrual), and organs can harm in some contexts and heal in others. Consider,for example, the worth assigned to centuries-oldsaints' relics throughoutEurope (Geary of body parts in the Mediterranean and Latin 1986), or ex voto representations America, craftedobjects that hold the power to heal. The body can also be lovingly consumed so that its essence will not be lost, where body fragmentation simply precedes the full corporaland symbolic integrationof the dead among kin throughendocannibalism(Conklin 1995, Lindenbaum1979). To summarize,the humanbody has long been an object of commodificationin a host of forms: First, it frequentlyemerges as a site of production,where the associated demandsof capitalistlaborrapidlydehumanizesubjects;second, female bodies in particular are frequentlyprized for theirreproductive potential,renderthem vulnerable to a third, commodification; ing especially heightenedtheoretical concern for certaincategories of bodies can renderothers invisible; and, finally, body fragmentsmay be emotionallychargedobjects of desire, embodyingprized transformative propertiesthat bear the power to harm or heal. As this overview shouldbe understoodat times in literalterms,at underscores,body fragmentation otherssymbolically. Thus, we mustpay close attentionto metaphorical references of fragmentation and objectificationbecause they frequentlyflag body commodification. The themes outlined here define, in short, the bedrock for analyses of medico-clinicaland relatedscientificcontexts. contemporary
MEDICO-CLINICAL COMMODIFICATION: An Overview

The two new investmentfrontiers,outer space and inner space, vie for the futuresmarket. S Franklin(see Haraway1992:319) in postunification Hogle (1999), writingof organandtissue procurement Germany, questions a frequentassertionmade by anthropologiststhat the commodification of the medicalizedbody is, in fact, a new development.After all, the humanbody has been commodifiedin a host of contexts: For centurieswithin Europe alone, bodies have long served as work objects for anatomistsand researchscientists, as well as prized curios for medical collections (Hogle 1999:23, 35). One need only turn to the works of historianR. Richardson(1987, 1996) to encounterdetailed accounts of medical commodificationover several centuries. Writingespecially
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SHARP of developmentsin Britain,she describeshow expandinginterestsin the internal workingsof the body have drivena lengthyhistoryof commercialization.Further, the demandsfor corpses andtheirpartshave long been plaguedby a host of moral dilemmasfocusing on consentandreparation, financialandotherwise. Among the most disturbinghistoricaltrendsis the tendency within the medical marketplace to exploit the bodies of the poor and disenfranchised,where paupersfrequently emergeas being of greaterworthdeadthanalive (Richardson1987; see also Knott 1985, Laqueur1983). Richardson(1996) also stresses that currentdebates over the distributionof valued body partsparallel much earlierargumentson how to alleviatethe scarcityof corpsesneededfor dissection.We need only considersuch relatively recent contexts as Tuskegee, Nuremberg,military- and prison-based trials in the Third World to expose a clinical and research, and pharmaceutical related scientific propensityto prey on the disenfranchised. As these historical antecedentsunderscore,socially expendablecategories of persons are ironically transformed into valued objects throughtheirinvolvementin medical research. Foucault's (1975) writings on clinical practice are pivotal here: the medical art of dissection marks among the most profoundepistemic shifts in the history of biomedicine. From the Renaissanceonward,dissection offered new ways of and, of course, fragmentingthe body, generating,in turn, seeing, understanding, new forms of knowledge and, ultimately, sociopolitical power (Foucault 1975; cf Sawday 1995). It is importantto understand,however, that it is not merely dissection-that is, the opening up and peering into the body-that characterizes this transformation. To this one must also addthe artof surgery(Hirschauer1991, associatedtechnologies have rendered Selzer 1974), in which, most importantly, of the transformations body (yet another shift involves vipossible permanent sual technologies; this is discussed below). Butchart(1998) extends Foucault's argumentsto colonial southernAfrica, exploring shifts in medical and industrial perceptionsof the colonized body: An early one-dimensionalapproachfocused on surfaceappearance, color, andtexture;a subsequenttwo-dimensionalapproach and a late-emergingthree-dimensional internal approachinanatomy; privileged & Comaroff cf Comaroff of constructions 1998; (Butchart personhood tegrated 1992, Packard1989). Such examplesunderscorethe significanceof medico-clinicalpracticesin mediating the objectificationof the body. In response to Hogle (1999), what, then, is so unusualaboutcurrentmedical trends?Martin(1992) similarlyasks why anthropologistshave showeredso much attentionon the body in recent years. She appealsto Levi-Strauss(1967), who argueddecadesbefore thata suddenincrease in scholarlyinterestin the primitiveappearedto herald the imminentdisappearance of this social category. Martin suggests that currentinterest in the body As she explains, we are now witnesssimilarlycoincides with its disappearance. in and transition "a dramatic practice... the end of one kind of body percept ing of that-like the another" and globaleconomies-is open, flexible, body beginning andunbounded(Martin1992:121;cf Appadurai1996). Csordas(1994), writingof embodiment,likewise states that"thebody is passing througha criticalmoment,"
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one offering the "methodologicalopportunityto reformulatetheories of culture, self, and experience"(p. 4). this "criticalmoment"?An assumptioncentral How, then,mightwe understand to this essay is thatthe post-WorldWarII period serves as an especially important watershedfor understanding body commodificationwhen medical technologies roles. More play pivotal specifically, we have recently witnessed the advent of iron then the respirator;potent immunosuppressants the and that dialysis; lung allow for the implantation of foreign tissue; cyberneticsystems; such visual technologies as X rays, sonography,fiber optics, and magnetic resonance imaging; and rapidshifts in the overlappingfields of genetics and immunology. Such technologies have an overwhelmingcapacityto challengeboundariesbetween life and death,humanand machine, self and other. They also privilege some bodies while excludingotherson local, national,andglobal levels. As such, theyheralda radical shift in how we must now envisionbody transformations and associparadigmatic ated forms of commodification.As philosopherMorgan(1991) argues,"we have arrivedat the stage of regardingourselves as both technological subject and oband literallycreatablethroughbiological engineering"(p. 30). ject, transformable In essence, certainbiotechnologies now encourageself-objectification.Morgan's warningclearly demandsa detailed considerationof the culturalpotency of new biotechnologies. Andrews & Nelkin (1998), in turn, expose a significantincrease in the commercializationof the body, a process that drives often-heateddebates on a global scale "overthe taking,use, anddistribution of body tissue,"and,further, of genetic and One encounters references in testing gene patenting. frequently lay and professional writingsof the ever expandingmarketsfor humantissue, where the body is reducedto a "sourceof raw materialfor salable products"(Andrews& Nelkin 1998). To borrowfrom Kimbrell(1993), we are witnessing the global expansion of a "humanbody shop": The printmedia within the United States, for example, regularlypublishesbody "atlases"(Flye 1995) consisting of images of partitioned human bodies that expose an arrayof parts that can either be removed for use elsewhere or be replacedwith partsof humanor otherorigins. Andrews& Nelkin and diversity of disputes over body (1998) furthernote a recent "proliferation tissue," yet they underscorethat myopic scientific constructionsof the body are regularlyprivileged,and thatthese, in turn,rarelyrevealculturalsensitivity. They identify this disjunctionas "symptomaticof a much largerproblem-a growing divide between scientific and social views of the body in the commercialcontext of the biotechnology age" (Andrews & Nelkin 1998:53). Another related trend is the intensificationof biotechnology as an industry(Olson 1986). Driven by a highly "technocratic" approach,clinical medicine frequentlymonopolizes access to the humanbody, so that competing understandings are devalued and silenced (Davis-Floyd & St. John 1998). Further,as Lock (1993b) asserts, the medicalized body is regularly "reified, isolated, decontextualized,and abstractedfrom real time, actual location, and social space" (pp. 370-71) (see also Andrews & Nelkin 1998:35, Illich 1976, Taussig 1980, Zola 1978). Within this framework,
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the commercialized,fragmentedbody emerges as yet a more advancedform of dehumanization. Medico-clinical dehumanizationassumes a host of forms, where even living bodies are quickly fragmentedand transformed into scientific work objects. van Kammen(1999) illustrates,for example,thatmale andfemale bodies areregularly reduced to their perceived reproductivecapacities and limitationsin the context of fertility drug testing. In turn, Sered & Tabory(1999) uncoverhow patientsin an Israeli breastcancer clinic are routinelydehumanizedand, thus, experience a medicalized form of "social death"(see Patterson1982), their names (and thus identities) transformedinto mere numberson a chart. In their attemptsto preserve their sense of humanity,patients generate "treatment" ratherthan "illness narratives" cf & Kleinman (Sered Tabory1999; 1988). Duringcancer treatment, clinicians promotethe idea that "one's body is workingagainstthe self," and patients who regularlycope with "pain,disability, and powerlessness"rapidly fall into passive roles that"involvethe dismemberingof the body."In response,these women considercarefullyandcriticallywhat, in fact, it meansto be human(Sered & Tabory1999:231). Yetanotherpervasivethemeraisedfrequentlyin discussionsof the new biotechnologies is the question of ownership-of entire bodies, their processes, their tangible (and, increasingly,microscopic) parts, and even of associated scientific knowledge. Forexample,bitterphilosophicalandlegal battlesarewaged over surrogates' rights;patientsnow claim ownershipof their DNA, where even genetic informationis consideredpart of or equal to the self; and organ transplantation is rife with proposalsto commercializeboth body partsand the donationprocess. centers on whetherthe A frequentlyasked question within much of the literature is heavily skewedby a that in be viewed as concern fact body may privateproperty, Westernandcapitalistinterests.In turnthereis a pervasiveemphasison autonomy, one presentedas a universalright within much of the medical and legal literature (Andrews 1986, 1992; Campbell 1992; Caplan 1992; Chadwick 1989; Childress 1992; Gold 1996; Kass 1985; Murray 1987; Russell 1981). Here, the majority of writersdraw (often implicitly) upon the writings of either Locke or Kant (for example, see Ketchum1992, Oliver 1992, Petchesky 1995). As De Witte & Ten Have (1997) argue,specific philosophicalstances generate different sorts of debates. They explain that, accordingto Locke, that which is generatedby (or mixed with) one's labors constitutes one's property;one may thereforeclaim rights to the body as an instrumentof industry.Kant, however, offers a radically different stance throughhis supreme principle of morality as embeddedin the categoricalimperative:Thatis, one must always act in ways that reflect how one wishes others would act. Kant also raised questions of body ownership, asking whether we own our bodies, or if we are simply stewards of them. Although his comments were brief, Kant opposed selling any part of oneself because such an action might then incline one to sell all of one's parts (cf Chadwick 1989). De Witte & Ten Have (1997) then offer otherunderutilized models: They ask, for example, what of Bentham'sutilitarianism,which states
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that we shouldjudge all actions in referenceto how they ultimatelygeneratepain or happiness? They explain that Bentham, unlike Locke, recognized no natural propertyrights, only those based in law. Further,he expressed little interest in the body, instead being concernedexclusively with propertythat was externalto the person. [Not only did Bentham insist that his preservedcorpse regularlybe put on display, he also bequeathedhis body to science and arrangedto have it publicly dissected (Richardson 1996:92)]. Marx offers yet anothermodel that privileges the collective ownershipof modes of production,the laborprocess, and commodities themselves. (One might consider,for example, the implicationsfor and laborvis-a-vis childbirth.)De Witte & Ten Have discussions of reproduction thatthese variousmodels of the body as property conclude (1997) by underscoring a of generate spectrum possibilities, rangingfrom no rights, to limited control,to full ownershipof the body andits partsby individualor collective parties. Clearly, certain argumentsabout rights to the body dominate some contexts more than others. More troublingfrom an anthropological perspective,however,is this fact: This arrayof philosophical argumentsexposes the trap of (post)enlightenment theory. Once issues of propertyownershipand autonomytake center stage, they displace competingculturalconstructionsof the body, otherpossible reactionsto the dilemmas of biotechnologies, and, finally, the shaping of alternativeethical responses. Specific examples provided below are designed to foregroundthese concerns. The conclusion then offers a brief review of alternativeapproaches.
THE NEW BIOTECHNOLOGIES AND THE COMMODIFIED BODY Reproduction

Reproductionand associatedtechnologies currentlydefine intensifiedsites of anthropologicalinterest, where the commodifiedfemale body, its reproductiveorgans and processes, and, in turn, the fetus have generatedan impressive array of works. As outlined above, female reproduction renderswomen's bodies particularly vulnerableto regulation and commodification.Set against the context of currentbiotechnologies, (post)feminist critiques offer an obvious analytical drivenby the understanding thatwomen's bodies areconsistentlymaframework, nipulated, fragmented,employed, and raided in ways altogetherdifferent from men's bodies. Thus, women's bodies are consistently privileged, renderingmen virtuallyinvisible within the literature. Pregnancy and Female (In)Fertility The birthingprocess is subject to a host of forms of objectificationand commodification. Withinmedico-clinicalcontexts, obstetricalrecordsarereadilyemployedas a means of surveillance,decision making, and wrenching control of childbirthfrom women, processes that are all the more radically experienced by the disenfranchised,particularlyif their cultural
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SHARP differfrom those of the clinicians who treatthem (Kaufert& O'Neil backgrounds Within FourthWorldcontexts, clinical medicine rapidlyassertsits power 1990). throughtechnological hegemony (Andrews & Nelkin 1998). A host of medical practices underminesfemale agency over their reproductivecapacities (DavisFloyd 1994, Duden 1993, Ginsburg1990, Lock & Kaufert1998, Raymond1993), whereby the female subject may be rendered"invisible"(Casper 1998), transformedinto a "workobject"(Casper1998) or "laboratory" for medical practiceor research(Rowland1992). The sonogram,a visual technologyemployedroutinely in many countriesduringpregnancy,may fetishize the fetus while displacingthe mother (Hardacre1997, Petchesky 1987; for interestingcontrasts, see Georges 1996, Mitchell & Georges 1997). The power of visual technologies lies in their andthus easily penetrable; furtheruncannyability to renderthe body transparent more, they profoundlytransformthe ways in which we "map"(Berland 1996, Diprose & Ferrell 1991) and thus perceive bodies, persons, and, ultimately,ourselves (Cartwright1995, Dumit 1997, Taylor 1998). As Davis-Floyd asserts, the mother'sbody is devaluedas a site of production as theobstetrician strivesto deliver "theperfectbaby." As she explains, "thisidea of the baby as separate,as the product of a mechanicalprocess... implies thatthe technocracy ultimatelycan become the producerof thatproduct,as of so many others"(Davis-Floyd 1994:1127-28). Femalereproduction raisesmanythornyquestionsaboutchoice as well as about body ownershipand integrity.Childbirth,after all, generatesa host of medically valued by-products,includingthe umbilicalcord, placenta,and fetal brainmatter andothertissues fromneonateswho do not survive. In suchcontexts,women might ask are these me? Are they mine? Or are they social property?Pechesky (1995) assertsthatalternative readingsarepossible: e.g. Bangladeshiwomen's activistF. AkhterscornsWesternfeministconstructionsof the body as propertyas mirroring interests; to regardthe body as propertyreduces it to "a capitalist, patriarchal power" [reproductive] factory,'objectifiesit, anddenies"the "natural 'reproductive of the body (see Petchesky 1995:394-95). The irony here is that heated debates over self-ownership-whether phrasedin Lockeian,Kantian,or Marxisttermsarisebecauseso muchis at stake. As Andrews(1992) argues,it is one thingto claim it is anotherentirelyfor otherpartiesto lay claim one's body as one's own property; to it. One only need consider the all-too-real potential of cloning, paired with currentattemptsto develop an artificialwomb, to realize the ability of science to of "natural" wrenchcontrol(and ownership)of culturallyspecific understandings bear These birth and of forms or embodied developments (Squire1995). pregnancy and motherhoodobsolete. the frighteningpotentialto renderfemale reproduction A political-economic approachto reproductionuncovers other conundrums. Individualnation-states,for example, may insist upon radically differentundersoldiers'bodies standingsof the body. Militaries,afterall, consistentlyappropriate violence wroughtupon in a host of spatio-temporal settings;andthe dehumanizing bodies throughtortureexposes nefariousclaims upon particularized categoriesof transgressivebodies (Axel 2000, Daniel 1997, Das 1997, Green 1998, Scarry 1985). Populationprogramsdefine yet anothersignificantarenathat reflects an
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intensifiedinterestin female bodies. In a host of countries,the poor are common targets of state policies that hold their bodies culpable, especially where population size is an issue (Hartmann1987, O'Brien 1981, Yanoshik& Norsigian 1989), a trend that has remained pervasive since the writings of Malthus, two centuries ago [Malthus 1976 (1798)]. In certain contexts, the state may claim collective rights to citizens' bodies and their reproductivepotential. Thus, as Anagnost(1995) arguesfor post-MaoChina,the citizen is simultaneouslya "conbody that defines an open site of state disciplinary suming" and a "producing" is when the nation practice, plagued by a "surfeitof bodies." Within this conthat determine the worth of surplusbodies are complex. Some urfactors text, ban households, for example, rely on clandestine forms of body traffickingin their searchfor brides and childrendrawnfrom ruralterritories; others may willfor additional births. Handwerker (1995), writingly pay state-imposedpenalties of in both illustrates how "women's and ing infertility China, fertility infertility are situatedas critical markersof national 'progress'" (p. 377). Here women remain inescapablyculpable, locked in a double bind of blame and responsibility where (in)fertility locates their social and political worth in their reproductive capacities. The Fetus The fetus, in turn, raises troublingquestions about uniqueness and autonomy:Is the fetus part of the female body or a separateentity? Within the United States, shifts in definitions of its social worth are inevitably framed by the abortiondebate (Franklin1997, Franklin& Ragone 1998, Ginsburg& Rapp 1995, Hartouni1991, Hopkins 1998b, Morgan& Michaels 1999, Stacey 1992); thus, fetuses may occupy multiple or even competing categories of personhood. Those thatdid not reachfull termhave long been commodifiedas medical curios, transformed into prized objects of scientific scrutiny,research,and collection. As withinthe UnitedStatesthat shows, this practiceis so controversial (1999) Morgan these "corpses"must be hidden from public view (cf Casper 1994, 1998; Stabile 1999). Conjoinedtwins offer an especially vivid example of competing cultural readings:as Thomasmaet al (1996) makeclear,a sacrificedtwin may be described as a murdervictim, appendage,unjustaggressor,or organdonor,an arraythatexposes multiple definitions of personhood, social worth, and the economic value for an unusualcategoryof the fragmentedbody. Similarly,Casper(1998), writing of experimentalfetal surgery,uncovers yet other competing constructionsof the fetus (as well as of the pregnantwoman): as the mother'sorgan,as an autonomous being, as a work object, or as social propertyamong, for example, obstetricians, perinatologists,fetal surgeons,the pregnantmotherand her kin, and anti-abortion activists(cf Franklin1995:336-37, Ward1995). Hardacre illustrates (1997) further how the fetus can be transformed throughvisual technology.As she shows, in recent years in Japan,fetal images have been commodifiedthroughadvertisements employed by religious groups, an effort that has altereda once dormantcreature into a menacingsocial force requiringcommercializedritualresponsesto appease its anger.
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Certainreproductive technologies also markor facilitate responses to market demandsfor those babies deemed socially desirable, while allowing for the termination of others who harborstigmatizedqualities. For example, children are occasionally gestated and borne in an effort to offer compatiblebone marrowto siblings in need (Morrow1991). Such categoriesof fetuses andpotentialchildren are thus reducedto being parts-of-themselves, as definedby theirmedical and/or social value (Franklin1995; Franklin& McNeil 1988; Layne 1999; Ragone 1994, 1996; Ragone 2000). In-vitro fertilizationallows prospectiveparents to select the numberof embryosto be implanted,so that they might set the upperlimit of live births. Othertechniquesnow facilitate sex selection and genetic testing for unwanteddisabilities(Fine & Asche 1988). Such practicesareso commonas to be a normalpartof prenatalcare (Browner& Press 1995) in many nations,allowing for new constructionsof personhood,where, as Strathern (1992b) argues,professionals may discardunwantedaspects of humanityonto "thecutting-roomfloor" (pp. 111-14). Taussiget al (2000) identifysuchpracticesas heraldingthe clandestine arrival of a new "flexibleeugenics,"a processdrivenby a biological imperative and the all-too-Americandesire for individualizedperfectibility.As Rapp (1999) asserts, "this is a marketplaceof biomedical free choice," where genes become "alienableobjectsof desire"thatallow one to remodelandreimaginethe body and the self. Surrogacy Surrogatemotherhoodemerges as the quintessentialexample of the of femalebodies andtheirreproductive commodification capabilities,aninstitution within the United States, involving brokers, that is now intensely bureaucratized formalandcomplex contracts,andhefty fees (Gostin 1990, Ragone 1994). Advertisementsnow frequentlyappearin college newspapersand on the Web, detailing andcapabilitiesof an imagined,andthus idealized, surthe desiredcharacteristics rogate whose worth lies in her assumed genetic propensitytowardintelligence, beauty,manners,schooling, body size, and poise. Such developmentsunderscore how certaincategories of female bodies, the uterus,reproductive processes, and fetishized. the fetus are now routineand unquestionably Surrogacythus raises a host of concerns: the most pronouncedfocus on reproductiverights and autonomy in a realm overrunwith the language of commerce. Surrogacyhas generateda host of theoreticalresponses that underscore suchthemesas enslavementversusself-ownership(Petchesky1995), wherethe inlabor"(Oliver 1992), "contracted stitutionitself has been referredto as "estranged motherhood"(Ketchum 1992, Oliver 1992), "contractpregnancy"(Holmes & Purdy 1992), "incubatoryservitude,"and "the renting of a womb" (Hopkins 1998a). Others express concerns that surrogacyultimately preys on the bodies of disenfranchisedwomen in financial need, an issue that is mystified by the language of gift exchange (Ragone 1994; cf Malm 1992). Several authorsnevertheless express alarm over currentfeminist responses, underscoringthe fact that argumentsagainst surrogacyunderminefeminist agendas in other spheres thatlittle attention (Andrews1988, Caddick1995, Petchesky1995). It is interesting
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is given to cross-culturalconcerns; when offered, they focus almost exclusively on other Anglophone and postindustrialcontexts, generally in referenceto legal disputes over surrogates'rights. As Ragone and others explain, EuroAmericans in the United States tend to stress genetic materialas definingthe link to the fetus, whereas Australianand British laws grantmore weight to the woman who bears the child (Ragone2000; cf Strather 1992b). Cross-cultural analogiesareessential because they underscorethe dangerof assuming that homogeneity characterizes seemingly similarpopulations. In orderto expandthese boundariesa bit, I offer one brief comparativeexample from West Africa (Uchendu 1965:50): What might we learn from the Igbo institutionof female husbands, where prosperousmarketwomen take wives of theirown, have a handin selecting theirlovers, and maintainrightsto subsequent offspring? Such examples might free currentdebates on surrogacyfrom all-tooWesternconcerns with propertyrights and body ownership.Headway has been made, however, within the realm of kinship (Finkler 2000, Franklin& Ragone 1998, Haimes 1992, Strather 1992a). Strathern (1992b) builds a strongcase for new emergentforms of "enterprising kinship"in England,drawingheavily upon her comparative materialfrom Melanesia(Strather 1992b). Her comparisonsoffer refreshingresponsesto the assumedimmutability of social relations. They also expose more forcefully the troublingnatureof the language of commodification thatsurrounds reproductive technologiesin Britain.As she explainsfor Britain(in contrastto Melanesia), "thereis something about the marketanalogy that is less than benign. It tends to collapse all other analogies into itself, the effect being ratherlike that of money itself which, in differentiatingeverything,makes itself the only source of difference"(Strather 1992b:35-36; cf Edwards1993).
Organ Transplants
The literatureon organdonation,procurement, and transplantation (realmsthat I referto togetheras organtransfer) has long been dominatedby open discussionsof body commodification.Withinthe UnitedStates,for example,legislativeconcerns alone have historicallyfocused on questionsof organrationing,the prohibitionof the open marketingof organs,and, most recently,experimental policies involving financialrewardsfor kin who consentto donation(Fox & Swazey 1992:64). A host of corporateentities now specialize in the sterilization,storage,and redistribution of human tissue for needs that range from pelvic implants, to oral surgery,to skin replacement(Flye 1995). Organretrievalrelies on a highly bureaucratized professional structure:Within the United States, this involves a dense national networkof organizationsthat serve as brokersfor humantissues and organs. In addition,the legal international tradingin humanbody partsis a routinepractice, as exemplifiedby exchanges thatcrisscross much of Europe(Hogle 1999). This medical realm is rife with potent forms of mystified commodification: Although organs are frequently described as "gifts of life" (an expression that originatesin the blood industryand thatlikewise is used to describe surrogacy),it
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is, in fact, a multi-million dollarmedical industrywhere clients in need pay steep fees for the procurement, and surgicalreplacementof preparation, transportation, This rhetoric of body parts. gift exchange disguises the origins of commercialized body parts, silencing in turnany discussion of the commodificationprocess for example,in public (Sharp1994). Slippageneverthelessoccurs,a fact mirrored, anxieties about the open marketingof organsthat can be purchasedby the highest bidderor offered firstto politicians and other celebrities (Caplan 1992). Even anonymousdonation,portrayedas an act of great social kindness, has its darker side, for as Fox & Swazey (1992) explain, many organ recipients suffer terribly from "thetyrannyof the gift" in their intense desire to repay,as it were, this debt of life (p. 39). The donor body offers compelling comparativematerial for discussions on reproduction.Whereas female bodies emerge as sites of reproductivecommodmale" ification, the donor body is, as Ikels (1997) explains, "disproportionately in nearly all countriesbecause men are more likely to be victims of highway and brain work-related accidents,homicides, and suicides, contextswhereirreversible death occurs (a common prerequisitefor potentialdonor status)(p. 106). The objectificationof donorsis centralto the procurement processas well, wherepatients into dehumanized sustainedin a liminal stateby arerapidlytransformed "cyborgs" a complex arrayof technologies (Hogle 1995a). A varietyof partiesnevertheless embracecompetingideologies thatmay confirmor underminesuch (re) constructions of the dead. Within the United States, transplantprofessionals and organ recipientsregularlyreduce donors to their parts: The heartmay be describedas a pump, the liver and kidneys as filters. Donor kin, on the otherhand, may view organsas embodyingthe essence of lost kin, living on in the bodies of transplanted of fictive kinship a recipients, process that,in turn,generatesnew understandings (Sharp1994). Donor kin may also challenge or undermineprofessionalefforts to obscure the origins of transplantable organs,relying increasinglyon such radical mortuaryforms as donor quilts and virtualWeb cemeteriesthat publicly disclose kin"in defianceof professionalcensorship(Sharp the namesof their"commodified 2000b). Among the most startlingquestionsthatcirculatein the realmof organtransfer afterall, necessitates is the dynamicnatureof self andpersonhood.Organtransfer, that body partsbe removed from donors who appearto be alive. Sustainedby a complex arrayof technologies, they are warm to the touch, they breath,many of theirorgansstill functionproperly,andlike otherpatientsreceivingintensivecare, they take in fluids and otherforms of nourishment(Slomka 1995). To those who knew them (and otherswho challenge brain-death criteria),donorsareconsidered to be alive andfully human. Even clinical professionalsfrequentlyexhibitdiscomet al 1989), so they may describepotentialdonors fort with braindeath(Youngner as trulydead only once their organsare removedand they are disconnectedfrom the respirator (Hogle 1995b). In Hogle's words, "withthe technologicalcapability to sustaina brain-death state,the body sends mixed signals ... the body appearsto be alive. Biological and technological cues, then, must be created"to markthat
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"he is 'dead,' but he has not 'died"'; as such, potential donors are transformed into the ambiguous category of "living cadaver"(Hogle 1999:65-66; see also Bibeau 1999, Kaufman2000). Following procurement, transplanted organsbear the potential for transformation, host a of readings among different generating kin a Donor and alike parties. recipients may perceive donor'spartsas living on in their new bodies, frequentlytransferring the donor's qualities to recipients, a constructionthatbears strongresemblanceto sorcerypractices,as outlinedabove. Until recently,lay discussions within the United States have focused primarilyon shift is now marked qualitiesembodiedin whole organs,but a recentparadigmatic in some quartersby a heightenedinterestin far more minusculepartsof the self. More specifically,an increasinglypopularconcerncenterson folk understandings of "cell memory"versus"cellreplacement." of cell memoryarguethat Proponents dead donorsin fact assertthemselves at the cellularlevel, integrating theiroriginal into the bodies of others. tastes, etc, personalities, Opponentsargue against atomized memoryby assertinginsteadthatthe body continuouslyreplaces all cells will inevitablybe obliteratedhy the host or recipient and, thus, donor "memory" These models of atomized body. humanityparalleldevelopmentsin genetics and a theme below. immunology, explored The realm of organ transferremains fairly unique to discussions of biotechnologies; unlike a host of other topics, it has generatedan impressive arrayof cross-culturalwork. Here I offer a cursoryreview. Among the most significant concernsinvolve reactionsto braindeathas a medicalizedredefinition of the end of life. The relianceon a host of medicaltechnologies-on the one hand,to maintain the donorbody priorto andduringprocurement and,on the other,to measurebrain activity and other vital signs-exposes the slipperynatureof medical incursions into the realms of personhood. Here still-warmcorpses are rapidlytransformed into sources of viable commodities. As the works of numerousanthropologists underscore,understandingsof this process are by no means uniform from one nationalor culturalcontextto another.Lock (1997, 2000), Lock & Honde (1990), and Ohnuki-Tierey (1994), all of whom write of Japan, and Ikels (1997), who focuses on China,Taiwan,and Singapore,togetherexpose how clinical constructions of death challenge Shinto and Buddhistbeliefs about an embodied soul or cherishedpropertiesof the self are also seated in specific orspirit. Particularly gans: Kidneys,for example, arerepositoriesof yin and yang (Ikels 1997), so their transfer to otherbodies is highly problematic.Localizedunderstandings of kinship and body integrityin Japaneseand Chinese contexts underminethe possibility of anonymousdonation,a favoredpracticewithin the United States (Nomoto 1998). as Lock & Honde (1990) assert, Japanoffers a radically different Furthermore, involves open public deperspectiveon medical ethics: In Japan,transplantation bate anddecision making,whereasin the UnitedStatesthey areconfinedprimarily to clinical circles. be historHogle (1999), in turn,assertsthatdiscussions of body fragmentation informed: As she illustrates for a host of taboos ically postunificationGermany, the of and the surrounding procurement body fragments properhandling of the
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SHARP dead expose anxietiesabouteugenics policies and medicalexperimentation under Nazism. Today,skin is rarelytaken from Germanbodies. Instead,it is imported from countrieswhere social taboos are less pronounced.It is odd that the origins of such prohibitionsremainunknownto many Germanprocurementspecialists, but recent reconstructions of nationalhistory are markedby the silencing of discussions of past wartime atrocities (Hogle 1999). Finally, Egypt exposes the myopia of universalistthinkingwithinmedical ethics, as framedby Westernmodels. Here, enlightenment concernsof the body-as-property areirrelevant.Instead, the Qur'anand Hadithguide discussions on decisional authority,the ethical behavior of physicians, medical justice, and autonomy. Nevertheless, P Marshall cautionsthatWesternideas may asserttheirhegemony (unpublishedmanuscript) within clinical arenas,as was trueat a medicalconferenceon transplantation in the Islamic world (cf Aswad et al 1992, Hathout 1991, Morsy 1988, Rispler-Chaim 1989, Sacedina 1988). The literatureon organ donation especially in the United States is rife with concerns of scarcity. Authors commonly assert that the demand for organs far outnumbersthe supply, and humanorgans are openly describedas "scarce"and "precious" goods thatfrequently"go to waste"(Fletcher1969, Peters 1991) when, in fact, they shouldbe "recycled" for social reuse. The competitionfor these commodities is so fiercethatJoralemon(1995) has describedit as a medical "battlefor body parts."For severaldecades, proposalshave been routinelyofferedby a host of parties who hope to expand the marketsupply of transplantable humanbody These include the threshold of death and thus parts. redefining personhood,so that and cadavers be can donors; anencephalic non-heart-beating developing bioartificial organsand xenotransplantation; consent laws for presumed organdonation; a direct market where firmsfill oradvocating approach, specializedprocurement ders generatedby transplant centers;and offering forms of "rewarded gifting"to kin in the form of estate and income tax incentives and assistance with surviving burialfees (Bowden & Hull 1993; cf Blumstein 1992, 1993; Brecher 1994; Daar etal 1996; Murray1996; 1992a;Hansmann1989;Land& Dossetor 1991; Marshall Peters 1991; Schwindt& Vining 1986; Sells 1992a). Such practiceshave been labeled by critics as nothingmore than "paiddonation," commercialism," "rampant or "frankentrepreneurial commerce"(Daar 1992b, Sells 1992b, Smith 1993; see Marshallet al 1996:8-9). Cohen (1999:146), assuming an internationalstance, refers to such open discussions of commercializationas evidence of disturbing forms of "flexible"or "purgatorial" ethics. Even those who oppose commodification may neverthelessemploy the language of commerce, describingfinancial incentives as "cheapening"organ donation (Bowden & Hull 1993:15). Among the strongestcriticisms of body commodificationhas been levied by sociologists Fox & Swazey (1992). As they argue,"the 'de-gifting' of transplantation thatthis marketapproachentails has been accompaniedand reinforcedby the progressive 'biologization' of donated organs.... Increasingly,organs are being thought of as 'just organs,'ratherthan as living partsof a person"that might be given willingly and unselfishly to others. This "biological reductionism... has insidious
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implications"for constructionsof self, definitionsof what it means to be human, and more generally of life as it should be lived (Fox & Swazey 1992:207). This increasedcommodificationof the body, pairedwith associated forms of medical hubris,eventuallycompelled these authorsto abandonthis field following several decades of carefulresearch(Fox 1996:262). Concernsover access, scarcity,and, ultimately,ownershiphave generatedanxas thievery. FolkloristCampionieties on a global scale over organprocurement Vincent(1997) has carefullydocumentedrumorsof organsnatchingfrom over 40 nations,where a pervasivetheme includes raidingthe bodies of innocentsand the disenfranchised.Carefulattentionto culturallyspecific contexts expose the logic of folklore. As White (1993) explains for East Africa, ambulancesretaina "vama developmentlinkedto theiruse duringcolonialbloodcampaigns, piric"character, when colonized subjectswere captured,drainedof blood, and releasedwith little or no explanation(cf Sharp2000a). In this context, a standardmedical practice emerges as little more thancolonial sorcery. Such tales arefurthercomplicatedby the fact thatboth the legal andclandestinetradingin body partsdoes, in fact, exist. Until 1994, one could sell a kidney in India, a practicenow drivenunderground in response to legislated prohibitions(Cohen 1999, Marshall2000, Marshallet al 1996, Reddy 1993); wealthy clients from a host of countriesencounterfewer than do the poor or uninsured;and executed financialobstacles to transplantation of transplantable define a source organs,as documentedfor prisonersmay regular Chinaandelsewhere(Guttman1992, HumanRightsWatch1994, Ikels 1997, Lam have generateda host of responses,rangingfrom 1991). Tales of organtrafficking "disinformation" services within the US State Department(Leventhal 1994), to efforts by humanrights organizationsto documentand combat clandestinebody trafficking(Cantarovich1996; Chugh & Jha 1996; Human Rights Watch 1994; Rothmanet al 1997; Scheper-Hughes1996, 2000).
Other SurgicalTransformations
Otherrealms of surgicalpractice, such as cosmetic surgeryand genderreassignment, may advance or counter previous argumentsconcerning the medicalized and commodifiedbody. Both are often describedas "elective"forms of surgery, whereby the self is willingly and radicallytransformed throughthe remappingof the body's anatomy. Social constructionsof the significanceof such surgeriesas elective ultimatelyrely on the language of autonomy and free choice. As some authorshave argued,however,such rhetoricin fact mystifies the commodification of bodies (often female ones). Thus, these two domainsare intriguingby the very fact that they generate such highly contradictoryreadings about individual and even collective agency. Currentdiscussions of cosmetic surgerydrawheavily on feminist understandings of the body,pairedwith political-economicconcerns. Undersuch conditions, nose jobs, face lifts, body tucks, liposuction, etc., expose patients as the victims of oppressive, idealized standardsof beauty, where physical appearancedrives
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SHARP definitions of self and social worth. Such practices uncover a racialized hieraris a common practice chy of beauty:As Kaw (1993) shows, eyelid reconstruction women of Asian a who look not only with Caucasian descent, among equate but underscores the sexist, racist, beauty intelligence. PhilosopherMorgan(1991) and ageist violence of cosmetic surgery,stressingin the strongesttermswomen's dependenceon "theknives thatpromiseto sculptourbodies, to restoreour youth, to createbeautyout of whatwas ugly andordinary.Whatkindof knives arethese? context. Magic knives in a EurocenMagic knives. Magic knives in a patriarchal tric context. Magic knives in a white supremacistcontext. Whatdo they mean? I am afraidof these knives"(p. 32). She forcefully assertsthat such termsas "cosmetic" and "electic"mystify the realities of eugenicist thinking, and the paired pathologizing and colonizing of women's bodies. These are forms of "coerced voluntariness" that are drivenby a "technologicalimperative" to conform. Associatedbiotechnologiesdrivethe desirefor "twentieth of 'feminina versions century as "an artificial ever and more perfecta'" increasingly perfect object."Through radical and painful forms of surgicalalteration,women are told they may "override the genetic code,"a false promisethatunderminesfeministunderstandings of self-determination.In short,"we are creatinga new species of woman-monster" bodies" (Morgan1991:30-34; cf Basalmo 1992). imprisonedin "artifactual In contrast,the categoryof the transsexualgeneratesa wider arrayof interpretations. Here, surgicalinterventions(especially when adultpatientsare involved) may be celebratedas liberatorypracticesthatallow the true self to emerge (Bolin of an the proliferation 1988, Devor 1997). Nevertheless,Stone (1991) underscores clinical tradein gender reassignment,one that intensely profitabletransnational extendsfrom Palo Alto, CA, to Casablanca,Morocco. Among the more troubling paradoxesof surgical reassignmentis the all-too-frequentfetishizing of gender dualism. In clinical contexts, strictdefinitionsof male and female bodies emerge amountof attentionmay as the only viable possibilities, where an extraordinary of one's genitals. In essence, then, genderidenfocus on the outwardappearance tity is understoodto run only skin deep (or, more subtly, physical assignment of the transformed facilitatesthe subsequentinternalization self). This fetishizing of genderdualismruns contraryto the extraordinary arrayof evidence in anthro(Bolin 1999, Herdt1994, Kulik 1998, pology of genderplasticitycross-culturally Lancaster& di Leonardo1997, Morgan1989, Morris1995, Nanda 1990, Ortner& Whitehead1981, Parker1991, Parker& Aggleton 1999, Shapiro 1991). If we turnto those medical interventionsthat affect the lives of intersexedinfants,thispictureis rendered increasinglycomplexbecausehereself-determination is impossible. As Kessler's(1998) compellingworkin the UnitedStatesillustrates, clinicians reveal little tolerancefor sexual ambiguity,and even far less tolerance thannonprofessionalsfor variationsin genital size and shape. Drivenby outdated psychological theoriesof genderidentification(as rootedat least initially in one's anatomy),medicine rapidlyreducesthe bodies of intersexedinfantsto theirgenitals. Withindays of birth,theirgenderis quickly assigned and literallybuilt upon their bodies throughgenital reconstruction.In this context, female identity can
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length), a phallocentric hinge on the absence of a penis (or a penis of a particular a can be constructed that also assumes that potentially within vagina approach as childrenare The voices of adults altered surgically any body (Kessler 1998). In is silenced. little thus, turn, and, consistentlyignored regard given to the greater offered the alternative of (Devor 1989, 1997). by category transgendered flexibility a of medical Such considerations fruitful as well for host other interventions prove or therother bodies-cochlear for the hormone deaf, implants growth involving and for dwarfism et al The world 2000). limb-lengtheningsurgeries apy (Rapp of the intersexedexposes yet again an atomized model of the body, one where self, gender, and sexuality are unproblematically collapsed and rapidly assigned established within a framework of medical aesthetics. criteria narrow following
Genetics and Immunology

Currenttrends in genetics and immunology generate evidence of bodily fragmentationpar excellence, where correspondingscientific constructionslocate the essence of our humanity within our DNA (Martin 1994a, Taussig et al 2000). This shift, argues Rabinow (1992), marks the ultimate displacementof the soul in Westerndiscourse, where individualand collective identities are dependenton scientificconstructions,a process he refersto as "biosociality." Drawinguponthis concept, Rapp et al illustratethat individualswho share such common labels as Down syndrome,Marfansyndrome,or forms of dwarfism,for example,assertties of kinship that supersedeother biological links, an act that fosters strong sentiments of social inclusion among the socially stigmatized(Rappet al 2000). This new "hegemonyof the gene" (Finkler2000:3) relies heavily on an atomizationof the body into the smallest of biologically recognized fragments. Accompanying these developmentsare concerns over the commercialization of increasinglyminutebody fragments,associatedinventions,and new categories of scientific knowledge. Genetics research has generated heated debates over ownership,focused especially on patentclaims. Within the United States, ownership rights may be grantedfor the discovery, creation, and, in turn, marketing of genetic processes associated with "new life" (Rabinow 1996; cf Andrews 1991, Caulfield& Jones 2000, Hayden 1998, Nelkin & Andrews 1998, Suzuki & Knudtson1989). As Rabinow'swork on FrenchDNA illustrates,variousparties may lay claim to individuals'genetic materialas definingthe nationalbody, their coded fragmentssuddenly redefinedas a precious nationalresource that should be guardedby the state (Rabinow 1999). Given the involvementof multinational in genetics research,ownershipof DNA rapidly supersedesnapharmaceuticals tionalboundariesandentersa transnational arena. Current developmentsunderthe of the Human Genome offer a case in point. Here, aegis DiversityProject(HGDP) discussions on the ownership of genetic material and knowledge are pervasive (Pompidou 1995, Roberts 1987, UNESCO 1995). The atomizationof the body lies at the heartof this debate,raisingquestionsabouthow increasinglyminuscule humanpartsmay still embodypersons. Even scientificinformation is now equated
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with the body andthe self, an issue raisedby Finkler(2000) in her workon genetic testing for breast cancer. Although patients may request or consent to genetic testing, they neverthelessraise questionsover ownershiprights.Finklerasks: "To whom does genetic informationbelong: the individualor the family?"(p. 4). To this one mustaddinsurancecompanies,pharmaceutical andeven the corporations, nation, all of which define partiesthat may profitcommerciallyfrom embedded knowledge. Finkler'swork underscoresthe underlyingdisquiet among research subjectsthat theirbodies have been violated, their intimateboundariesbreached, the essence of theirvery being commodified. De Witte & Ten Have (1997) ask how genetic materialmight differ from other whatarewe to makeof the assumption thatourhumanity body parts?Furthermore, now rests not simply in our body fragments,but in the informationsurrounding them? Shouldbothfragments andinformation be definedas individual,communal, oruniversal corporate, properties? Theythenask morespecifically,"... can anyone 'own' the human genome... or is [it] the propertyof humankind,'the common of UNESCO (1995)?" heritageof humanity,'as proclaimedin a recentdeclaration De Witte & Ten Have (1997:52). Furthermore, does it make sense even to speak of genetic materialand informationin the same terms? Can both claim the same moralstatus?As these two authorsshow,answersarefarfromuniform. In contrast to the models from the United States and France above, the Danish Council on Ethics has drawna careful distinctiondesigned to guide the issuance of patents. The Council allows for the grantingof patentson modified and synthetic genes, butnot on naturally here, of course,is the inevitable occurringones. The quandary confusion over what, in fact, defines the "natural" when humanbody boundaries are increasinglybreachedand generationsof humantissues transformed through genetic tampering? Such contexts also generate concerns for exploitativepractices wielded on a global scale by postindustrialnations capable of creating, managing, and marketing new biotechnologies (Haraway1997, Kevles & Hood 1992). Andrews & Nelkin (1998) underscore the ethicaldangersof preyingon peoples in ThirdWorld nations. Pharmaceutical andothercorporate entitiesnow drawblood samplesfrom indigenous peoples so that they may one day provide "curesfor diseases in the developed world and productsaffordableonly in wealthy countries"(Andrews& Nelkin 1998:55), an image hauntinglyreminiscentof White's (1993) description of vampiricambulancesin colonial Kenya,andof sorcerymoregenerally.As Rapp et al (2000) explain, within the United States, some individualsconsideredgenetically unusualnow proclaimthemselves to be an "endangered species." Similar concerns are raised in Third World contexts, where actions associated with the HGDPexpose insidiousinsultsrendered by scientistswho wish to " 'immortalize' the cell lines of groupsthatare going to become extinct."Moved by the fear that DNA stockpilingcould displaceincentivesto solve localized problemsof survival, the WorldCouncilof IndigenousPeoples votedunanimouslyin 1993 to "rejectand condemn the HumanGenome Diversity Projectas it applies to our rights, lives,
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and dignity" (Andrews & Nelkin 1998:55; cf Nelkin & Andrews 1998). Such practices have thus been labeled by various authorsas little more than mystified forms of "biocolonialism"(Andrews& Nelkin 1998), "biopiracy" (Shiva 1997), or "biodiversityprospecting"(Hayden 1998), as well as a highly racializedform of a "new manifest destiny"(Ikemoto 1997). Historicalantecedentsto these exploitativepractices-and theirresponses-exist, for example, in legislation in the United States and Australiathat now dictates the reparation of skeletal and other remainsto indigenouspeoples (Andrews& Nelkin 1998:60). Withthe increasing commercializationof humanfragments,we are indeed witnessing an intensification of "mining"activities focused on the body of Homo economicus (Nelkin & Andrews 1998).
Cyborgs
If genetic technologies define a new frontierof exploitativeexplorations,the cyof human,animal, and technologicalparts,emerges as borg, as an amalgamation emblematicof newly imaginedpossibilities-in both nightmarishand celebrated forms. A burgeoninginterdisciplinary in science andtechnology studies literature now frequentlyfocuses specifically on the cyborg in medical and other contexts (Dumit 1997, Gray 1995, Hopkins 1998b). Frankenstein'smonster symbolizes scientificpotentialgone awry,an image thatcrops up repeatedlyin social science and medical discussions of currentbiotechnologies(Helman 1988, Morgan1991, Sharp 1994:366, Squire 1995). Here the centralquestionis who is the monsterthe creatureor its maker? Hospital units are regularlyoccupied by cyborgs in a host of forms. Potentialorgandonorsare suspendedin cyborgicanimation,linked to life-supportsystems designed simply to postpone their deaths (Hogle 1995b; cf Kaufman2000). These same technologies supportpregnant brain-dead women who, following Cesareansections, may in turnbecome organdonors(Hogle 1999, infants (Casper 1998), the aged Murphy 1992). Similarly,the lives of premature in palliative care, and accident victims in intensive care units are routinely sustainedthrougha host of technologiesfastenedto andembeddedwithintheirbodies. in Japan,identifies the associOhnuki-Tiemey(1994), writing of transplantation ated widespreaddiscomfortas rooted in the "transgression of basic culturalcategories and the emergence of a new 'nature'" (p. 239), words that most certainly hold true as well for troubledculturalresponsesto the cyborgic human. Especially unsettlingis the now routineuse of a host of artificial,mechanical prostheses that extend life and enhance bodies. Heartvalves, pace makers,artificial hip joints, prostheticarms and legs, and synthetic lenses are now regularly the monsternow has a legitimate (and implantedin humanbodies. Furthermore, unstigmatized)medical label: "chimera"is now used routinely to encompass a host of hybridforms (Jankowski& Ildstad 1997). In the exuberanceto extend the boundariesof life, xenotransplantation and bioartificialorgansdefine a new frontier of technocraticmedicine. These developmentsare proposed,first,in orderto
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alleviate scarcityin a troubledmarketof humanbody partsand, second, because Even the commodificationof they are often viewed as ethically unproblematic. altered animal often remains genetically species unchallenged.After all, simians, for example, alreadydefine an existing categoryof scientificwork objects (Lynch 1988, Papagaroufali 1996, Suzuki & Knudtson1989). The cyborg also troublesthe safety of personal (Papagaroufali1996) as well as internationalboundaries(Fishman et al 1998, Hunkeleret al 1999). During a recent conference on xenotransplantation, several participantschallenged the over the need for the open exchange of exuberance, general expressing anxiety informationamong nations. Julvez (1998), for example, raises concerns over the cross-species transmissionof pathogens. Yet an even more startlingopinion was offered by Effa (1998) from the CameroonBioethics Society: Rejecting the assumed miraculousquality of xenotransplantation's medical potential, he instead voices grave concerns over inequity and potential exploitation.As he explains, "because of their exorbitantprice, acquiringthese prostheses still remains the privilege of an infinitesimalwell-to-do minority."He challenges the hubrisassociated with xenotransplantation research,askinghow realisticsuch workmightbe "whenwe know very little aboutthe structure and use of the naturalorgan?" Furthermore,widespreaddistrustalreadyexists within African communities,where biomedicineis often perceivedas posing significant"psychological,sociological, and cosmological"threatsto communities. Researchersmustrecognize the inherent dangersthat will accompanythe inevitable expectationimposed on Africans to "adaptto scientific breakthroughs and progress in biomedical technologies," work that is certain to exploit vulnerableAfrican bodies in the name of scientific progress (Effa 1998). The power of Effa's words lies in the fact that they voiced assumptionthatnew biotechnologiesare void trumpthe all-too-frequently of significantethical problems. New medicaltechnologiesarealso troublingbecausethey challengepreviously assumedimpermeableboundaries.As Papagaroufali (1996) explains, many societies share an "imagined"sense of "originalwholeness... as unique to humans" andrelatedpracticesespecially troubling. (p. 241), renderingxenotransplantation Here Haraway's(1991) groundbreaking work is centralbecause it so frequently focuses on the complexities associatedwith "thereinventionof nature."She first underscoresthe oppressiverelationsthatshape "fractured identities,"turningthen in the melding of human,animal,and machine.Here the to the potentialharbored cyborg emerges not as the monstrousby-productof oppression, but as a newly politicized and potentially liberating hybrid (Haraway 1992:328-29). Hopkins (1998) likewise underscoresthe importanceof exploring how new technologies intersectwith existing oppressivesocial institutionsbecause they bear the potential to reinforce,subvert,or alterexisting paradigms.Echoing Keller'swords that openedthis essay, Haraway(1992) hails the analyticpotentialof the cyborg,which, those potentplaces where by its very definition,inevitablyinhabitsthe "margins, best In this is cultured" one mode, 303). theory may in fact celebrate,rather (p. thancondemn,the monstrouscyborg.
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CONCLUSION
What, then, are we to make of this arrayof contemporarysocial and politicized concerns for body fragmentation? Frequently,new biotechnologies are hailed as miraculousadvancementsthatchallenge the frontiersof scientificknowledge and practice,a stance promptlyproblematizedby anthropological inquiry.As a comstatic of the parativediscipline, anthropology rapidlyforegrounds understandings on that universalist concerns for individual body rely autonomy,personalchoice, and the body-as-property.Nevertheless,currentresearchis hamperedby a compartmentalizedapproach,whereby specific topics are often linked to particular theoreticalapproaches.This conclusion offers threegeneralsuggestionsdesigned to break down these barriers.The first involves grantinggreaterattentionto the as it pertainsto the commercial use of the body; the meaning of the "natural," second underscoresthe mystifyingpowerof metaphorical thinkingin science; and the thirdis a call for greateranthropological involvementin ethical debates.
Nature, Body, Economy

Within anthropology,the transformation of natureis considered an intrinsically humanactivity,where the "natural" body in a host of formsemergesnot as a static but culturallymalleable category.Humansregularlyinfringe upon and (re)order all ecological terrains,clearing forests and other swatches of earthfor domiciles, farm and medicinal plots, ceremonial space, and work stations. In turn, landscapes rangingfrom gardens(Benoit 1997) to mountainsides(Bastien 1978) unso that the body itself is mapped upon the dergo metaphoricaltransformations, world. The human body, too, may be quite literally sculpted and, thus, transformedthrougha host of processes, at times decorative,at othersmutilating.Hair, skin, andgenitals,for example,arealteredthroughtechniquesdesignedto enhance marthe body and,by exbeauty,alteror perfectgender,or maim andpermanently the As in reflected host this of the tension, contexts, intersectionof nature person. and cultureis deeply ingrainedin anthropological constructionsof the world, of of and their where human activities bodies, processes, shape constructionsof the natural. Any attemptto universalizethe body is thus impossibly flawed, driven inevitably by idealized and ethnocentricdefinitions of beauty, shape, size, mochildbirth" bility, etc. One need only consider the absurdityof defining "natural to encounterlimitations: What might this mean for the Igbo woman who takes female husbands,for a Latinagestationalsurrogate carryinga child for an infertile Asian couple, or for a motherwho bears conjoined twins? A far more fruitful approachinvolves exploring those boundariesthat are assumed to separatenaturefrom cultureor the naturalfrom artifice. As this article's examplesreveal,these borderzones arehardlysecure.Whenconsideredespecially in reference to currentbiotechnologies, constructionsof the humanbody and of humannatureitself emerge as deeply troubled.As Franklinhas recentlyasserted, the "contestedlocation between science andnature" generatesa host of intriguing
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SHARP questions (Franklin1995:336-37). Naturein particular occupies a pivotal analytical position: In Morgan'swords, it now "functionsprimarilyas a frontierrather than a barrier... transforming the humanbody into an increasinglyartificialand ever more perfect object"(Morgan 1991:31). Of particular concern for both authorsarethe transformative associated with current powers biotechnologies(Hogle woulddo well to patrolwith care 1995b, Kaufman2000). In short,anthropologists these shifting borderzones. Thus, how might anthropologists explore, contextualize, and problematizethe boundariesbetween science and nature,or the natural and artificial?How aretransformative processes understood locally, in contrastto potentiallymore universalisticclinical constructions?Where,when, and how do breachesoccur? Of whose "nature" do we speak, and in what terms? As the examples above reveal, science and medical practice rapidly objecor tify nature,breakingdown bodies-literally throughsurgicaltransformations, metaphorically throughlanguage and daily practice-into increasinglyatomized fragments.Myriadforms of objectificationrapidlydisplacethe self, exposing the humanbody to the worldof commerce. Commodification, in turn,generatesan array of anxieties. Withinsome realms,for example,scarcityemergesas a dominant concern, ultimatelyexposing, as Appadurai(1986a) has argued,the hidden links between consumption,demand, and desire. Here organ transferoffers a case in point. Medical professionalsandpotentialrecipientsalike engage in an insatiable search for transplantable organs, and policy makersoffer a host of strategiesdesigned to alleviatethe shortageof these scarcebody parts. Responses rangefrom with xenotransplantaproposed forms of "rewarded gifting" to experimentation tion. Otherexamples reveal a hungerto stockpile humanmaterial. For instance, the HGDP is driven by a deep-seateddesire to understand the human organism in a word, collecting-human genetic materialon a global by "mapping"-and, scale. Associated experimental,scientific knowledge marksa radicalshift in unof (im)perfectionwithin our species. As such, this process bearsthe derstandings to harden boundariesthat define the social worth of particular potential persons. the increased commercialuse of humanbody partsraises troublingquesFinally, tions aboutthe values associated with categories of both the living and the dead. Againstthese concerns,mightwe begin to speakof a commercein luxurygoods of humanorigin? Clearly,the regulation,control, rationing,use, and knowledge of humanbodies and theirpartstogetherexpose a host of conundrums that insist on careful anthropological investigation. An intensifiedfocus on flexible boundariesmay very well free the discipline from the propensitytowardtheoreticalcompartmentalization, where specific topics currently theoreticalreadings.A more generalconcernhere generateparticular involves the need to break free of the body-as-property paradigm,and where a cross-fertilizationof ideas might, in turn, generatea host of new questions. For example, how might feminist argumentsof exploitativepracticesexpand underor immunology? Couldanxietiesaboutscarcity standingsof organtransplantation alter readingsof cosmetic or fetal surgery? Does the hybridcyborg generatealternativecritiques of accumulationin reference to, say, genetic material? Such
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questions offer possibilities for breaking down existing theoretical boundaries, potentially enhancing anthropologicalunderstandingsof the linkages that unite nature,the humanbody, and economies.
The Powerof Metaphors

Driven by the works of Mauss [1973 (1935)] and Douglas (1970), a pervasive understandingwithin anthropologyis that the human body generates a host of potent metaphoricalconstructionsfor orderingthe world (cf. Scheper-Hughes& Lock 1987). Kass (1985) likewise assertsthat the languageemployed to describe the body reflects how it is understoodin ethical terms (cf Murray1987). Indeed, constructionsof the science and clinical medicine generatea host of metaphorical Martin 1990, 1994b; 1989, Sontag 1989). As illustratedregubody (Keller 1995; context of commodification,metaphorical within the this article, larly throughout thinkingrapidlydepersonalizes,desubjectifies,andthusdehumanizesthebody and its parts. As Richardson(1996) furtherunderscores,forms of "semanticmassage" are frequentlyand deliberatelyemployed in contexts involving body commercialization. An especially pervasiveexampleis the "giftof life,"an expressionapplied simultaneouslyto blood donors, surrogates,and organdonors. Organtransfer,in turn, offers an especially compelling domain for analysis because discussions of commodificationoccur openly and frequently.Thus, bodies that fail to become the donation donors"go to waste,"the languageof commerceis said to "cheapen" but "donors."In turn,the imagery process, and the braindead are not "patients" the "recycling"of humanbodies downplaysthe sense that cadavers surrounding are medical refuse. Policy makerswork cooperativelyand aggressivelyto perpetuate language that foregroundsgift exchange even as they consider the further commodificationof the body througha host of marketingstrategies. In many clinical arenas,the body is frequentlyreimaginedas a machine. For example, both Haraway(1989) and Martin(1990, 1994a) argue that within immunology, the body is frequentlyenvisioned as a militarizednation-state. Keller (1995) also illustratesthat within science, the body has been comparedwith a clock, telegraph,computer,and cyberneticsystem, and machines,in turn,are anthropomorphized.Rhetoricalshifts can also guide the directionof new research because they profoundlyaffect scientificperceptionandhow researchagendasare envisioned (Keller 1995). Furthermore, the female body frequently emerges as highly exploitable,the male body may be an emblematicprototype. Davis-Floyd (1994), writingof childbirthwithinthe United States,explainsthatin clinical contexts "the male body is metaphorizedas a better machine than the female body. In form and function it is more machine-like-straighter-lined, more consistent and predictable,less subjectto vagariesof nature... and consequentlyseems less In contrast,female bodies "areseen as inherentlysubjectto likely to breakdown." malfunction"(Davis-Floyd 1994:1126). In yet otherculturalcontexts, male bodies are associatedwith particular technologies, where metaphoricalconstructions and even the potentialof the nation. Alter's (1997) work status, signify strength,
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SHARP on male Indianwrestlersoffers a case in point: The practiceof semen retention may renderthe male body a benign "hydraulicsystem," a more volatile "pressure cooker,"or a lethal "time"or "atomicbomb"capableof "nuclearmeltdown" (cf Alter 1994, Cohen 1997). In othercontexts,one may even speakof "fathering" (but never mothering)technology (Easlea 1983). These and othergendermetaphorsrapidlyexpose which bodies-and technologies-are consideredmost productiveand valued. They also bring to the foregroundlegitimate ways to fragmentand use the body, ultimatelyrevealing how routinely technologies transformhumans into commodities. As a result, a new sense of "use value"has come into play. As Andrews & Nelkin (1998) explain, a host a metaphorscurrentlyunderscoresthe ubiquityof body commodification, where the process of "objectifyingthe body enables scientiststo extract,use, and "researchers patentbody tissue withoutreferenceto the personinvolved."Further, often referto the body as a 'project'or 'subject'-a systemthatcan be dividedand dissected down to the molecularlevel.... This reductionistlanguage is increasingly permeatedwith commercialmetaphors.Body partsareextractedlike a mineral, harvestedlike a crop, or mined like a resource.Tissue can be 'procured'-a termthatis morecommonlyused to referto land,goods, or the prostitutes provided for a client. Cells, embryos,or tissue can be frozen, banked,placed in librariesor repositories,marketed,patented,bought,or sold" (Andrews& Nelkin 1998:540). Clearly,it is imperativethat anthropological investigationspay close attentionto those processes thatcloak commodifiedbodies in metaphor.
Towards an Ethics of Body Commodification in Anthropology

Over a decade ago, Koenig (1988:467) noted the paucity of social science interest in medical technologies. As this review reveals, however, significant strides have since been made in anthropology, where myriadexamples offer compelling critiquesof dehumanizingprocesses. A concernhere is that anthropologists may imagineonly social scientistsas definingtheiraudience;notableexceptionsinvolve work on science andtechnology,and forays into culturalstudies, interdisciplinary feminist arenas. Yet how might anthropologytake a more activist and even radically ethical stance (Scheper-Hughes1995) in its critiqueof biotechnologies? If, as advocatedabove, mutableborderzones define a key terrainfor futureresearch, associatedquestionsmight focus more clearly on the ethics of the increasedcommercializationof the humanbody, where clinicians, scientists, medical ethicists, and policy makersare potentialaudiences. One particularlyfruitful approachinvolves problematizingstandardmodes of ethical inquiry. Kleinman (1999:70, 72, 77) asserts that clinical bioethics is mired in a Eurocentricpropensityto privilege "ethical"abstractuniversalsover localized "moral"concerns. Criticalethnographyoffers a much needed alternative "methodof knowledge production," in which local constructionsof injustice are furtherenriched throughcomparativestudy (cf Hoffmaster 1992). Attempts to reconcile the universal with the local are exemplified by two essays within
OF THE BODY COMMODIFICATION
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Kleinman's volume (Kleinman et al 1999). ContemporaryIndia offers a lens throughwhich Cohen (1999) examinesheateddebatesover the commercialization of transplantable organs;Das (1999), in turn,exposes the myopia of global health mustbecome more concerned as policies appliedto India. Certainlyanthropology with bioethical questions; even more crucial is the need for bioethics embraces methodologicalapproach. in-depth,critical ethnographyas a fundamental In an essay on "genethics," Diprose (1991) has notedthatthe humanbody often remainsabsent from medical ethical debates, where universalistconstructionsof humanrightsareinsteadpriviledged(cf Schenck 1986, Suzuki& Knudtson1989). Morgan(1991) is similarlypuzzled by the absence of discussions over the ethics of cosmetic surgery.The growing field of feminist ethics offers a partialsolution (Diprose 1994, 1995; Holmes & Purdy 1992; Komesaroff1995), yet clearly, anthropologycan most certainlyexpandthese boundaries.This is a discipline, after all, that has long assertedthe importanceof problematizingthe seemingly mundaneandroutineaspectsof humanlife [Malinowski1961 (1922):1-25]. Numerous have, in fact, made significantstrideswithin the field of bioethics anthropologists this, by doing just questioningthe medical use of the humanbody as a research dehumanized or denaturalizedsubject, and commodified product (Clark object, 1993, Marshall1992, Marshall& Koenig 1996, Muller 1994, Slomka 1995:126061; see also Fox & Swazey 1992, Komesaroff1995, Weisz 1990). Slomka(1995), for example, has arguedfor a more critical and socially informedunderstanding of personhoodwithin medicine, illustratedthroughher work on artificialnutrition and the use of otherassociatedtechnologies among the dying (cf Kaufman2000). The "routinization" of medicalpracticeemergesas yet another productivefocus because ethical questioning frequentlysubsides as clinical technologies become normalized.Ultrasound imaging,for example,has become a regularfeatureof prenatalcare, a process Mitchell arguespersonifiesthe "cyborgfetus"through"technological quickening"(Mitchell & Georges 1997). The transformative quality of this and many other biotechnologies is neverthelessfrequentlyoverlooked, consideredso mundaneas to escape notice withinclinical contexts. Thus, specialized wardsnow sustainthe neardead, sometimesfor yearsin persistentvegetativestates (Kaufman2000), and even the Chimera(Jankowski& Ildstad 1997) has emerged as a naturalized monsterof sorts. Fox & Swazey cite routinization as a tragicdevelone thathas silenced fartoo manyethicaldeopmentin the realmof organtransfer, bates (Fox 1996:260-61). Yet Koenig (1988) offers anotherview of routinization: Althoughtechnologies frequentlymove from experimentalto standard categories of practice,even within early stages the concept of "routine" may be employed to downplay associateddangersand risks (p. 465). In closing, we would do well to heed Fox & Swazey (1992), who ask, "Whoshall guardthe guardians?"(p. 170). As this reviewhas shown,anthropology clearlydefinesa disciplinecapableof challenging not only new and contestedpractices,but also the mystificationassociated with routinization.A moreradical,ethical stancewill inevitablyfurther problematize the borderzones between natureand society, self and other,humanand machine, generatingeven morecriticalreadingsof the commodifiedbody andits parts.
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ACKNOWLEDGMENTS I wish to express my gratitude to a host of individuals. I am indebted to several members of the Notorious Six-especially B Hayden, B Larkin, P Silverstein, and Z Strother-for their insightful comments on an earlier version of this essay; students from the seminar "The Anthropology of Affliction" also consistently generated lively debates on body commodification; and A Gavin proved indispensable throughout as a research assistant. I owe much to P Marshall, whose writings have proved to be a rich source on property ownership vis-a-vis human body parts. I also wish to thank S Lindenbaum for her unwavering support of this project from its onset; M Lock for her insightful review of an earlier draft; and V Daniel and the other editors of the Annual Review of Anthropology for the opportunity to address this compelling topic of research. Finally L Dean and R Parmer deserve much praise for their technical expertise throughout the production process. Visit the Annual Reviews home page at www.AnnualReviews.org LITERATURE CITED Alter JS. 1994. Somatic nationalism: Indian wrestlingandmilitantHinduism.Mod.Asian Stud. 28:557-88 Alter JS. 1997. Seminal truth: a modem science of male celibacy in north India. Med. Anthropol.Q. 11:275-98, 303-5 Anagnost A. 1995. A surfeit of bodies: population and the rationalityof the state in postMao China. See Ginsburg& Rapp 1995, pp. 22-41 Andrews L, Nelkin D. 1998. Whose body is it anyway? Disputes over body tissue in a biotechnologyage. Lancet 351:53-57 Andrews LB. 1986. My body, my property. Hastings Cent.Rep. 16:28-38 AndrewsLB. 1988. Surrogate motherhood:the challenge for feminists. Law Med. Health Care 16:72-80 AndrewsLB. 1991. Legal aspectsof genetic information.YaleJ. Biol. Med. 64:29-40 Andrews LB. 1992. The body as property: some philosophical reflections-a response to J.F.Childress.Transplant. Proc. 24:214951 AppaduraiA, ed. 1986a. Introduction: commodities and the politics of value. See Appadurai1986b, pp. 3-63 AppaduraiA, ed. 1986b. The Social Life of Things: Commoditiesin CulturalPerspective. Cambridge, UK: Cambridge Univ.Press AppaduraiA. 1996. Modernityat Large: Cultural Dimensions of Globalization. Minneapolis: Univ. MinnesotaPress Aswad S, SouqiyyehMZ, HuraibS, El-Shihabi R. 1992. Public attitudestoward organ donation in Saudi Arabia. Transplant.Proc. 24:2056-58 Axel B. 2000. TheNation's Tortured Body: Viand the Formationof olence, Representation, a Sikh Diaspora. Durham,NC: Duke Univ. Press Basalmo A. 1992. On the cutting edge: cosmetic surgeryand the technologicalproduction of the genderedbody. CameraObscura 258:207-38 Bastien JW. 1978. Mountain of the Condor: Metaphor and Ritual in an Andean Ayllu. ProspectHeights, IL: Waveland Benoit C. 1997. Sainte Radegonde, gardienne des cimetieres: r6flexions pour une arch6ologiedes savoirsreligieuxa la Guade33:87-107 loupe.Nouv.Rev.Ethnopsychiatr. Berland J. 1996. Mapping space: imaging technologies and the planetary body. In
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The Commodification of the Body and Its Parts Author(s): Lesley A. Sharp Source: Annual Review of Anthropology, Vol.

Annu. Rev. Anthropol.2000. 29:287-328 Copyright? 2000 by AnnualReviews. All rightsreserved

THE COMMODIFICATIONOF THE BODY

AND ITS PARTS

New York 10027, Departmentof Anthropology,BarnardCollege, New York, e-mail: LSharp@barnard.edu

(DE)CONSTRUCTING THE BODY

MEDICO-CLINICAL COMMODIFICATION: An Overview

COMMODIFICATION OF THE BODY

THE NEW BIOTECHNOLOGIES AND THE COMMODIFIED BODY Reproduction

COMMODIFICATION OF THE BODY

Genetics and Immunology

Nature, Body, Economy

The Powerof Metaphors

Towards an Ethics of Body Commodification in Anthropology

OF THE BODY COMMODIFICATION

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