Sociological and ethical issues in transplant commercialism.
OBJECTIVE
'Global transplant commercialism' (practices and policies involving international trade in organs from living vendors, e.g., 'transplant tourism') is currently subjected to unprecedented criticism. In parallel, the debate around 'local transplant commercialism' (practices and policies that confine trade in organs from living vendors to national markets or economic unions) is heating up. In an attempt to assess the potential outcomes of these trends, this article reviews and discusses some sociological and ethical issues, ending with a proposal for a reinvigorated anticommercialist strategy.


RESULTS
The current international campaign against global transplant commercialism is conducted by an ad hoc alliance between strange bedfellows, proponents of local transplant commercialism on the one hand and opponents of any transplant commercialism on the other. Disparities in the rigor of the respective ethical discourses, the expanding list of precedents of legitimized commerce in the human body, and the political economy of transplantation, all suggest that the former have the upper hand.


CONCLUSIONS
Recent achievements in the struggle against international organ trafficking may not herald the abolition of transplant commercialism but rather presage its reconfiguration in deglobalized forms. In light of such a prospect, those who wish to prevent the pervasive commodification of the human body from entering the gates of transplant medicine should consider devising a new, perhaps more radical, strategy.
Epstein
Miran
M
Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK. m.epstein@qmul.ac.uk
D003132:Commerce / Q000191:economics / Q000941:ethics* / Q000331:legislation & jurisprudence; D035881:Compensation and Redress / Q000941:ethics* / Q000331:legislation & jurisprudence; D033161:Government Regulation; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000941:ethics; D006801:Humans; D007391:International Cooperation; D019520:Living Donors / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000600:supply & distribution; D009042:Motivation; D016377:Organ Transplantation / Q000191:economics / Q000941:ethics* / Q000331:legislation & jurisprudence; D028701:Patient Rights; D012959:Socioeconomic Factors; D009927:Tissue and Organ Procurement / Q000191:economics / Q000941:ethics* / Q000331:legislation & jurisprudence; D014195:Travel