Entangled exchange: Reconceptualising the characterisation and practice of bodily commodification

Richard Titmuss' classical 1970 study of blood donation has provided a powerful conceptual model for characterising transactions involving human bodily materials. This now paradigmatic model suggests that such transactions are typically organised in accordance with one or other of two dichotomous, and mutually exclusive, modes of exchange: gifting or commodification. In this paper I utilise findings from my own and others' empirical research to illustrate the range of complex, multiply constituted, and contested modes of commodification that now typically attend the exchange of human body parts and tissues of which Titmuss' model can take no effective account. Drawing on work by Radin, Callon, and Miller I illustrate the complex justificatory work that those involved must perform to fit their lived experiences of tissue exchange into this now outmoded paradigm. I then consider how the protagonists themselves ontologise their practices and with what effects. In the second part of the paper I consider how neo-liberal ideologies and instruments are being employed to suborn a variety of highly differentiated and geographically distinct practices of bodily commodification to the 'logic of the market'. I explore here what the operative effects of defining the global circulation of body parts and tissues as a new 'economy' might be. I then consider how, if at all, a market logic could 'Value' all those 'calculations of interest' and 'values' that underpin exchanges of human body parts and tissues in specific national, communal or institutional settings. I conclude by reflecting on the desirability or possibility of performing normative assessments of the ethicacy of highly geographically and culturally differentiated practices of bodily commodification. (C) 2007 Elsevier Ltd. All rights reserved.