While names like Aschheim- Zondek and Krigler –Najjar, Guillian-Barre, Rokitansky- Kuster- Hauser roll off the tips of our tongue, how many doctors know about Burke and Hare or the Tuskegee trials, or Henrietta Lacks or Nuremberg?
When you have a biomedical model of medical education these are missing pieces of information critical to an understanding of where we came from and therefore where we may risk going again and that the road to hell is often paved with good intentions……
The scene in Munnabhai MBBS when Circuit brings him a Japanese tourist as a ‘body’ is not far from the truth in the 18th century!
The newly minted doctors in Britain had no way of obtaining anatomical knowledge besides doing dissections on dead bodies. Burke and Hare were grave diggers who supplied these bodies. These shady deals would take place with the doctors and of course the fresher the body the better the price. You see where this is going don’t you ?!
Burke and Hare figured out that the freshest body was perhaps one which had not even reached the grave yet….and they set up a system of identifying people who were unlikely to be missed and then killing them and providing those bodies to the doctors.
After a spree of 16 such murders they were eventually caught. Hare turned informer and received immunity while Burke was hanged, his corpse dissected and put on display at the Anatomical Museum of Edinburgh Medical School where it remains.
Dr. Robert Knox who bought these bodies, possibly knowing their origins, was never convicted but eventually hounded out of Edinburgh.
And that was that. Or so you would think.
Fresh scandals involving organ donation keep popping up all over the world with alarming regularity. Who does your body belong to? That is the question. Till recently, as an Indian, if you committed suicide but failed then you would be jailed because you tried to murder a citizen aka government property. Ever thought of yourself as that ?!
Read more in this brilliant article about who actually owns your body: http://digitalcommons.law.yale.edu/cgi/viewcontent.cgi?article=3066&context=fss_papers
So many laws, policies, practises and medical advice is such that punishments are created for things you may choose to do to your own body. http://reason.com/archives/2011/07/29/does-your-body-belong-to-you or if others do to your body –which is why assault, rape, murder carry severe punishment. (Unless you are and Indian woman and your husband rapes you. Apparently he owns you since marital rape is not yet recognized by the law.)
This also has very interesting implications for the right to have an abortion, the right to refuse antenatal care or a caesarean section and the right to euthanasia but maybe that is material for another blogpost !
What if you are a prisoner on death row, or maybe just in jail for a really long time and you happen to have the same blood group as a powerful person either rich or political who needs a liver or a kidney ….or two? Who would you appeal to if someone took it off you citing fake medical reasons?? If you are a political prisoner who isn’t fortunate enough to have been awarded something that will keep the eye of the global media on you, who is going to ask questions?
Who does your blood belong to?? Our filmi heroes and their mothers are forever going on about mera khoon, khoon ka karz, khoon bhari maang and so on. But what if you make a voluntary blood donation and someone uses it to take cells from it which they then replicate in vitro and use for experiments including developing and testing chemotherapy drugs, vaccines, antibiotics, anti- venom and such? These experiments result in the discovery of miracle products that could save thousands of lives. Yipee. But the pharma company makes billions and you never get even a rupee cos they never tell you. Well, they never even asked you in the first place, remember?
You think I am inventing a paranoid dystopian fantasy?? This is exactly what happened to Henrietta Lacks, whose cervical cancer cells were found to grow like magic in vitro in a way that no one had succeeded thus far. Her cell lines are still alive and probably account for over billions and billions of dollars in profits and research grant. More than 60,000 articles have appeared based on HeLa cell research including cancer and AIDS.
What did she get in return? Well, she died within weeks of that sample being taken. What did her family get? Nothing. Not only that, the He La genome has been sequenced and made public for anyone to see ! http://www.the-scientist.com/?articles.view/articleNo/48492/title/Henrietta-Lacks-s-Family-Seeks-Compensation/
If you have a sibling or a family member who has the power to ensure that you ‘volunteer’ a kidney or bone marrow even if you don’t want to, who really owns you? If you are known to have a rare blood group, how safe are you? Can you be kidnapped and kept, like in a Stephen King novel, to produce that blood willy- nilly simply by existing? What if you possess something that can only be used post mortem?? What if you were a planned pregnancy because your organs are needed for the older child?
The movie “Never Let Me Go,” is based on a book which talks of some children who have been created in a laboratory to be Donors. They have no parents in the sense we use the term. They exist to grow hearts, kidneys, livers and other useful items, and then, to die after too much has been harvested.
If you think these are just crazy conspiracy theory meets dystopian imagination, then do check out this fascinating and terrifying book –The Red Market. http://www.npr.org/2011/06/10/136931615/blood-bones-and-organs-the-gruesome-red-market
Here I quote the first two paragraphs:
“I weigh just a little under two hundred pounds, have brown hair, blue eyes, and a full set of teeth. As far as I know, my thyroid gland pumps the right hormones into the twelve pints of blood that circulate in my arteries and veins. At six feet two inches, I have long femurs and tibias with solid connective tissue. Both of my kidneys function properly, and my heart runs at a steady clip of eighty-seven beats per minute. All in, I figure I’m worth about $250,000.
My blood separates neatly into plasma, red blood cells, platelets, and clotting factor and would save the life of someone on an operating table or stem the uncontrolled spilling of a hemophiliac’s blood.
The ligaments that keep me together can be scraped from my bones and implanted in the wounded knee of an Olympian athlete. The hair on my head could be made into a wig, or reduced to amino acids and sold as a leavening agent for baked goods. My skeleton would make a striking addition to any biology classroom. My major organs — heart, liver, and kidneys — could go on to prolong the lives of people whose organs have failed, and my corneas could be sliced off to restore sight to the blind. Even after death a determined pathologist could harvest my sperm and use it to help a woman conceive. The woman’s baby would have a value of its own.
Since I’m an American, my flesh sells at a premium; if I had been born in China, I would be worth much, much less.”
There is no doubt that ethical organ donation saves lives and is something we should all consider signing up for.
In some countries organ donation is automatic unless you opt out. That could have its own set of problems of course. But in India, organ trafficking continues. http://www.livemint.com/Politics/pxj4YasmivrvAhanv6OOCJ/Why-organ-trafficking-thrives-in-India.html
The article says : “Rakesh Senger, national secretary, from Nobel Peace Prize winner Kailash Satyarthi’s NGO Bachpan Bachao Andolan (Save the Childhood Movement) says that while trying to locate missing children, many times he has found dead bodies of children without their vital organs. “What was shocking was that their kidneys or other vital organs were missing. In many cases, police just says the body was lying in a stream, where some animal must have eaten the child’s organ,” says Senger. “It is much easier to file a case of kidnapping and murder against unknown persons. If you accept the organs were missing, you have to do a thorough investigation. So, the details in such cases get murkier.”
We are barely making sense of this gut churning information when the article goes on to say this:
Shroff says the demand for organs could be met if the country taps into the pool of people who are brain dead and promotes organ donations. “So many accidents happen in the country. Out of those, several people have brain injuries. We need to tap this pool. If this happens, we may not even require living donors,” he says.
To me this conversation is just getting drowned out by my brain blaring out Burke and Hare, Burke and Hare !!! Think ‘accidents’ in rural India, power dynamics and class and caste issues, consent and autonomy and control, and it is a terrifying thought that we could be looping back into the days of the body snatchers again.
Next week in part 2 we find out who these people are