Body, self, and the property paradigm.

The remarkable developments in biomedical research and technology of the past quarter century have made the human body not simply a subject of study and observation, but an object of manipulation in revolutionary ways. We seek to create new life through reproductive technologies, to sustain life through the drama of an organ or tissue transplant, to preserve life by means of research on retrieved tissues and cells. Such manipulation has generated provocative paradigms for rethinking and seeing the human body, among which is the image of the body as property. In light of the many potential lifesaving uses of the body in medicine, we cannot avoid questions about whether the human body is a form of private property and whether persons own their bodies. In seeking to make sense of the body, moreover, we may also seek to make cents of it. The property paradigm is frequently embedded, for example, in proposals advocating a commercial market in body organs and tissues. This kind of policy recommendation does not follow necessarily, since property can be given or sold (as well as not transferred at all). Still, as an OTA report suggests, "calling the body property may act to make the use of market incentives with respect to the body and its parts more acceptable."[1] Thus, our images of the body can influence policies regarding the method of procuring valued body tissues, and correlatively, adopting a particular policy can reflect a certain understanding of the moral status of the body. In light of this paradigm-and-policy dialetic, two distinct, though related, questions emerge. First, is seeing the human body through the conceptual lens of 'property' appropriate? Second, what ethical and practical implications emerge from this paradigm? In many instances, discussions of the disposition of organs, gametes, or cells have sought to address the second question of practices without having given sufficient attention to the preliminary question of the appropriateness of the paradigm. In the absence of this attention, we can miss the significance of our understanding of the body for our sense of self-identity. We cannot then just assume the validity of the property paradigm of the body and proceed to practical ethics. I want to explore the relations between the body, the property paradigm, and a sense of self, first identifying three differnet moral meanings expressed by the paradigm in the discourse of biomedical ethics and then assessing the paradigm's validity by proposing two different accounts, one religious, the other secular, for thinking about claims of ownership of the body. I will conclude by considering the practical implications these two accounts may hold for the issue of organ procurement. Territorial Integrity An everyday occurrence (it seems) in the state of nature that passes for our home life: a wailing child, having lost out in the kid wars, comes to me lamenting, "He bit me." "Where did he bite you?" "On my arm (hair, cheek, neck, leg, foot, etc.) [sob, sob]." Even as, and perhaps especially as, children we identify our sense of self with bodily experience ("me"), yet we also experience the otherness of the body: "my arm" is related to but somehow different from "me." This domestic example of the identify-yet-otherness of the body raises, at one level, the "mind-body" problem in embryonic form, but at another level, it illustrates a profound sense in which we may perceive the body as a form of property. We do not think it inappropriate to use possessive pronouns in referring to the body: "My body aches"; "You need to take better care of your body." We thus experience the body both as what we are and as what we have or possess. The body is nevertheless a distinctive kind of possession. To designate the body as property is to make a spatial or territorial claim that issues in a demand on others to respect its integrity. This does not mean the boundaries of the body are always inviolable, but it does entail that one's body has intrinsic value irrespective of its potential instrumental worth to others. …