El comercio infame: capitalismo milenarista, valores humanos y justicia global en el tráfico de órganos

This article documents the growth of “transplant tourism” and the global traffic in human bodies, desires, and needs. Organ transplantation today takes place in a transnational space with surgeons, patients, donors, sellers and brokers following new paths of capital and technology. In general, organs flow from South to North, from third to first world, and from poorer to richer bodies, and from black and brown to whites and from females to males. The “scarcity” of organs and tissues combined with the scarcity of patients of sufficient means to pay for these expensive operations, has spawned a lucrative business driven by the market calculus of supply and demand. The spread of new medical technologies and the new needs, scarcities, and commodities –for instance, fresh organs and tissues– that they inspire raises urgent public issues concerning: the reordering of relations between bodies and the state in late modernity; the appearance of “fluid” and divisible bodies that disrupt early modern notions of the indivisible and autonomous body-self; the emergence of new forms of barter and social exchange that breach the conventional dichotomy between gifts and commodities and between kin and strangers; the interplay of magic and science; and the power of rumours and urban legends to challenge the official medical and transplant “narratives” on the meanings of life, death, and sacrifice.Este artículo documenta el crecimiento del “turismo de transplante” y el tráfico global de cuerpos, deseos y necesidades humanas. El transplante de órganos tiene lugar hoy en día en un espacio transnacional en el que circulan cirujanos, pacientes, donantes, vendedores e intermediarios que siguen los nuevos caminos del capital y de la tecnología. En general, los órganos fluyen de sur a norte, del tercer al primer mundo, de los cuerpos más pobres a los más ricos, de negros y cobrizos a blancos, y de mujeres a hombres. La “escasez” de cuerpos y tejidos, en combinación con la escasez de pacientes con medios suficientes para pagar estas costosas intervenciones, han hecho surgir un lucrativo negocio impulsado por el cálculo de oferta y demanda de mercado. La extensión de nuevas tecnologías médicas y las nuevas necesidades, escasez y mercancías –por ejemplo, órganos y tejidos frescos– que inspiran, hacen surgir debates públicos de carácter urgente, relacionados con: la reordenación de las relaciones entre los cuerpos y el Estado en la modernidad tardía; la aparición de cuerpos “fluidos” y divisibles que ponen en cuestión nociones de la primera modernidad acerca de lo indivisible del cuerpo –self–; la aparición de nuevas formas de trueque e intercambio social que rompen la dicotomía convencional entre dones y mercancías y entre parientes y extraños; el juego mutuo entre magia y ciencia; y el poder de los rumores y leyendas urbanas de plantear un reto a las “narrativas” oficiales médicas y de transplantes acerca de los significados de la vida, de la muerte y del sacrificio

Violence and affective states in contemporary Latin America

This special issue brings together scholars interested in the analysis of the social, cultural and affective dimensions of violence. The contributions explore the connections between situated experiences of violence and shifting affective states, relations, sensations and contingencies in contemporary Latin America. The articles consider how violence might constitute a nexus for the production of subjectivities and forms of identification, relationality and community, alterity and belonging, in a range of Latin American contexts including Argentina, Brazil, Guatemala, Mexico and in the Mexican diaspora in Spain

‘Missing out’: Reflections on the positioning of ethnographic research within an evaluative framing

Contemporary approaches to evaluating ‘complex’ social and health interventions are opening up spaces for methodologies attuned to examining contextual complexities, such as ethnography. Yet the alignment of the two agendas – evaluative and ethnographic – is not necessarily comfortable in practice. I reflect on experiences of conducting ethnographic research alongside a public health evaluation of a community-based initiative in the UK, using the lens of ‘missing out’ to examine intersections between my own ethnographic concerns and those of the communities under study. I examine potential opportunities posed by the discomfort of ‘missing out’, particularly for identifying the processes and spaces of inclusion and exclusion that contributed both to my ethnographic experiences and to the realities of the communities engaging with the initiative. This reveals productive possibilities for a focus on ‘missing out’ as a form of relating for evaluations of the impacts of such initiatives on health and social inequalities

Is It Ethical for Patients with Renal Disease to Purchase Kidneys from the World's Poor?

Background to the debate: In many countries, the number of patients waiting for a kidney transplant is increasing. But there is a widespread and serious shortage of kidneys for transplantation, a shortage that can lead to suffering and death. One approach to tackling the shortage is for a patient with renal disease to buy a kidney from a living donor, who is often in a developing country, a sale that could—in theory at least—help to lift the donor out of poverty. Such kidney sales are almost universally illegal. Proponents of kidney sales argue that since the practice is widespread, it would be safer to formally regulate it, and that society should respect people's autonomous control over their bodies. Critics express concern about the potential for exploitation and coercion of the poor, and about the psychological and physical after-effects on the donors of this illegal kidney trade

Revisiting Ruddick: Feminism, pacifism and non-violence

This article explores feminist contentions over pacifism and non-violence in the contextof the Greenham Common Peace Camp in the 1980s and later developments offeminist Just War Theory. We argue that Sara Ruddick’s work puts feminist pacifism, its radical feminist critics and feminist just war theory equally into question. Although Ruddick does not resolve the contestations within feminism over peace, violence and the questions of war, she offers a productive way of holding the tension between them. In our judgment, her work is helpful not only for developing a feminist political response to the threats and temptations of violent strategies but also for thinking through the question of the relation between violence and politics as such

Story in health and social care

This paper offers a brief consideration of how narrative, in the form of people‟s own stories, potentially figures in health and social care provision as part of the impulse towards patient-centred care. The rise of the epistemological legitimacy of patients‟ stories is sketched here. The paper draws upon relevant literature and original writing to consider the ways in which stories can mislead as well as illuminate the process of making individual treatment care plans

The precautions of clinical waste: disposable medical sharps in the United Kingdom

This article deals with recent changes in UK guidance on clinical waste, in particular a shift to disposable, single-use instruments and sharps. I use interviews conducted with nurses from a GP practice and two clinical waste managers at alternative treatment and incineration sites as a springboard for reflection on the relationship between the legislation on clinical waste management and its implementation. Scrutinizing the UK guidance, European legislation and World Health Organization principles, I draw out interviewees’ concerns that the changed practices lead to an expansion of the hazardous waste category, with an increased volume going to incineration. This raises questions regarding the regulations’ environmental and health effects, and regarding the precautionary approach embedded in the regulations. Tracing the diverse reverberations of the term ‘waste’ in different points along the journeys made by sharps in particular, and locating these questions in relation to existing literature on waste, I emphasize that public health rationales for the new practices are not made clear in the guidance. I suggest that this relative silence on the subject conceals both the uncertainties regarding the necessity for these means of managing the risks of infectious waste, and the tensions between policies of precautionary public health and environmental sustainability

Things of the ground: Children's medicine, motherhood and memory in the Cameroon grassfields

Copyright @ 2011 Cambridge University PressSoon after birth, infants in the Cameroon Grassfields chiefdom of Oku are submitted by their parents to rites known generically as ‘children's medicine’ (k∂fu ∂bwan). Ostensibly performed to protect infants from harm and illness, the rites are in fact fraught with tension: they embrace contradictory perspectives regarding the social role of the mother and belie the normative ideal extolling her as a figure of nurture and protection. The article argues that, beyond their overt purpose and symbolism as rites of passage, the rites evoke collective memories of child abductions and contemporary anxieties regarding the anticipated departure of older children and adolescents into foster care or migrant labour. Going beyond a classic tripartite model, the article takes a long-term view that sees life-crisis rituals as a form of collective memory that bears witness to social tensions that cannot be resolved – in this case the contradictions inherent within the hallowed image of the mother and the compromised nature of parental love