Monday, February 12, 2007

Back-room Dissections

Interesting piece in Reason on the business of human tissue, it's a good read:


As the scandal unraveled in 2005, prosecutors revealed that Mastromarino had netted $4.6 million in three years of back-room dissections. He paid undertakers $1,000 a pop for providing access to the dead, paid cutters $300 to $500 for extracting the most marketable parts, and, according to his lawyer, managed to take home up to $7,000 per body. (One of Mastromarino's former employees contends the boss was pulling in double that.) The New York Police Department later interviewed the families of 1,077 people whose bodies were raided for spines, bones, tendons, and other tissues. BTS had cut deals with funeral homes in New York City, Rochester, Philadelphia, and New Jersey.

Cooke's bones were sold to Regeneration Technologies, one of the country's largest tissue banks. The company says Cooke's bones were deemed unsuitable for implantation, but it can't say the same for other pieces of tissue it bought from Mastromarino. The tissues BTS distributed ended up everywhere from a woman's neck in Kentucky to a man's jaw in Tampa Bay. Hundreds of people wake up every morning knowing that they are partly composed of stolen body parts.

In February 2005, Mastromarino and three others were indicted on 122 charges, including body stealing and opening graves. The grisly story received perhaps more media attention than any such scandal since a wave of body snatching in the 18th century. A February 2006 Paula Zahn Now segment spun the story into the perfect media narrative, complete with a villain, a celebrity, and a whistleblower. But that telling, and many others, failed to point out that much of Mastromarino's basic business model was perfectly legal, common, and necessary to the biotech industry. If Mastromarino had been smarter, he could have made a fortune off body parts while staying well within the limits of the law.

Law and custom both prohibit the sale of cadaveric tissue, a ban heartily supported by bioethicists like Arthur Caplan, the influential director of the University of Pennsylvania's Center for Bioethics. The prohibitionists warn of the degradation and commodification of human beings, but scientific progress has blurred the line between tissue and commodity. Doctors need a constant stream of remains to perform-and profit from-their work. The current compromise treats the body as property once it's in the hands of a corporation but as a "priceless" gift as it passes from a donor's family into the marketplace.

Where does the recovered tissue end up? According to Cindy Speas, WRTC's director of community affairs, the organization is "not involved in any way with anything that is not a not-for-profit." And it's true that the consortium doesn't send tissue directly to corporations. Instead, WRTC provides tissue to LifeNet, another nonprofit, whose mission is to "improve the quality of human life" and "serve the community." LifeNet posted $107 million in revenues in 2004 for "tissue/organ procurement, processing fees, and reimbursements."

From LifeNet, the tissue enters the for-profit system. LifeNet has contracted with LifeCell, the company that makes AlloDerm, along with other "alliance partners" such as Osteotech, the firm that makes bone putty. Standard and Poor's lists LifeCell's value at $888 million. >From there, tissue can end up as replacement skin for a young burn victim or cosmetic filler for a thin-lipped socialite.

Here's the crux of it:

Six years ago, two journalists at The Orange County Register undertook the most extensive investigation to date of the legal tissue trade. They linked 59 nonprofit tissue procurement agencies with publicly traded, for-profit firms. They also called each agency for comment, and the recorded answers are a jaw-dropping chronicle of deception and arrogance. The director of the nonprofit California Transplant Donor Network, which at the time was selling bone to Osteotech, admonished the Register, "It is not legal to sell organs and tissue." Others explained that families could not comprehend the distinction between nonprofit and for-profit. A spokesperson for the University of Miami Organ Procurement Agency, which sells skin and bone to the biotech company CryoLife, explained, "We can't be educating donors at the bedside."


It's a tough trade off between creating a demand for human tissue that is directly felt by people or pretending that demand doesn't exist and cutting them out of the profit loop.

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