Even in this era of enthusiasm for free markets, controversy rages over the appropriate boundaries of the free enterprise system-what should be for sale and what should be kept out of the domain of the market?' The debate is particularly fierce when transfers of human tissue are concerned. Permitting market exchanges in human body components, it has been suggested, can lead to a variety of undesirable social consequences. Humans may become "commodified," with each person valued solely or primarily on the basis of the monetary worth of her physical components. Human body parts might be employed to make "profits," a prospect that arouses fervent opposition. The availability of monetary compensation for human tissue may discourage gratuitous transfers of life-saving or health-enhancing materials, which many insist are superior to bargained-for exchanges on the grounds that such gifts promote altruism and reinforce a sense of community. As the value of the human body increases due to advances in medical science and biotechnology, so do fears that pressure to increase the amount of available tissue will result in the expansion of markets for human tissue.
This Article argues that markets in human biological materials not only exist but are for all practical purposes unavoidable, and that the ostensible debate over whether human tissue ought to be bought and sold distracts attention from pressing questions relating to the allocation of the burdens and benefits of the dramatic scientific advances of the past several decades. The failure to recognize both the pervasiveness and the near inevitability of commerce in human biological materials, I will argue, exacts a heavy cost. Without an understanding of the magnitude and distribution of the economic returns generated by commerce, it is impossible to assess the desirability of current regimes.