This is a horrifying book. It isn't news that human tissue and organs are bought and sold, but it is horrifying to learn the extent, the heartlessness and sometimes the ghoulishness of this international trade. The latest frontier is genetics. One in five human genes has already been patented in what the author calls “the great genome grab”. And it's all developing so quickly. A pessimist might wonder whether, in this field, our laws and ethics can even keep pace, waddling earnestly along like the fat boy in a school relay race, falling ever further behind these brilliant, amoral new light-speed technologies.

Donna Dickenson is professor of medical ethics and humanities at London University, and an optimist, in that she believes it is possible to control our own devices and desires. “Resistance is not futile,” she says. But she clearly intends this book to be an alarm call. “In today's global market, a healthy human egg from a young white European woman is more valuable than gold.” Indeed, in an arresting image, she says we are in the middle of a new gold rush, “whose Klondike is the human body”.

Yet legislating seems a near-impossible task, when laws are national and the business is global. It may be illegal for young women to donate eggs in Germany and Italy, but since it is perfectly legal in the UK or Spain, what barrier is that to anyone with a passport?

Neither the free market nor the totalitarian state regulates things well at the moment. America's full-throttle, gloves-off capitalist ethic produces price lists for body parts such as “Hand, $350-$850, Brain, $500-$600, Eviscerated torso, $1,100-$1,290.” Bone dust is valuable in periodontal surgery, as is skin for grafts both in burns cases and in the cosmetic industry, and human fat for lip and breast enhancement. The trouble is, fat is slowly reabsorbed and digested, so the customer has to keep having top-up fat injections all her life. The latest fashion is for “umbilicoplasty” - navel enhancement. Meanwhile, in the new Russia, tissue from the aborted foetuses of impoverished Ukrainian women is used in “rejuvenating treatments” for Moscow's trophy wives. That many young women today pay their way through college by selling their eggs to the IVF industry is no great surprise, maybe, but accounts of girls travelling from eastern Europe simultaneously to “work the cabarets, sleep with men, and sell their eggs” are deeply discomforting.

Then again, as so often, if you think free-market capitalism is bad, look at the alternatives. Worst practice, by a long chalk, is to be found in China. Here the body parts of executed prisoners are sold off for a tidy profit: an image of the all-powerful modern state as not merely parasitic, but positively vampiric, fattening off the corpses of those it has slain. We're not necessarily talking murderers and rapists here either. There are 160 capital offences in China, including tax evasion. After the Chinese state began its persecution of Falun Gong Buddhists in 1999, “the number of liver transplants surged from 118 to over 3,000 in the space of four years”.

A Canadian report found that the sale of organs from executed Chinese (and Tibetan?) prisoners supports both “health and military systems”. The organs from a good specimen might fetch up to $500,000, and although nobody knows how many people China executes per annum - they're strangely secretive about it - it must add up to a handsome sum. Perhaps even the People's Olympics have profited: games by the People, for the People, and thanks to the People's kidneys.

With this in mind, it's worth remembering that, even if the free market produces considerable ugliness, at least it is essentially free. Logically, if one assumes that individuals, not the state, own their bodies, then surely they should be entitled

to sell off an egg or a kidney if they choose. Indian villagers can get around £400 for their kidneys - and don't underestimate what a huge, life-changing sum £400 is in an Indian village. Should the rich really be lecturing the poor about the evils of free-market economics and the commodification of the human body?

In English common law, however, we don't own our bodies. We are our own bodies. And for Dickenson, this astonishing fact - far from being an anomaly - actually offers the way forward through the bioethical minefield. Her argument is complex and modestly tentative. Essentially, she wants us to regard our bodies (from kidneys to cells to DNA) not as personal possessions, but as a kind of common wealth that the law should be protecting. Yet what we are seeing today is the rapid privatisation of this genetic commons by ruthless clinics, laboratories and biotech companies, in the same way that common land was privatised by the Enclosure Acts of the 18th and 19th century. Thus Genentech, the patent-holder of Herceptin (a drug that increases survival rates in women who are genetically predisposed to breast cancer), holds multiple patents not just to the drug, but to the HER2 gene on which the drug acts. “Any researcher or drug company wishing to develop an alternative, cheaper drug must obtain permission from Genentech or risk being sued for patent infringement,” she writes. The National Health Service has restricted its use of the drug because of cost: monopolies being what they are, the price won't fall any time soon. Dickenson has many other examples of the consequences of “defensive patenting”. Her analogy with the Enclosure Acts may not be perfect, but it's a powerful starting point.

For you, you powerless peasant, don't even have any rights over your own body tissue once it's taken from you. Hence the memorable fact that most lip-plumping operations around the world today employ a synthetic collagen developed and patented by a highly profitable Californian group, Inamed Aesthetics, from the cells of a boy born in the early 1990s.

“The young man, as he now is,” Dickenson dryly notes, “remains happily unaware that his genital tissue can be found in the lips of women around the world.”

Body Shopping: The Economy Fuelled by Flesh and Blood by Donna Dickenson
Oneworld £16.99 pp226

What's your body worth?
Are you worth more dead or alive? Although the trade in body parts is illegal in America, a loophole allows brokers to charge unspecified ‘processing' fees when supplying flesh and blood to eager buyers. A recent American price list suggests that some of us are sitting, or standing, on a nice little earner: a leg is worth $1,000, a foot $400, a forearm $850, a shoulder $650. Curiously, a head fetches $900 intact, but more if it's sold in two parts: brain and head-without-brain. Some American medical schools have even developed profitable sidelines as corpse wholesalers: since an entire cadaver can fetch as much as $100,000, it's easy to see why.

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