Boston was once the epicenter of old-school Irish-American politicians, those incorrigible bullshitters whose endless blarney often masked old school corruption. Their orations were a wonder to observe, however plentiful their sins, and I had the good fortune to do so once or twice.
One old pol told a joke that went like this:
“O’Shaughnessy got sent up the river, like, to the slammer for a long sentence. One day the warden sees him on a stretcher. ‘Warden,’ he says, ‘they’re taking out my tonsils.’ He thinks nothing of it until six months later when O’Shaughnessy is on the stretcher again. ‘Warden,’ says he, ‘they’re taking out my kidney.’ Another six months go by and there’s old O’Shaughnessy on the stretcher yet again. ‘Warden,’ he says, ‘they’re taking out my’ – but the warden interrupts him.
“‘Ah, no ye don’t, O’Shaughnessy,’ he says. ‘I’m on to you. You’re trying to escape.’”
That old groaner may soon become living body horror for the incarcerated population of Massachusetts. A new state bill, HD 3822, would “allow eligible incarcerated individuals to gain not less than 60 and not more than 365 day reduction in the length of their committed sentence ... on the condition that the incarcerated individual has donated bone marrow or organ(s).”
We could find ourselves living in a world where the X-rays of the poor are the shopping carts of the rich.
Crime and Control
An idea like this reflects this country’s social and spiritual ailments: the pathogens in its past, the psychoses of its present, the prognosis for its future. But maybe it was bound to be proposed sooner or later in a culture built on racial slavery and economic exploitation. “Nearly two million people, disproportionately Black, are living in prisons and jails instead of their communities,” notes the Sentencing Project,“(compared to) the early 1970s when this count was 360,000.”
If today’s prison population had grown at the same rate as the overall population it would be less than one-third its current size. Instead of finding ways to reduce the per capita prison population, the US tripled it. There is little to no evidence that higher incarceration rates reduce crime. There is even the possibility that concentrated incarceration and longer sentences increase crime. But the incarceration continues. Why?
Racism plays a huge part, of course, fostered by a well-nourished climate of fear. The incarceration rate for Black people is roughly five times that of Whites, a product of this society’s longstanding commodification of black bodies.
It is slavery in another form, using forced or coerced labor from unfree people for the economic benefit of the prison system itself. And, as the Prison Policy Project writes, “the(ir) paltry wages they receive often go right back to the prison, which charges them for basic necessities like medical visits and hygiene items.” Even phone calls to family and friends, so essential to well-being, are billed at usurious rates which many prisoners cannot afford.
Wealthcare
Mass incarceration is useful for some people, to be sure – especially those who benefit from the current order. It is a form of social control that targets Black, Brown, and poor White people, as well as the mentally ill – groups whose marginalization maintains the status quo. Now, Bay State lawmakers hope to collect body parts from these marginalized human beings.
Who would get those body parts? The list of out-of-pocket costs for transplant recipients in the United States is daunting. It includes monthly drug costs, copayments, deductibles, transportation, lodging, food, lost wages, and childcare. As Kaiser Health News reports, thousands of patients have been denied transplants because they didn’t qualify financially. Patients whose drug coverage runs out can pay $3,000-$4,000 per month for anti-rejection medication.
One hospital’s executives defended its denial policy by saying, “The ability to pay for post-transplant care and life-long immunosuppression medications is essential to increase the likelihood of a successful transplant and longevity of the transplant recipient.”
Who can pay these kinds of costs? The 27 million people who don’t have health insurance? The half of all Americans who report that they would be unable to pay a $1,000 medical bill, “including 68 percent of adults with low income, 69 percent of Black adults, and 63 percent of Latinx/Hispanic adults”?
Patients, some of them desperately ill, are forced to beg for transplant money online. Some succeed. Many don’t. Medical ethicist Arthur Caplan (who I have criticized in the past) is right. “It may be a source of anger,” Caplan told Kaiser, “because when we’re looking for organs, we don’t like to think that they go to the rich. In reality, it’s largely true.”
In this context, prison organ sales could become another vehicle for the upward transfer of resources — in this case, of very human resources.
The Choice of the Choiceless
The legislators promoting this bill undoubtedly believe it would benefit everyone involved. Prisoners would get released earlier, and sick people would get the transplants they urgently need. But it violates two founding principles of any moral society – communal responsibility and respect for the individual. Having forsaken our responsibility to both prisoners and the unwell, will we now make up for our collective failures by pressuring one group to sacrifice its organs for the other?
It remains to be seen whether this bill ever becomes law. In conceiving it, however, lawmakers have already done something irreversible. They’ve moved the “Overton window,” the range of ideas considered politically acceptable, even further into the frontiers of parasitic imagination.
This bill crosses a divide no society should cross, forcing its most powerless subjects to make choices that are no choice at all. Freedom or body parts: that’s no choice for people with children to feed, breezes to feel, love to make, stars to see once again. It devalues their humanity, and ours. It makes humanity itself transactional.
This country’s critical donor shortage could be addressed by working to dismantle the social and economic barriers of the past, by building a national spirit of community and solidarity that would encourage people to help each other. Medical care for everyone could increase the pool of available donors while encouraging the kind of civic spirit that could produce more donations.
Or we can do what these legislators propose, by forcing already-exploited populations to sell themselves off piece by piece. O’Shaughnessy’s joke could become America’s future, where millions live in a film world that is part Rod Serling and part David Cronenberg. However morbid and inhumane, there’s no denying that this approach would preserve the status quo for those who benefit from it.
Community or cannibalism: that’s the choice. But then, that’s always been the choice. When it comes to racial and economic justice, this bill is the X-ray of a social body with an end-stage disease.
Other recent stories of interest:
CVS, Walmart to Cut Pharmacy Hours as Staffing Squeeze Continues
Layoffs by Email Show What Employers Really Think of Their Workers
A baby spent 36 days at an in-network hospital. Why did her parents get a huge bill?
These weight-reduction programs are getting pretty extreme.
The sickening implication of the proposal is that stripping a body for parts somehow makes the body more worthy (and the obvious inverse is those who do not go along with the program will suffer further/longer).