Organ Farming and Social Anxieties

I’ve been reading a great deal of young adult fiction about organ farming and harvesting lately. It’s not that I’m on some sort of deliberate reading theme, it’s just what’s coming up in my ever-growing pile of books that need to be read. I’m not going to go so far as to say that this is the new dystopian, or even the new vampires, but it’s definitely a theme that I’m seeing pop up more, and like other trends in fiction, it speaks to social anxieties in a way I find fascinating.

Two recent examples: The Unwind Dystology (Neal Shusterman), in which teens can be ‘retroactively aborted’ by effectively being parted out in a process known as unwinding, and a book I won’t name because I don’t want to spoil it (it’s not out yet, but I will be talking about it at more length very soon!), which features teens held captive in what is more or less a gilded birdcage so that adults can harvest limbs, organs, and other necessities at will. Both books put teens in the effective position of being property that adults can use as they will, a larger theme in teen literature and real life, where as dependents, teens are subject to the rule of their parents.

There’s a lot to discuss just within this theme, of the disempowerment of teens and the nightmarish circumstances of a dystopian world where they can be used as sources for spare parts. Many teens experience the frustration of feeling like they aren’t treated as whole human beings, and this is a very literal extension of that common adolescent experience. It also touches upon real-world conflicts involving teens, parents, and medical decisions—sometimes teens and their parents do not agree on medical treatments, for example, which raises uncomfortable questions about autonomy.

How do you address a teen who refuses cancer treatment, for example? What about a teen in a family of Jehovah’s Witnesses who wants to accept a blood transfusion to save her life and it not a member of her family’s faith? These are issues society is grappling with more and more as youth rights movements push for more teen autonomy, and medical technology advances to the stage where parents and teens alike need to make complicated decisions. Historically, the assumption was that hospitals needed to treat children and teens according to the wishes of their parents, but thinking on this is changing in some areas, with an emerging argument that people under 18 need to take an active role in their medical decisions.

The organ farming and harvesting theme is also a complicated and rich one, though it’s not new: people have been writing about the concept of human beings used as spare parts for a very long time. What intrigues me here is the emergence in a YA context, where teens are the lesser social class being used as a source of organs, and where they don’t have the autonomy to decide on their own to sell parts, as seen in some dystopian fiction where people may sell organs to support their families or escape dire circumstances (and as seen in the real world).

Instead, here we have the realisation of a deep social anxiety, the fear that the use of donor organs, tissue, and other biological materials may go too far, and that we may have created a monster in the process of building a world where it’s possible to save lives with new lungs, new hearts, new livers, and more. Organ donation was extremely controversial at the start as people debated the nature of clinical death and expressed fears that people might be used as donors while still alive—or might be killed for their organs. These fears persist, and in some cases have very real reflections, as in China where there are concerns about the source of ‘donor’ organs from prison facilities.

In the Unwind Dystology in particular, one of the most terrifying things about the books is that at any time, your parents could sign an order and you could be sent away to be unwound, with no opportunity to advocate for yourself. You’d be killed for your organs as a healthy, active person: not a person in a state of brain death after a severe accident. In Belgium, lines are being blurred even further as doctors develop protocols for organ donation after euthanasia, with several test cases involving actual patients who requested physician-assisted suicide but also wanted to donate their organs for transplant, research, and other purposes.

We are living in an ethical Wild West when it comes to the use of donor material; should we allow people to pay for organs? Should we change the laws on organ donation to encourage more enrollment, addressing the critical shortages in available material? Should physician-assisted suicide be permitted and should patients be allowed to donate material if it’s suitable for use? If a patient is a suitable candidate for donation, who gets to make the final call, especially if the patient didn’t express strong wishes one way or the other before death? How do we address concerns about coerced ‘donation’ and exploitative practices, such as the sale and brokerage of organs in many regions of the world?

These are anxieties that are beginning to spread, and they are sparking a growing number of conversations in the media. Thus, it’s not surprising to see them emerging in pop culture as well, where many such anxieties are often expressed, if not worked out. Just as vampires once served an important role for exploring worries about society, narratives about the abuse of teens for their organs are stepping into an important conversation, creating a starting ground for more uncomfortable discussions in the real world. While teens today don’t need to fear unwinding, we as a society have some very real fears to think about.