Carney's story starts when he was living and working in India, showing around groups of American students; one of his charges commits suicide and he is plunged into the grisly midst of the bureaucracy of human remains and the disposal thereof. Carney uses this story as a jumping-off point for a series of investigative chapters, each of which is a relatively self-contained look at a different part of the "red market" -- the black market for human bodies and their parts.
Many of these chapters focus on India, which seems to be at the middle of much of the red market trade, having the unique and unfortunate combination of huge population, massive poverty, widespread corruption, ineffectual bureaucracies, enormous wealth discrepancy, and a post-colonial relationship with the west whose legacy is a set of trade routes and relationships for everything from articulated skeletons (dug up by grave-robbers who terrorize whole villages) to human hair (the sole example of a purely altruistic supply-side in the book -- it's donated by religious pilgrims to help fund a temple) to "orphans" who are actually poor children, kidnapped by unscrupulous brokers who know that Westerners would rather adopt a healthy, well-looked-after kid than a genuine orphan who's endured privation in an underfunded orphanage.
But Carney also looks at other red markets, grilling cowboy and quack doctors in Cyprus who trade in extreme fertility therapy, preying on vulnerable eastern European women who are coerced into giving up their eggs; recounting his own experiences as a human guinea-pig in pharmaceutical trials in the American midwest; and investigating Falun Gong claims about mass-arrests and organ harvesting from political dissidents in China.
On the way, Carney looks at the wider context of the red markets, the history of graverobbing and medical education, the toothless efforts to contain the trade, and especially the ethical and regulatory frameworks for human tissue and human beings that have been employed and discarded in the past. Carney lays a lot of the blame for the red market in the principle that tissue donors (and birth-parents of adoptive children) should be anonymous. He stipulates that this principle was taken up with the best of intentions, but that the net effect has been to rob the system of transparency, so that middlemen and "buyers" can disclaim any connection to unethical conduct at the supply side.
Carney also asks some pointed questions about whether market logic can be applied to human tissue, and what it says about the equal sanctity of human life when unequal human wealth puts some of us in a position of selling (or being robbed of) our organs, blood, skin, remains and children so that the rest of us can enjoy a few more years of life, or fertility, or a family.
All of this is raised in order to ask how the real benefits of adoption, blood transfusion, organ transplantation, fertility therapy and so on can go on to be enjoyed without being a less-than-zero-sum game that visits enormous tragedy on the many to improve the lives of the few. Carney examines the claims that synthetic human tissues will come along soon to alleviate the pressure that creates the red markets, and finds it wanting. He notes that each expansion in the supply of human tissues has been attended by an equal growth in demand, created by entrepreneurial surgeons who expand the definition of who might benefit from the use of the tissue.
Carney writes with a novelist's eye for character and detail and a muckraking reporter's gift for asking uncomfortable questions about stuff that most of us shy away from learning too much about. The Red Market is a gripping account of an invisible crime wave that lurks in the wings of every story about miracle medical breakthroughs and dazzling recoveries from the brink of death.
Published 7:32 am Tue, May 31, 2011