The Red Market: book on the criminal trade in orphans, organs, bones, skin, eggs, hair, and other human flesh

Scott Carney's The Red Market is a book-length investigative journalism piece on the complicated and sometimes stomach-churning underground economy in human flesh, ranging from practice of kidnapping children to sell to orphanages who get healthy kids to pass off to wealthy foreigners to the bizarre criminal rings who imprison kidnapped indigents in "blood farms" or lure impoverished women into selling their kidneys.

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.

The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers


  1. “…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…”

    Welcome to the USA, circa 2030.

    1. You anti-capitalism freedom hating socialist! Now get back to working for our CEOs.

  2. Not sure if I could read this. It’s an important topic but I can’t imagine I could stomach the details.

  3. Ordered. Like freshaccondi, I have my doubts about stomaching the book, but worst case I read it the same way I did Jane Mayer’s “The Dark Side”–a few pages per day, allowing the disgust and anger to abate overnight. Thanks for the rec, Cory.

  4. “…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…”

    The distinction between selling and being robbed is vital. Being robbed produces less-than-zero benefit, while selling improves the life of both willing participants. Value is subjective, and it is therefore meaningless and erroneous for people to judge other people’s voluntary trades based on some argument of lack of net benefit. Prohibiting such trade is similarly dangerous ground, resulting is a worse situation.

    Regarding the sanctity question, did you know that a human life is not infinitely valuable? This is simply seen by considering the resources one puts into protecting one’s life.

    The focus on unequal wealth is telling about your prejudices. What about other unequal circumstances of life that put people in position of trading (giver or recipient) organs? Wealth is much less of a given in life than other factors (country and year of birth, state of medical development, physical and genetic attributes, personality). Unlike these other things, wealth can be altered by creativity and production.

    Btw, how is giving one’s hair to fund one’s temple “purely altruistic”? Don’t pilgrims benefit from the transaction? Or are you assuming that satisfaction gained can only be observed in material factors?

  5. This is why my main political position is abolitionist.

    This whole slavery thing hasn’t ended by a long road.

  6. Seems like this cannibalism rev2. Just that the digestion process is economic rather than chemical.

  7. As Freakonomics says, whether or not you like the thought of selling kidneys, the death rate from kidney failure in Iran (where selling kidneys is legal) is near zero. Compare that with the death rate in the USA.
    I don’t have the citations but most likely you can get them from your copy of Freakonomics or from their blog site.

  8. There are enough children who need parents in your home country that you don’t ever have to sponsor child kidnapping abroad.

  9. That’s worth a read. I’ve often wondered where the corpses came from for the traveling Chinese plastination shows. Even the so-called artist Dr. med. Gunther von Hagens (né Gunther Liebchen) lied about where he got his corpses, saying they were donated by art-loving friends (who happened to look Chinese).

    1. He didn’t say they were the corpses _of_ his friends? Maybe his art-loving friends all chipped in and bought some Chinese corpses to donate to his show… Just sayin’…

  10. Posted this comment back in 2009’s UCLA: livers for sale! post, still relevant.

    This is exactly why selling one’s own organs should be legal. The privileged find a way around the limitations, and the poor still get screwed. One need only look at the failed prohibition on drugs and alcohol to realize just because something is illegal doesn’t mean no one is going to do it.

    Some may find it repulsive that someone would benefit from buying someone’s liver or kidney, but the doctor’s, the nurses, the hospital, and the recipient all benefit greatly from the process, why not the donor too? Further reading here and here, and further viewing here.

  11. Just ordered this up. I do a fair amount of legal work for clients in the medical travel business (e.g., traveling abroad for discount elective medical procedures, most often cosmetic or dentistry, but everything from that to orthopedics to live-donor renal transplants (i.e., where you bring along your sister or other willing and matching donor)) and while I am a great champion of the industry, there is a bit of utopianism here and there that understates some of the peripheral effects of the business. I’ll read this with a great deal of interest.

  12. Thanks for the great review Corey. A lot of people here are bringing up great issues with the system of body exchanged. I’d be happy to answer any questions that people have. I just spent the last six years writing this and . . . er. . . have a lot that I can get off my chest (you know, metaphorically).

    Scott Carney

  13. Wow. Typically with any press release, my mind goes to the Science Fiction that predicted current events, in this case Larry Niven’s Gil Hamilton series The Long ARM of the Law. Organ-legging was what he called this trade, or at least the parts involving parts.

    It’s only a matter of time before somebody gets the idea that science fiction is nothing short of slow-acting witchcraft, and all it’s practitioners should be burnt at the stake.

    I think I would be best appreciated medium rare, with au jus and some nice grainy mustard.

  14. The author’s surname is quite apt, both in the sideshow sense and in the “meat-loving” sense.

    “Cooter, we were beaten by the best.”

  15. @Mr Carney –

    Do you get much into the recent Kosovo organ selling ring? Fascinating and dreadful story, that. I’m sure I’d love to ask some questions, but I’d like to read the book first (should get it delivered Thursday). Is there an obvious contact email for you to ping you after I’ve had a chance to, er, digest this?


  16. Personally, I think that we should give money to those who are on the donor list. We’d have a lot more people on the donor list, and probably abolish the “red market” if we simply gave money to the family of the deceased for allowing their organs to be used in the case of their death. It would probably be cheaper to pay the family of someone who recently died $10,000 for a kidney than to pay for the ongoing costs of dialysis. Same goes for a heart transplant. Probably cheaper to pay for the heart of a deceased person than to pay the ongoing medical expenses associated with a heart that needs replacing. Most people don’t bother putting their name on the organ donor list. But put some money behind it, and there would be people lined up to get their name on.

  17. I just created an account so I don’t come up as “anon” This is Scott Carney, the author of “The Red Market”

    @ Mista: funny. My name is indeed appropriate for this subject matter, although in my case I prefer “circus worker” to “meat” but that’s just a preference.

    @bmcraec : I definitely couldn’t resist referring to “Never Let Me Go” in the book.

    @ Bevatron: I actually don’t go into Kosovo at all in the book. It’s a shame because what happened there during the war is horrible. In fact, I found during my research that there were far too many ways that the body is sold illegally for me to ever possibly cover. There are huge gaps where I don’t explore organ rings in south america, the bone thefts of Biological Tissue Services in New Jersey, the NY Rabbi caught in a kidney ring, plastinated cadavers in South Shore Seaport. The list is extensive. Instead I have tried my best to look at ten or twelve distinct markets and look a similarities that might provide a lens to examine all red markets.

    @kibbee you’re not alone. The problem with incentivising organ donation is that it can turn into coercion very easily.

  18. If there is a demand, there WILL be a market, and Black markets are much less nice than open markets, but you knew that. The distinction between selling and being robbed is vital – you can’t own what illegal to sell. This is exactly why selling one’s own organs should be legal. Criminals will play fast and dirty, take what they want, and and sell it – the poor still get really, really screwed and are down a kidney, BECAUSE of the law.

  19. You know…if we just made more crimes capital offenses, there’d be plenty of organs to go around and euthanasia would have to get relatively painless so as not to damage the goods. Plus, then we could stop spending so much dough on medical research.

    Are we living in the future of Larry Niven or Philip K. Dick? I can’t tell anymore. Oh well, at least we still have Sarah Brightman to sing the arias though:

  20. Consequences vary.

    Donating hair or blood or skin or eggs or sperm or even bone marrow is relatively easy — it grows back.

    Donated hearts and lungs come strictly from the dead.

    In between we have the market that however illegal, happens.

    Partial liver donations, like the one Steve Jobs bought, are lifesaving for the recipient and difficult but not insurmountable for the donor.

    Kidneys are interesting. Only in the USA (or non-civilisation) is kidney failure life-threatening. Over 20 years on dialysis is survivable in the rest of the western world. (To be clear: kidney failure is not on its own fatal)

    Make no mistake — kidney transplants are financially very important. By not killing the donor, and making sure the purchaser is available (rich person on dialysis) this is the most lucrative and morally defensible argument.

    Sure donors should get paid in this circumstance — everyone else is. But why does it happen at all? Kidney donation (as well as partial-liver donation) is a once-in-a-lifetime event. Shouldn’t the donor get lifetime-level compensation? Oh right, their poverty should redouble their punishment.

  21. This looks like a fascinating book; one I’m not sure I’ll be able to stomach!

    One topic I’ve always wondered about was conflicts of interests around doctors being offered incentives to encourage organ donation, versus the extent to which they will ‘go all out’ to save someone critically injured, or on life-support, if they know they are a registered organ donor. It pains me to think that way, but I can see it happening. I guess you could run a study comparing mortality rates on ER patients who were registered organ donors, vs those that weren’t.

    I agree that black markets are generally worse than legal markets, but given how badly open markets perform in many areas, there are huge risks around a legal Red market.

    See also: Boy regrets selling his kidney to buy iPad

  22. Huge *brrr!* on this whole topic. As an aside: the part about India’s “post-colonial relationship with the West whose legacy is a set of trade routes and relationships for everything from articulated skeletons”, etc., was actually something I learned in college in the 1990s. One day, a prof made an off-hand comment on the fact that the skeletons used to teach human anatomy in European universities often came from India. He added that (as was obvious in the specimen on display that day) the average dimensions of the bones showed that the individuals from whom they were harvested must have been short and thin and probably malnourished.

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