Starry Decisis: Our Bodies, Our Cells

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As anyone who’s seen Doc Hollywood knows, Los Angeles has a fairly secure footing in the medical community, or at least the cosmetical medical community. The city is also home to one of the world’s premiere research hospitals, the UCLA Medical Center, which recently benefited from a $200 million donation by David Geffen. Last year, the hospital suffered a PR blow when one of the workers in its morgue was arrested for selling body parts from corpses. It won’t be the first time UCLA was dragged into the choppy waters where law, medicine and morality converge.

In the case Moore v. UC Regents, the California Supreme Court decided that patients don’t have a property right in their body parts once they’ve been removed. This means that the doctors can do whatever they want with the lumps, warts, and discolored moles they prune from our bodies, provided they tell you about it first. Moore, for his part, had a condition called hairy-cell leukemia. He went to UCLA Medical Center for testing between 1976 and 1983, which involved biopsies aplenty, as well as a splendectomy. Moore flew to UCLA all the way from Seattle, believing the checkups to be necessary. Meanwhile, his physicians were creating valuable cell lines and “blood products” for distribution in the scientific research community.

Cell lines are a lucrative proposition for doctors, who can sell them to biotech companies who later develop patents related to the genetic material they contain. The UCLA doctors in this case did just that. Moore sued, claiming that the doctors had breached their contract, breached their fiduciary duties and were liable for conversion – a fancy word for stealing.

Conversion has two components. (1) You had something and (2) Someone else now claims that something as his own. Proposition (1) is what gave the court trouble. Do harvested cells still belong, in some sense, to the home-body? Both the majority and the dissent offered impassioned arguments. Both sides agreed the doctors had done something wrong. They had violated their duties as paid physicians, but Moore and the dissent argued they violated his dignity as well.

Justice Panelli, for the majority, declined to create a new right for patients. There was no basis in statutory law or in case law for a property right in body parts - in fact, separate state statutes existed to limit property rights in organs, blood and fetuses, as special "objects" sui generis (legalese for "standing on their own"). Further, there was no reason to create such a right now.

State courts, who tend the garden of the common law (or judge-made law), can openly weigh social, economic and other policy arguments in their decisions. The court noted that allowing patients to sue to control the use of their excised cells would roll a stone in the path of scientific progress, which relies on the open sharing of cell lines in the develop of patented medicines. Everyone down the chain would become liable for conversion, often unknowingly so, if patients could claim their cells as their own. Contract law and fiduciary law could do the job here, Panelli concluded, without conversion liability.

Justice Mosk, in an opinion twice as long as the majority's, disagreed on every point. He emphasized that while patients leave the operating tables with less than what they started with, doctors stand to gain much, much more from distribution deals and patents. Patients were being denied dignity and equity as they were exploited by the men in the labcoats. In one particular flourish, Mosk plays his biggest card:

Another [sign of our respect for the body] is our prohibition against indirect abuse of the body by its economic exploitation for the sole benefit of another person. The most abhorrent form of such exploitation, of course, was the institution of slavery. Lesser forms, such as indentured servitude or even debtor's prison, have also disappeared. Yet their specter haunts the laboratories and boardrooms of today's biotechnological research-industrial complex.

We tend only to see this kind of language when a judge feels alone in the woods. You might recall former California judge Janice Rogers Brown making a similar argument about big government.

The cell has only become more relevant and incendiary, as a subject of litigation and legislation, in the time since this case. With big ticket issues like stem cell research and (shhhhh!) abortion on the table, it becomes increasingly important for lawmakers, both in the capitol and the courthouse, to figure out the line where who you are becomes what you have.