It’s not everyday that we get to see great masses of people alter their attitudes as a cherished act of motherhood is converted into a lucrative market. That’s what is happening these days with breast milk, as recently reported by the New York Times. Biotech firms want to capitalize on the rich therapeutic potential of breast milk by turning it into high-tech medical products that can fight infections, improve blood clotting and deal with intestinal and infectious diseases.
This keen commercial interest in acquiring breast milk – an intimate part of the human body associated with maternal love and nourishment – raises all sorts of troubling new questions. Who will have privileged access to breast milk in the future – biotech firms backed by the deep pockets of venture capitalists, or premature babies who need the milk, especially from their own mothers? Will the emerging big business of breast milk lead to the closing of “milk banks” that provide donated breast milk to hospitals and nursing mothers at cost (i.e., the costs of donor-screening and pasteurization)?
The rise of a new market for breast milk brings to the fore the fundamental issue of inalienability – the idea that certain things are so valued that it is not ethically appropriate to exchange them for money in the marketplace. This is a topic that is near and dear to commoners, of course, who are constantly trying to prevent and reverse market enclosures that commodify everything from water and the atmosphere to the human genome and childhood.
Years ago, I learned a lot about inalienability from Margaret Jane Radin’s book Contested Commodities: The Trouble with Trade in Sex, Children, Body Parts and Other Things (Harvard University Press, 1996). She argues that liberal societies have a recurrent problem caused by a philosophical conundrum: It values freedom and individual choice, but it also values the dignity of personhood. So what happens when our “freedom of choice” in the marketplace runs over our integrity and dignity as human beings – such as having intimate aspects of our bodies converted into market commodities?
“Conceiving of all human exchange in terms of the market metaphor,” said Radin, “creates the risk that we will become incapable of transcending that rhetoric’s presuppositions about human nature, and thus unable to inspire deeper, more humane visions of the good.”
Commodification is a worldview that implies all sorts of attitudes, behaviors and relationships toward other human beings. If money, efficiency and individual freedom trump all else, and if all values are to be reduced to a price, launching the fiction that everything is commensurable on that single scale of value, then we start down a path toward social disintegration. A libertarian ethos trumps ethical and social norms, which "interfere" with our "market freedoms."
If and when the market worldview comes to redefine the value of breast milk, we will enter a new regime in which companies will be entirely free to interpose themselves between nursing mothers and needy babies, much as Nestle's once did with its milk formula. The Times reports that one company, Prolacta, has produced a “fortifier” compound for premature babies using breast milk. It costs about $180 an ounce, or about $10,000 for several weeks of milk for one baby.
All of this will inarguably contribute to GDP, and it may provide medical benefits for the special-needs babies who need the fortified milk. But can neonatal hospital units really afford such a product – and will commercial demand for breast milk dry up milk banks and convert desperate or poor nursing mothers into milk machines?
And what of the inevitable social inequalities that will arise? Mothers who can afford not to sell their milk will become socially privileged, while desperate mothers who need the money will be induced into selling their breast milk -- much as jobless people with a car often turn to Uber to try to scrape by. Free-marketeers invariably dismiss the ethical issues by retorting, “It’s their choice!”
And some liberal feminists as well. One of the most depressing responses to the Times’ story came from Jessica Valenti, a columnist for The Guardian. The headline of her recent column: “For-profit breast milk? It’s her body, and it must be her choice.” Valenti conjectures that “business involvement [could] lead to some positive changes for families who do want to use breast milk but don’t have access to it” – noting that government regulation of breast milk could help weed out tainted, unsafe milk.
She concludes, “No matter what the future holds for breast milk, though, we can’t be surprised when a market is created for something we continue to tout as near-magical. And if we value women’s bodily autonomy we’re going to have to get comfortable with the choices she makes – whether it’s breastfeeding, formula feeding, or pumping for cash.”
Valenti perfectly expresses the standard liberal view that markets are more or less benign, that regulation will work as designed, and that any individual choice must be respected. The social inequities and changing norms that will result from the marketization of a once-inalienable resource don’t even get a mention from her. "Individual autonomy" (within a corporate-dictated context) is all that matters.
But there is no obvious reason why therapeutic innovations using breast milk must be market-driven. One could imagine a large-scale commons-based trust or regional co-operatives to collect and allocate milk without all the ethical problems raised by investor-driven enterprises. Of course, the shark-filled venture capital world is usually the first to arrive on the scene of new profit opportunities, dictating its own vision of proper relationships toward “resources” (i.e., private, monetized, tradeable, profitable). Meanwhile, the opportunities for co-operative finance, nonprofit and government leadership on this issue – though feasible – are utterly missing.
And so the profit-minded biotech world is beginning to escort mother’s breast milk onto the auction block. A new commodity is being inducted into the market dream machine of progress and innovation. The real questions ought to be what this new market will do to us as human beings and to the culture of parenting – and why there has been so little attention paid to building more humane, commons-based alternatives.