# Abstract In December 2010, the governor of Mississippi suspended the dual life sentences of two African American sisters who had been imprisoned for sixteen years on an extraordinary condition: that Gladys Scott donate a kidney to her ailing sister Jamie Scott. The Scott Sisters’ case is a highly unusual one, yet it is a revealing site for inquiry into US [[biopolitics]] more broadly. Close attention to the conditional release and its context demands a broader frame than traditional bioethics and helps to push science and technology studies (STS) analysis of race past its conventional focus on genetics. This article draws on the Scott Sisters’ case as a site for interrogating the US context of racialized mass incarceration and kin-oriented and consumerist valorization of organ donation. Tensions between racialized exclusions, the promise of consumerist freedom, and the lack of expectations of the state are foundational to a distinctly American biological citizenship. By putting the Scott Sisters’ case into conversation with broader arguments about incarceration as a site of racialization and STS literatures of organ transplantation and of biological citizenship in diverse geographical sites, this article seeks to articulate some of the racialized contours of biopolitics in the United States. # Introduction “This article attends to the Scott Sisters’ case in light of the broader critique of mass incarceration as a racist institution, and in light of how prison imposes biological control on prisoners—both in ordinary circumstances, by structuring access to health care, and in extraordinary circumstances, such as organ donation schemes.” (Pollock, 2015, p. 2) The biomedical process of organ donation renders particular relations visible, and drawing on STS literature of organ donation helps to understand the particular interplay of kinship, Christianity, and access to care in this case. My analysis puts different models of [[biological citizenship]] and [[therapeutic citizenship]] into relief in order to highlight the specificity of the US context of famously high-tech medicine and infamously unequal access to care. # [[biopolitics]] of race in the US beyond genetics and bioethics “Since, as Jamila Jefferson-Jones (2013, 121) has emphasized, Barbour was a contender for the Republican presidential nomination at the time, ‘‘Haley Barbour needed to appear racially tolerant and capable of leading a diverse nation at just the same time that Jamie Scott needed to be released for a life-saving renal transplant,’’ leading to a convergence of interests that aligned in this unusual way.” (Pollock, 2015, p. 6) [[Insights]] Such is how [[Power asymmetry|power]] takes grip into human decision-making The year following their conditional release, in Barbour’s final days in office, he pardoned an extraordinary number of prisoners, but the Scott Sisters were not among them (Robertson 2012). Neither the transplant nor the reincarceration has come to pass. In the months after their release, reports emerged that the sisters were too unhealthy and obese to be eligible to give or receive a kidney (Gates 2011), but there are no signs that they are being returned to prison. Yet this narrative of prison release conditional upon organ donation is a revealing site for considering how incarceration plays a role in the constitution of racialized biological citizenship in the United States. # Prison and the Body > Governor Barbour’s perverse condition is extraordinary but not unprecedented. In 2007, state legislators in South Carolina considered a bill that would have shortened, by 180 days, the sentences of prisoners who agreed to donate a kidney; as Lee (2009) points out, this represents a collision of two markets: the open market of criminal justice plea bargaining and the closed market of human body parts. Plea bargains for reduced prison time are normalized forms of coercion, but the fact that prison power is enacted on prisoners’ bodies becomes starkly explicit once the boundaries of the prisoner body are called into question. # Intertwined Tropes of Consumerism, Kinship, and Christianity Governor Barbour’s suspension of the Scott Sisters’ sentences plays not only on tropes of mass incarceration, but also on particular constructions of organ donation in the United States at the intersection of hope and kinship, both of which are inextricable from Christianity. In their analysis of global ‘‘[[tissue economies]],’’ Cathy Waldby and Robert Mitchell highlight a very secular version of the Christian promise of eternal life when they argue that the ‘‘fantasy of a regenerative body’’ creates demand for the bodies of others, and in the absence of enough willing compatriots, for third-world bodies (Waldby and Mitchell 2006, 180; see also Scheper-Hughes 2002). But there is a mesosphere here worth paying attention to: even before turning to the abstract national body and the abstract foreign body, many who seek organs focus desire on the tangible bodies of kin. This focus-on-family complements the [[neoliberalism|neoliberal]] politics of organ markets, because ==both market and family are key private spheres that step in for the role of the state==. Organ donation in the United States is very private. It is a personal affair, where claims by the family supersede those by the state. Organ donation is valorized in the United States, and its appeal draws on two different conceptions of eternal life: a consumerist fantasy that the body can be forever fortified (Waldby and Mitchell 2006) and the Christian veneration of giving of one’s body that another might live. # Tensions within US [[biological citizenship]] One origin of the term biological citizenship has roots in the anthropology of resource-poor settings. It comes from anthropologist Adriana Petryna, who has given a rich account of fieldwork in post-Chernobyl Ukraine. How might we think about the contours of American biological citizenship in Petryna’s (2002) terms: negotiations over scarce state recognition and medical resources that invoke medical, legal, and scientific criteria? Alondra Nelson’s (2011, 184) analysis of the health politics of the Black Panther Party calls for ‘‘a return to the work of Adriana Petryna and, in particular, to the milieu of catastrophe and deprivation that impelled her theorization of biological citizenship.’’ Experiences of imprisonment informed the health activism of the Black Panther Party (Nelson 2011, 168), and Nelson’s call is deeply relevant. Petryna’s form of biological citizenship is being negotiated when prisoners demand the right to health care and is being both validated and denied when prisoners are released because of illness: release from prison restores the citizenship of the ill prisoner, but it also releases the state from obligation. At the same time, the more consumerist model of biological citizenship posited by sociologist Nikolas Rose and his colleagues is also at play here. Rose and his coauthor Carlos Novas write about a new kind of biopolitics that has emerged in North America, Europe, and Australia (Rose and Novas 2005). Rose and Novas compellingly argue that contemporary biological citizenship projects such as personalized genetic testing are distinct from earlier racialized national projects, such as eugenics. Biology becomes the grounds for hope and creative identity practices, rather than pathology and determinism. Rose and Novas characterize this form of biological citizenship as distinctive of contemporary liberal democracies, and posit that the forms of biosociality that they find most novel are available in ‘‘Paris, San Francisco, or London,’’ but not sub-Saharan Africa (Rose and Novas 2005, 451). Some analysts of this model of biological citizenship have suggested that indeed it does not apply in contexts of deprivation (Bharadwaj 2008), but I do not think that the division is so clean. This model captures something important about the transformative power of biological knowledge, and it is why Gladys’ offer to donate a kidney to Jamie should be understood not in terms of coercion as it would be in classical bioethics, but acknowledged to be an expressive act in which transplant medicine becomes a site of kinship and care. It is not clear at the outset which presents a deeper denial of prisoners’ independent personhood: denying a ‘‘right’’ to donate and receive organs in an act of kinship and care (Goldberg and Frader 2011), or demanding organ donation in exchange for release. ## Thus, there are two problems with the temporal and geographical cartography of new biological citizenship. First, Rose and Novas’ framework paves over heterogeneity both within the Global North and within individual countries. Eliding distinctions between and within rich countries ignores their particular racial histories; the United States was founded on racial genocide and racial slavery as fundamentally as it was founded on notions of liberal democracy, and race remains fundamental to the new biocitizen as it was to the old (Roberts 2010). Second, the new biological citizenship does not simply replace the old. Rose’s form of biological citizenship does not capture the radically unequal access to biomedical consumption in America. The role of racialized incarceration in structuring access to health care and exclusion from personhood highlights an underlying ambiguity about how the huge prison population can be understood to be part of the US body politic. The Petryna model of [[biological citizenship]] is helpful for understanding situations of scarcity and deprivation, the Rose model is helpful for understanding situations of consumerist creativity, and Nguyen’s [[therapeutic citizenship]] captures situations of abandonment by the state. I argue that these models must be combined in order to understand the biopolitics around the Scott Sisters case, and the role of mass incarceration in constituting biological citizenship in the United States more broadly. Indeed, the tensions between racialized exclusions, the promise of consumerist freedom, and the lack of expectations of the state are foundational to a distinctly American biological citizenship. #to-write [[therapeutic citizenship]] can add an argument for equal access to innovative medicines If we are to grapple with biological citizenship in the United States, both our famously high-tech medicine and our infamously unequal access to it are fundamental. Our very bodies are shaped by our historical and contemporary context, characterized by both radical disenfranchisement and rhetorics of just treatment. In the United States, prison is not just a metaphor for power and control, but a potent way of organizing bodies in space, and constituting and depriving citizenship. Free at last, the Scott Sisters and their supporters have won a significant victory as they negotiated this context. The inhumane condition imposed on these sisters by the state is a grotesque instantiation of disparities in [[biological citizenship]], but one that reflects a broader terrain.