Organ trafficking is the trade in human organs, tissues, or other parts of the body, usually used for the purpose of transplanting organs for another person. According to the World Health Organization (WHO), organ trafficking is a commercial transplant where there is financial profit or transplants take place outside national medical systems. There is a global need and growing demand for healthy human organs for transplantation, and the demand far exceeds available organs.
There are about 90,000 people waiting for a new organ in the United States. The average wait time for heart and liver transplants in the United States between 2003-2014 was about 148 days. The average waiting time for donor organs varies greatly depending on the patient's condition and the waiting list for organs is managed by the United Network for Organ Sharing (UNOS)[1]. Patients who need a whole heart transplant wait an average of 73 days. On average, an individual must wait three and a half years for an organ available for transplantation, but there is a global shortage of organs available for transplantation. Trade in human organs is illegal in all countries except Iran. However, the legal status of organ trade is changing around the world. For example: In 2013, Australia and Singapore ratified a law allowing organ transplantation through monetary compensation for their organ donors. Kidney disease advocacy organizations in both countries have expressed their support for this new initiative.
The trade in human organs is illegal in many jurisdictions for various reasons, although the trade is widely practiced, as is transplant tourism (tourists traveling to a country for the purpose of transplanting organs in order to circumvent the law), it remains difficult to obtain Data on the extent of this black market. There is a great deal of controversy surrounding the issue of legalizing and regulating organ trade to combat illegal trafficking.
History
One of the first recorded cases in modern history is that of serial killers William Burke and William Hare, who committed 17 murders in Edinburgh, from November 1827 to October 1828, in order to sell the bodies to Dr Robert Knox. The first scientific report on this phenomenon dates back to a publication in the Lancet in 1990. The study followed 131 patients from the United Arab Emirates and Oman who underwent kidney transplants in Bombay and are said to have suffered from many post-operative problems.
In its report on organ trafficking in Europe, the Council of Europe's Committee on Social, Health and Family Affairs wrote: “Globally, organ trafficking is not a new problem. In the 1980s, experts began to notice a practice later called “transplant tourism”: wealthy Asians traveled To India and other parts of Southeast Asia to obtain organs from poor donors. Since then, other destinations have emerged, such as Brazil and the Philippines. According to some allegations, China is involved in the trade of organs taken from executed prisoners. The sale of organs still continues in India despite new laws in the country making the practice illegal in most areas.While current estimates suggest that the illicit organ trade is still relatively modest in Europe, this problem is not losing any of its seriousness, as it is very likely that The gap between supply and demand for organs continues to widen with new medical advances.
Cases by country
Major importing countries
Developed countries such as Australia, Canada, the United States, European Union countries, Oman, Saudi Arabia, and Japan are considered “organ importing countries.” However, medical tourism exists in many other countries, especially in Asia and the Middle East. According to studies conducted in 2004, more than 75% (132 registered recipients) of kidney transplants in Malaysia are the result of medical tourism outside the country (India and China), 91% of kidney transplants in Oman (in 2003), 73 Transplantation in China on South Korea (in 2003/124 through August 2004), 68% (667 registered recipients) of kidney transplants in Saudi Arabia (in 2006), and 450 recipients from Taiwan (in 2005) in China ( Two-thirds of them are for kidney transplants.
Transplant tourism develops from Malaysia until 1994 in India and then gradually replaced by China. There is also significant smuggling in Malaysia itself. In Oman, transplant tourism in India was completely replaced in 1995 by Iraq and then since 2002 is mainly conducted in Pakistan. In Turkey, illegal transplantation takes place in the same country and organ transplant tourism takes place in India in the 1990s, and then also in Iraq and Iran. Various studies have been conducted in a number of countries, including following the case of Tunisian and Saudi recipients who mainly go to Egypt and India. The case of 18 Arab-Israeli recipients who traveled to Iraq in 1998 to avoid the waiting period to donate. Case of Australian, English and former Yugoslav recipients heading to India and other Asian countries.
Rationing
Iran is the only country that allows the legal buying and selling of organs. However, Iran places restrictions on organ traders in an attempt to limit organ transplantation for tourists. The procedure takes place among Iranian citizens only, as foreigners are not allowed to purchase organs from Iranian citizens. The system is largely charitable, meaning it is volunteer-based; Donors or patients do not receive a fee for their donation.
Proponents of the legalization of organ trade have praised Iran's handling of organ trade as safe and efficient. An article in the Journal of the American Society of Nephrology notes that the Iranian model has avoided many of the problems associated with organ trafficking. The article notes that attempts in other developing countries have failed even to slow the continued growth of people on the transplant waiting list.
All countries around the world have issued a law aimed at preventing the illegal trade in organs on the black market, whether through an explicit ban or through legislation that verifies the identity of donors and recipients and the manner in which the transplant was performed. Several countries, including Belgium and France, have used a system that assumes consent to legally increase the proportion of organs available for transplantation. In the United States, federal law prohibits the sale of human organs; However, the government has created initiatives to encourage organ donation and compensate those who donate their organs. In 2004, Wisconsin took the initiative to offer tax deductions to living donors. However, the current trend around the world is to regulate the circulation of human organs.
Prices of human organs
In Iran's legal markets, kidney prices range from $2,000 to $4,000. On the black market, the price may exceed $160,000, and the sale process is carried out through intermediaries. When done through black market medical providers, the transplant can be dangerous for both donors and recipients; The recipient may often suffer from hepatitis or HIV. Prices paid to black market donors are likely around $5,000, but some donors may receive less than $1,000.
In Pakistan, travel and hospital expenses cost about $500, but this may be deducted despite agreeing on the price after a kidney transplant on the black market.
Reasons for legalization
safety
In the 1970s, drugs to prevent organ rejection were produced, but in the absence of medical systems, this helped boost the organ trade in the market. Living donors include kidney, liver, cornea, and lung transplants. Most organ trade involves kidney or liver transplantation.
In 2014, Robert Daltrog, Harvard Medical School Center for Bioethics in the Department of Global Health and Social Medicine, wrote an open letter to President Barack Obama and other U.S. leaders to support the establishment of pilot projects to study forms of compensation for living kidney donors. A number of health professionals, transplant professionals, ethicists, lawyers, clergy, academics and other supporters of the proposal co-signed the letter; In a previous paper published in the New England Journal of Medicine, the letter included headlines of the urgent need for more kidney donors; Reduced safety risks; Significant reduction in financial costs, morbidity and mortality rates associated with kidney transplantation; The extent of the government's ability to implement the kidney donation compensation system.
There are other health-related reasons to encourage rationing, which are as follows:
- The risk of donating a kidney is very small - as is some cosmetic surgery such as liposuction.
- On average, living kidney donors live longer than people with two kidneys.
- By using legal markets for organ donation, both donors and recipients would be more protected than those on the black market.
- A kidney from a living donor usually lasts years longer than a kidney from a dead donor.
- On the black market, donors may not receive adequate postoperative care.
Member safety
The legal blood donation business in the United States that compensates donors produces more blood donations than the uncompensated blood donor business in Britain. For decades, concerns about the quality of blood or circulating organs have been the main reason for opposition. However, proponents of organ trading say that technological screening is now effective enough to ensure the safety of organ trading.
Due to the shortage of organ donations, many of which are taken from the corpses of elderly or sick people, they may sometimes lead to failure of transplantation or lead to the development of several types of cancer. However, waiting for patients in need of a good quality organ can be dangerous, as these people are often at risk of death.
Haste and ignorance during donations
Professors Baker and Elias concluded that haste or ignorance during donations can be prevented by obtaining mandatory written consent. They also say that failure to compensate donors for their organs could contribute to fueling feelings of remorse for making a hasty donation decision. . Some transplant centers have solved this problem by “inventing” medical documentation for hesitant donors. Monetary compensation has also been suggested as a solution, since the need for more organs would increase pressure from friends and family on the donor when making the decision to donate.
