Introduction
The issue of organ donation is an issue that has elicited sharp reactions from many quarters. However due to lack of proper rules and regulations to govern this process people have resorted to organ trading in the ‘black’ market. Organ transplants arise when one either acquires an injury that destroys his organs or through certain illnesses that destroys some organs in the body and this will require an organ transplant to rectify this mistake. Due to technology and scientific innovations doctors worldwide are able to successfully transfer organs from one patient (donor) to another (recipient) if the doctors find out that the patient is in need of that particular organ and the donor can survive without it. The high cases of organ failure among many people throughout the world have led to many to resort to other means of getting these organs and this includes acquiring them through illegal means that pose a great risk not only to the donor but the recipient too. Various organs of the body like the heart, liver, kidney lungs and the pancreas are some of the examples of organs that are mainly traded through these black markets.
No matter how advanced medical sciences gets, organ transplantation not only remains a risky procedure, but an activity that questions a doctor’s ethics as well (Watts). Question of ethics apart, the procedure itself is very expensive and the procurement of a healthy organ very difficult as well. These constraints leads people to go at extreme lengths to acquire the these organs through illegal channels once they find out that they will not get them in time through the correct channels. Such desperation ushers in a situation where these people have to approach illegal sources to procure organs (Glaser). These sources are called the Organ Black Markets, and anyone who can pay a hefty amount, can get an organ from them no matter how the organ is procured or from where the organ is retrieved.
Organ Black Market
Organ transplant was first attempted successfully in December 1954 on a patient named Richard Herrick who suffered from chronic nephritis, where the donor was his twin brother Ronald Herrick a war veteran. Both claimed to have lived long and happy lives. Organ transplants happen every day and there are a wide variety of organs that get transplanted, from kidneys to liver lobes etc. Organ transplant is a very complex procedure and there is a plethora of things that can go wrong during a standard transplant. First and foremost is the safety of health of the donor, because extracting an organ from a healthy body is forcing the body to live with a deficiency for the rest of the life. The second is the chances of success of such a procedure. Third is the ethical dilemma of subjecting a healthy body to such a procedure to save a sick one (Truog).
The risks and doubts that go with organ transplant procedures reflect in the magnitude of shortage of valid organ donors. An organ donor has to satisfy certain medical conditions and tests in order to qualify for an organ donation. But most of the standard tests fail the validity of majority of the willing organ donors. However, most of these organ recipients usually goes a great length to acquire these organ including paying very high prices for them. With low probability of finding an organ through legal sources desperate recipients turn to illegal sources.
These illegal sources are the Organ Black Market that seemingly possess all the supply to organs from anywhere round the world. They can produce a kidney or a liver tissue or a cornea in any amount of time. And with the recipient paying a hefty sum, no one questions the source of such organs (Griffin).
Sadly though, such organs arrive from sources that can raise an outcry of objections. There are many sources from which an organ can be retrieved, but the best come from individuals who agree to donate their own body parts. Organ donation is a very sensitive issue; the donor’s health, previous medical records etc. are taken into full account to validate an organ transfer. But organ donors in many cases do not agree to undergo such elaborate processes. Most of these organ donors accept to undergo this procedure, not for a good cause, but to earn from the donation. In fact this very trend makes this noble cause a “trade”. Kidneys are sold at a worth of as much as 84,000 pounds, heart at more than a million pounds. However, this is the lighter of the deeper shades of grey associated with organ donations.
Organ harvesting from cadavers has been a trend for very long, especially in China, where it has been legal till very recently. Several articles describe the Chinese take on Organ Donation, harvesting and trade. China had a death penalty policy that allowed officials and coroners to harvest organs from cadavers of criminals who were executed. These organs were sold to “sources” that would supply them to prospective recipients. Individuals linked with organ black market sometimes extract organs from unsuspecting victims, some of whom are not even patients. Glaser describes a case from Bukhara in Uzbekistan in the article “Formula to Stop Illegal Organ Trade” (2007).
Glaser describes the case of a woman from Bukhara, Makbuba Aripova, who lost her husband to organ traffickers who took the man on a pretext of better opportunity. Glaser even comments about China in the same article, “Organ trafficking has developed as a by-product of China’s death penalty policy.” Such cases are very common and form the base of the Organs Black Market.
However, one other source on which this trade thrives is the sheer number of individuals who are willing to give away their organs. Monetary pressures being the first and foremost reason for such an act, others may include psychological conditions as well (Truog). But the question arises as to why Organ selling and buying wrong? And why is it that a black market has to exist for something like human organs? Addressing these questions one must remember that ethically it is always considered wrong to put one life in danger to benefit another for monetary gains.
Although physicians suggest donations from near relatives as a preference, forcing a reluctant individual to donate is not right in the legal sense as well. Hence, with an impending life threatening situation where else can a recipient turn to but the black organ market? Another strong reason that such markets exists is the fact that there are individuals who find profit in this form of business and can easily acquire organs from unsuspecting donors or even victims. Watts in a report to the Lancet, Legal and illegal Organ Donation (2013) describes the plight of unsuspecting donors as this:
“Pakistan has always been a popular destination for the transplant tourist and there are reports that in some villages in poor areas of Pakistan, almost no one has both kidneys.”
Watts goes on describe how China is a “favorite” place for people seeking kidney transplant and how tsunami hit Chennai victims in India had to sell off their kidneys in desperation of lost livelihood and poverty. The problem of Black Market operation is that the organs are acquired from very cheap, even unethical sources, and sold at tremendously high rates.
Remedy
Since the problem of Organ Donation and Black Market is so grave and its operating methods yet to be completely understood, there is a need to change the way the law understands organ donation itself. Muralidharan and his colleagues (2005) discuss about the laws that regulate organ donation and trade in their research and how these laws fail at doing so, with examples from the state of Tamil Nadu, India. Their research reveals many facts of the failure of law regulations in India as well as places with similar regulatory structure. Iran, another hotspot for organ donation and trade is covered in many researches.
The Iranian organ donation system is a highly systematic one. It locates prospective recipients and registers them so that whenever an organ is available for transplant it can be carried out in a legal manner. They keep a record of living related as well as non-related organ donors, and register cases that get paid for the organ donations (Hippen). However the Iranian system is under a lot of scrutiny and speculation as well, because of its apparent replenishing rates (Griffin). But many believe that the standard of control Iran sets on its donors and recipients is a model that needs to be followed if a fight has to be unleashed against the Organ Black Market
Watts summarizes a solution to the problem as he puts it, “Unless both living and deceased organ donations increase exponentially to match demand, there will always be desperate people who are willing to do anything to receive a kidney, or other body parts, and those living in abject poverty who are desperate enough to risk being donors.” Indeed the supply of donated organs can never match the demand of recipients.
Conclusion
This menace requires tougher rules and regulations so that it could be contained otherwise the organ black market will not end soon. There is need to make the process as transparent as possible to ensure the process is carried out according to the law and with qualified doctors after conducting all the tests required. Ethics may ask argue the validity of the purchase and sale of organs but with life at stake one can get into any length to save his life and thus making the organ black market very hard to control or get rid of. With proper mechanisms in place and proper regulations to curb this trade we can say that this war will be won finally.
Works cited
Glaser, Sheri R. Formula to Stop the Illegal Organ Trade: Presumed Consent Laws and Mandatory Reporting Requirements for Doctors. Human Rights Brief. 2007. Web. 8 Oct. 2013.
Griffin, Anne. Iranian organ donation: Kidneys on demand. BMJ 2007; 334. 8 March 2007. Web. 8 Oct. 2013.
Hippen, Benjamin E. Organ Sales and Moral Travails: Lessons from the Living Kidney Vendor Program in Iran. Policy Analysis. Cato Institute. March 20, 2008. Web. 8 Oct. 2013.
Muraleedharan, Vangal R., Stephen Jan and S. Ram Prasad. The trade in human organs in Tamil Nadu: the anatomy of regulatory failure. Health Economics, Policy and Law, 2005, vol. 1, issue 01. Web. 8 Oct. 2013.
Truog, Robert D. Perspective: The Ethics of Organ Donation by Living Donors. The New England Journal of Medicine. 4 Aug. 2005. Web. 8 Oct. 2013.
Watts, Jonathan. The Lancet: Legal and illegal organ donation. The Lancet, Volume 369. 15 June 2007. Web. 8 Oct. 2013.
