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Organ Trafficking: Why Do Healthcare Workers Engage in It?

Published online by Cambridge University Press:  28 July 2022

Trevor Stammers Open the ORCID record for Trevor Stammers [Opens in a new window]
Trevor Stammers*
Affiliation:
Independent Scholar, London, UK
*
Corresponding author. Email: tgstammers@doctors.org.uk
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Abstract

Organ trafficking in all its various forms is an international crime which could be entirely eliminated if healthcare professionals refused to participate in or be complicit with it. Types of organ trafficking are defined and principal international declarations and resolutions concerning it are discussed. The evidence for the involvement of healthcare professionals is illustrated with examples from South Africa and China. The ways in which healthcare professionals directly or indirectly perpetuate illegal organ transplantation are then considered, including lack of awareness, the paucity of both undergraduate and postgraduate education on organ trafficking, turning a blind eye, advocacy of organ commercialism, and the lure of financial gain.

Keywords

organ traffickinghuman traffickingorgan transplantationorgan salesorganized crimemedical complicity
Type
Research Article
Information
Cambridge Quarterly of Healthcare Ethics , Volume 31 , Issue 3 , July 2022 , pp. 368 - 378
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Notes

1. The search was performed in the then-current seven volumes of the Journal of Human Trafficking on 7 Aug 2021.

2. Capron, AM, Delmonico, FL. Preventing trafficking in organs for transplantation: An important facet of the fight against human trafficking. Journal of Human Trafficking 2015;1:56–64. doi:10.1080/23322705.2015.1011491 CrossRefGoogle Scholar.

3. Gawronska S. Illicit organ removal in Nepal: An analysis of recent case law and the adequacy of human trafficking and transplantation frameworks. Journal of Human Trafficking 2021. doi:10.1080/23322705.2021.1946655.

4. Sweileh, WM. Research trends on human trafficking: A bibliometric analysis using Scopus database. Global Health 2018;14:106. doi:10.1186/s12992-018-0427-9 CrossRefGoogle ScholarPubMed.

5. See note 4, Sweileh 2018, at Table 6.

6. See note 4, Sweileh 2018, at 1, Italics mine.

7. See note 4, Sweileh 2018, at Table 5.

8. Merrill, JP, Murray, JE, Harrison, JH, Guild, WR. Successful homotransplantations of human kidneys between identical twins. JAMA 1956;160:277–82CrossRefGoogle ScholarPubMed.

9. World Health Organization. Global Observatory on Donation and Transplantation; 2021 available at http://www.transplant-observatory.org/ (last accessed 29 Nov 2021).

10. Aubert, O, Yoo, D, Zielinski, D, Cozzi, E, Cardillo, M, Dürr, M, et al. COVID-19 pandemic and worldwide organ transplantation: A population-based study. Lancet Public Health 2021;6(10):e709–19. doi:10.1016/S2468-2667(21)00200-0 CrossRefGoogle ScholarPubMed.

11. Stammers, T. Organ Trafficking: A Neglected Aspect of Modern Slavery. Bristol: Policy Press; In press.CrossRefGoogle Scholar

12. Global Financial Integrity. 2017; available at https://www.gfintegrity.org/wp-content/uploads/2017/03/Transnational_Crime-final.pdf (last accessed 2 July 2021).

13. Shimazono, Y. The state of the international organ trade: A provisional picture based on integration of available information. Bull World Health Organ 2007;85:955–62. doi:10.2471/blt.06.039370 CrossRefGoogle ScholarPubMed.

14. Campbell D, Davison N. Illegal kidney trade booms as new organ is ‘sold every hour’. The Guardian 2012 May 27; available at https://www.theguardian.com/world/2012/may/27/kidney-trade-illegal-operations-who (last accessed 4 Jan 2022).

15. United Nations. Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Article 2; 2000; available at http://www.ohchr.org/EN/ProfessionalInterest/Pages/ProtocolTraffickingInPersons.aspx (last accessed 29 Nov 2021).

16. International Summit on Transplant Tourism and Organ Trafficking. The declaration of Istanbul on organ trafficking and transplant tourism. Transplantation 2008;86:1013–18.

17. See note 15, United Nations 2000, at 1014.

18. Radcliffe-Richards, J. Careless Thought Costs Lives: The Ethics of Transplants. Oxford: Oxford University Press; 2012, at 84–5Google Scholar.

19. Declaration of Istanbul. 2018, at 2; available at https://declarationofistanbul.org/images/documents/doi_2018_English.pdf (last accessed 4 Jan 2022).

20. Transplantation Society and International Society of Nephrology. Declaration of Istanbul on Organ Trafficking and Transplant Tourism; 2018; available at https://declarationofistanbul.org/the-declaration (last accessed 29 Nov 2021).

21. Declaration of Istanbul. 2018, at 3; available at https://declarationofistanbul.org/images/documents/doi_2018_English.pdf (last accessed 4 Jan 2022).

22. The State v Netcare Kwa-Zulu (Proprietary) Limited, Agreement in Terms of s105A(1) of Act 51 of 1977, Netcare Kwa-Zulu (Proprietary) Limited and the State, Commercial Crime Court, Regional Court of Kwa-Zulu Natal, Durban, South Africa, Case No. 41/1804/2010, 8 Nov 2010.

23. Naidoo V. More Convictions in Netcare Organ Transplant Case; 2010; available at https://www.politicsweb.co.za/documents/more-convictions-in-netcare-organ-transplant-case- (last accessed 4 Jan 2022).

24. Allain, J. Commentary on trafficking of persons for the removal of organs and the admission of guilt of a South African Hospital. Medical Law Review 2011;19:117–22CrossRefGoogle Scholar (last accessed 4 Jan 2022).

25. Comins L. New kidney scandal. Saturday Star 2011 Feb 26; available at https://www.pressreader.com/south-africa/saturday-star-south-africa/20110226/281479272909394 (last accessed 1 Dec 2021).

26. Comins L. Surgeons win epic court battle. The Independent on Saturday 2013 Feb 24.

27. Danovitch, GM. The high cost of organ transplant commercialism. Kidney International 2014;85:248–50CrossRefGoogle ScholarPubMed.

28. Anker, AE, Feeley, TH. Estimating the risks of acquiring a kidney abroad: A meta-analysis of complications following participation in transplant tourism. Clinical Transplantation 2012;26:E232–41 CrossRefGoogle ScholarPubMed.

29. See note 20, Transplantation Society and International Society of Nephrology 2018.

30. Cheung, M, Trey, T, Matas, D, An, R. Cold genocide: Falun Gong in China. Genocide Studies and Prevention: An International Journal 2018;12:38–62 CrossRefGoogle Scholar.

31. Huang, J, Mao, Y, Millis, JM. Government policy and organ transplantation in China. Lancet 2008;372:1937–38CrossRefGoogle ScholarPubMed.

32. Delmonico, F, Chapman, J, Fung, J, Danovitch, G, Levin, A, Capron, A, et al. Open letter to Xi Jinping, President of the People’s Republic of China: China’s fight against corruption in organ transplantation. Transplantation 2014;97:795–6CrossRefGoogle ScholarPubMed.

33. Paul, NP, Caplan, A, Shapiro, ME, Els, C, Allison, KC, Li, H. Human rights violations in organ procurement practice in China. BMC Medical Ethics 2017;18:11–15 CrossRefGoogle ScholarPubMed, at 12–13.

34. Editorial Office. Hangzhou Resolution announcement ceremony. Hepatobiliary Surgery and Nutrition 2013;2:316. doi:10.3978/j.issn.2304-3881.2013.11.03.

35. Huang, J, Zheng, S-S, Liu, Y-F, Wang, H-B, Chapman, J, O’Connell, P, et al. China organ donation and transplantation update: The Hangzhou Resolution. Hepatobiliary Pancreatic Diseases International 2014;13:122–4CrossRefGoogle ScholarPubMed.

36. Huang, J, Millis, JM, Mao, Y, Millis, MA, Sang, X, Zhong, S. Voluntary organ donation system adapted to Chinese cultural values and social reality. Liver Transplantation 2015;21:419–22CrossRefGoogle ScholarPubMed.

37. Xiang, YT, Meng, LR, Ungvari, GS. China to halt using executed prisoners’ organs for transplants: A step in the right direction in medical ethics. Journal of Medical Ethics 2016;42:10 CrossRefGoogle ScholarPubMed.

38. Rogers, WA, Trey, T, Fiatarone Singh, M, Bridgett, M, Bramstedt, KA, Lavee, J. Smoke and mirrors: Unanswered questions and misleading statements obscure the truth about organ sources in China. Journal of Medical Ethics 2016;42(8):552–3. doi:10.1136/medethics-2016-103533 CrossRefGoogle ScholarPubMed.

39. Paul, NP, Caplan, A, Shapiro, ME, Els, C, Allison, KC, Li, H. Human rights violations in organ procurement practice in China. BMC Medical Ethics 2017;18:11 CrossRefGoogle ScholarPubMed.

40. China Tribunal. The Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China: Judgment; 2020; available at https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf (last accessed 4 Jan 2022).

41. See note 40, China Tribunal 2020, at 113.

42. See note 40, China Tribunal 2020, at 150.

43. Keyue X. World’s First Double-Lung Transplant for COVID-19 Infection Succeeds in China; 2020; available at https://www.globaltimes.cn/content/1181228.shtml (last accessed 6 Dec 2021).

44. Lum A. Hong Kong ‘in denial’ about human trafficking problem, British lawmaker says. South China Morning Post 2018 Apr 27; available at https://www.scmp.com/news/hong-kong/hong-kong-law-and-crime/article/2143694/hong-kong-denial-about-human-trafficking (last accessed 17 Apr 2021).

45. Holland K. Ireland ‘in denial’ about human trafficking, says global expert. Irish Times 2020 July 30; available at https://www.irishtimes.com/news/social-affairs/ireland-in-denial-about-human-trafficking-says-global-expert-1.4316789 (last accessed 3 Dec 2021).

46. Abdel-Hamid A. Medical staff involved in organ trafficking arrested in Egypt. Al Arabia News 2017 Aug 27; available at https://english.alarabiya.net/features/2017/08/23/Egyptian-authorities-capture-a-network-for-trafficking-human-organs (last accessed 4 Jan 2022).

47. Perappadan BS, Trivedi S. The unravelling of a kidney racket. The Hindu 2019 July 27; available at https://www.thehindu.com/sci-tech/health/the-unravelling-of-a-kidney-racket/article28725737.ece (last accessed 4 Jan 2022).

48. AFP Kazakhstan holds doctor over Israel-linked organ harvesting scheme. Times of Israel 2019 Nov 21; available at https://www.timesofisrael.com/kazakhstan-holds-doctor-over-israel-linked-organ-harvesting-scheme/ (last accessed 4 Jan 2022).

49. Bytyci F. Kosovo doctors’ organ trafficking convictions confirmed. Reuters 2018 May 24; available at https://www.reuters.com/article/us-kosovo-organ-trafficking-idUSKCN1IP2JV (last accessed 4 Jan 2022).

50. Basnet G. Kidney trafficking: Selling poor men’s kidney: Ward chair, doctors and police in trafficking. Khabarhub 2020 July 14; available at https://english.khabarhub.com/2020/14/111998/ (last accessed 4 Jan 2022).

51. Chinese doctors jailed for illegal organ harvesting. BBC News 2020 Nov 27; available at https://www.bbc.co.uk/news/world-asia-china-55097424 (last accessed 4 Jan 2022).

52. United Nations Office on Drugs and Crime. Assessment Toolkit on Trafficking in Persons for the Purpose of Organ Removal; 2015, at 30; available at https://www.unodc.org/documents/human-trafficking/2015/UNODC_Assessment_Toolkit_TIP_for_the_Purpose_of_Organ_Removal.pdf (last accessed 4 Jan 2022).

53. Arulrajah P, Steele S. UK medical education on human trafficking: Assessing uptake of the opportunity to shape awareness, safeguarding and referral in the curriculum. BMC Medical Education 2018;18:137. doi:10.1186/s12909-018-1226-y (last accessed 4 Jan 2022).

54. Ross, C, Dimitrova, S, Howard, LM, Dewey, M, Zimmerman, C, Oram, S. Human trafficking and health: A cross-sectional survey of NHS professionals’ contact with victims of human trafficking. BMJ Open 2015;5:e008682. doi:10.1136/bmjopen-2015-008682 CrossRefGoogle Scholar.

55. See note 49, Bytyci 2018, at 6.

56. Grace, A, Lippert, S, Collins, K, Pineda, N, Tolani, A, Walker, R, et al. Educating health care professionals on human trafficking. Pediatric Emergency Care 2014;30:856–61CrossRefGoogle ScholarPubMed.

57. Chisolm-Straker, M, Richardson, L, Cossio, T. Combating slavery in the 21st century: The role of emergency medicine. Journal of Health Care for the Poor and Underserved 2012;23:980–7CrossRefGoogle ScholarPubMed.

58. de Jong, J, Ambagtsheer, F. Indicators to identify trafficking in human beings for the purpose of organ removal. Transplantation Direct 2016;2:e56. doi:10.1097/TXD.0000000000000568 Google ScholarPubMed.

59. Albugami, MM, Alotaibe, FE, Alabadi, AM, Hamawi, K, Bel’eed-Akkari, K. Transplant tourism following the Declaration of Istanbul: Poor outcomes and nephrologist dilemma. Nephrology 2017;23:1139–44CrossRefGoogle Scholar.

60. Ambagtsheer, F, Van Balen, L. ‘I’m not Sherlock Holmes’: Suspicions, secrecy and silence of transplant professionals in the human organ trade. European Journal of Criminology 2020;17:764–83. doi:10.1177/1477370818825331 CrossRefGoogle Scholar.

61. See note 55, at 770.

62. See note 62.

63. See note 55, at 772.

64. See note 55, at 773.

65. Moore, L, McAuliffe, E. Is inadequate response to whistleblowing perpetuating a culture of silence in hospitals? Clinical Governance: An International Journal 2010;15:166–78. doi:10.1108/14777271011063805 Google Scholar.

66. Caplan, A. Trafficking and markets in kidneys: Two poor solutions to a pressing problem. In: Akabayashi, A, ed. The Future of Bioethics: International Dialogues. Oxford: Oxford University Press; 2014. doi:10.1093/acprof:oso/9780199682676.003.0053 Google Scholar.

67. World Health Organization. WHA40.13. Development of Guiding Principles for Human Organ Transplants. Geneva: Fortieth World Health Assembly; 1987; available at http://www.who.int/transplantation/en/WHA40.13.pdf (last accessed 4 Dec 2021).

68. World Health Organization. Guiding Principles on Human Cell, Tissue and Organ Transplantation, as endorsed by the Sixty-Third World Health Assembly, May 2010, in Resolution WHA63.22; 2010; available at https://www.who.int/transplantation/Guiding_PrinciplesTransplantation_WHA63.22en.pdf (last accessed 4 Dec 2021).

69. See note 63, at 5.

70. Cherry, MJ. Kidney for Sale by Owner: Human Organs, Transplantation, and the Market. Washington, DC: Georgetown University Press; 2015 Google Scholar.

71. See note 18, Radcliffe-Richards 2012.

72. Taylor JS. Stakes and Kidneys: Why Markets in Human Body Parts are Morally Imperative. Aldershot: Ashgate; 2005.

73. Hippen, B. The case for kidney markets. The New Atlantis 2006;14:47–61 Google Scholar; available at http://www.thenewatlantis.com/publications/the-case-for-kidney-markets (last accessed 4 Dec 2021).

74. Matas, AJ. The case for living kidney sales: Rationale, objections and concerns. American Journal of Transplantation 2004;4:2007–17CrossRefGoogle ScholarPubMed.

75. Stammers, T. Trafficking, tourism and trading: A dark convergence in transplantation? In: Phillips, AM, De Campos, TC, Herring, J, eds. Philosophical Foundations of Medical Law. Oxford: Oxford University Press; 2019; at 237–52CrossRefGoogle Scholar.

76. See note 69.

77. Organization for Security and Co-operation in Europe. Trafficking in Human Beings for the Purpose of Organ Removal in the OSCE Region; 2013; available at https://www.osce.org/files/f/documents/e/b/103393.pdf (last accessed 4 Jan 2022).

78. See note 73, Hippen 2006, at 30.

79. World Medical Association. WMA General Assembly, Revised Statement on Human Organ Donation and Transplantation. Pilanesberg: WMA; 2006; PACE SHFAC. Trafficking in Organs in Europe (2003), Quoting WMA GA, Statement on Human Organ and Tissue Donation and Transplantation. Edinburgh: PACE; 2000.

80. See note 73, Hippen 2006, at 43.

81. Scheper-Hughes, N. Parts unknown. Undercover ethnography of the organs-trafficking underworld. Ethnography 2004;5:29–73 CrossRefGoogle Scholar.