Overseas transplants may promote human organ trafficking_92004

Posted: 9/17/04

Overseas transplants may
promote human organ trafficking

By Mandy Morgan

Religion News Service

WASHINGTON (RNS)–If Thomas Diflo, a doctor, hears his patients talk about going abroad to buy a kidney, heart or lung, he advises against it. If they do travel out of the country to purchase an organ, he will refuse to provide follow-up treatment.

Diflo and others in the medical community warn that Americans traveling overseas for body parts are fueling a trade in human organs that exploits the world's poorest people.

But in the United States, where more than 85,000 people are on waiting lists for organ donations, desperate patients are taking dramatic, risky action, even though the exchange of money for human organs has been illegal since 1984.

Some Americans go so far as to seek destitute people overseas who may believe they have no other choice than to sell their bodies in order to support their families, reported Eric Cohen, a resident scholar at the Washington-based Ethics and Public Policy Center.

“There are practices that happen in other parts of the world we shouldn't promote by going over there to buy” organs, Cohen said. “We don't want a system where living people would rather have money than their organs.”

Twenty years ago, Robert Veatch, a professor of medical ethics at Georgetown University, argued that allowing the sale of organs would unethically encourage poor people to offer their body parts for economic gain. But he since has changed his views.

“Let's admit that we've failed and let the poor do whatever they have to do to survive,” Veatch said. “If they are utterly desperate, the one thing that is worse than banning the sale of organs is letting them starve to death. In a better world, we'd have a decent welfare program so no one would be coerced.”

But the poor aren't the only ones who see the need to deal.

According to the U.S. Department of Health and Human Services, 6,000 Americans will die this year while waiting for an organ donation. Only 25,000 transplants took place in the United States last year, and the demand for organs is growing rapidly.

“The need for Americans to go abroad is contingent on the shortage of existing organs in the United States,” Veatch said.

The health care and legal systems of some developing countries may not ensure top-notch medical care and accountability, according to critics of the international organ trade.

“You don't know what you're getting involved in,” Veatch said, adding that people engaged in the organ trade may not be trustworthy. “There are anecdotes of people getting transplanted and having medical complications.”

Jim Cohan, a Los Angeles-based international organ transplant coordinator, said sending Americans abroad for transplants is about saving lives and prolonging the quality of life. In the past 12 years, Cohan has arranged for 450 people to have transplants in such countries as China, Mexico, the Philippines, South Africa and South Korea.

“Without me, most or all of those people would die,” said Cohan, who charges $125,000 for coordinating a kidney transplant and $240,000 for arranging a lung, heart or liver transplant. The fees include travel and surgery expenses for the organ recipient and a companion.

“I'm the last stop. People who have been on a waiting list for years are the ones I'm able to do my work with.”

Reports indicate some donors do not give their organs voluntarily.

In 2001, a U.S. State Department official testified he had heard of organs being harvested from Chinese prisoners while they were still alive. He also had been told Chinese prisons scheduled executions to accommodate the needs of organ recipients.

“In China, the vast majority of donors are prisoners who have been executed,” said Diflo, an associate professor of surgery at New York University Medical Center who has treated six patients with trafficked organs who were not under his care before the transplants.

“I know about it from patients I've seen and some of my other contacts. The patient makes the arrangements through an organ broker to travel to China.”

A Chinese Embassy spokesman denied the practice, calling such stories “fabrications.”

“Any form of trade of human organs is prohibited by the Chinese government,” said spokesman Sun Weide. “The Chinese public health institutes accept voluntary organs upon their death to rescue the very sick people and for scientific research. Bodies of executed criminals may be used, but the prisoners or their families voluntarily approve that.”

Michigan State medical anthropologist Debra Budiani conducted hundreds of interviews with doctors, patients, religious leaders and asylum seekers in several Middle Eastern countries and said all of the asylum seekers feared what might happen if they received medical treatment. They had heard rumors of others undergoing operations, only to discover they had missing organs unrelated to their illness.

Last year, 20 percent of organ donors in the United States were classified “other unrelated,” according to the Organ Procurement and Transplantation Network, a public-private partnership that coordinates organ donation in the United States.

Federal and state legislators are trying to devise ways to avoid the corruption of human organ sales while at the same time encouraging organ donation.

Earlier this year, President Bush signed into law the Organ Donation and Recovery Improvement Act. It authorized $25 million to be spent reimbursing organ donors' travel and other expenses as well as promoting public awareness of organ donation. Outright payment for organs remains illegal.

“The current system of organ donation strikes the right balance between promoting medical progress and preserving the dignity of the human person,” ethicist Cohen said. “If we tried a system of paying for organs, the organ supply would go up but the ethical cost is too great.

“Turning the body into a commodity and the dangers of creating a coercion of people who might want to sell their organs is too great. We have to think about culture as a whole.”