If physician Thomas Diflo hears his patients talk of going abroad to buy a
kidney, heart or lung, he advises against it. If they do purchase such an organ,
he refuses to provide follow-up treatment.
If physician Thomas Diflo hears his patients talk of going abroad to buy a
kidney, heart or lung, he advises against it. If they do purchase such an organ,
he refuses to provide follow-up treatment.
Diflo and others in the medical community warn that Americans traveling overseas
for body parts are fueling a human organ trade that exploits the worlds
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, said 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 shouldnt
promote by going over there to buy (organs),” Cohen said. “We dont
want a system where living people would rather have money than their organs.
This is a tragic human situation.”
Others disagree. “If they (the worlds poor) are utterly desperate,
the one thing that is worse than banning the sale of organs is letting them
starve to death,” said Veatch, a professor of medical ethics at Georgetown
University. “In a better world, wed have a decent welfare program,
so no one would be coerced.”
The issue is a life-and-death one – literally.
Federal agencies estimate that 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, while demand for organs is growing rapidly.
Thus, many Americans are opting to head overseas.
However, they should beware – they cannot be assured of top-notch medical
care and accountability, critics note.
“You dont know what youre getting involved in,” Veatch
agreed. “There are anecdotes of people getting transplanted and having
medical complications.”
Nevertheless, sending Americans abroad for transplants is about saving lives
and prolonging the quality of life, argued Jim Cohan, a Los Angeles-based international
organ transplant coordinator. In the past 12 years, Cohan said he has arranged
for 450 people to have transplants in such places as China, Mexico, the Philippines
and South Korea.
He 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. “Im the last stop,”
Cohan said. “People who have been on a waiting list for years are the ones
Im able to do my work with.”
Disturbingly, however, there are reports of donors around the world who do
not give their organs voluntarily.
In 2001, a U.S. official testified he had heard of organs being harvested from
Chinese prisoners while they were alive. He said he also had been told that
Chinese prisons schedule executions to meet 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.
“I know about it from patients Ive 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.
“Any form of trade of human organs is prohibited by the Chinese government,”
a spokesperson said. “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.”
However, Michigan State medical anthropologist Debra Budiani has conducted
hundreds of interviews with persons in several Middle Eastern countries. She
said asylum seekers in the area fear what may happen if they receive medical
treatment. They have heard rumors of others undergoing operations, only to discover
later they had missing organs.
Asylum seekers told Budiani about coffee shops in Egypt where organ brokers
would come to recruit them. Others vulnerable to organ theft or coercion included
the mentally ill and the homeless, Budiani said.
The number of trafficked or stolen organs is difficult to track, but can be
estimated based on how many organ donors are not related to the recipients,
Budiani noted. For instance, 80 percent to 90 percent of organ donors in Egypt
are not related to the recipients.
Last year, 20 percent of organ donors in the United States were classified
“other unrelated.”
Meanwhile, 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.
President George Bush recently signed a law that authorizes $25 million for
reimbursing organ donors travel and 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,”
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,” he emphasized.
“We have to think about culture as a whole.” (RNS)