The Organ Supermarket: a lawless domain

Body organs are a valuable commodity. Nearly every part of the human body has been transplanted – except of course the brain. As the Western world struggles to maintain a charitable stance on organ transplantation which results in long waiting lists, a thriving market in live transplantation exists in many less industrialized countries. Expendable organs, like kidneys, are the most valued. Advances in kidney transplantation and the body’s requirement for only one kidney make it the organ of choice for sales. World Health Organization estimates that more than 6000 kidney transplants are performed illegally each year.

Effective organ replacement is now part of a largely unregulated economy.

The exact number of organ sales is hard to determine because these sales are illegal in most countries and viewed as body trafficking. Organ sellers may be reluctant to come forward and face incarceration even if they have been coerced or mistreated by a growing industry of “organ brokers”.

Condemnation of the organ trade is easy. Especially when it doesn’t happen on our doorsteps.  Paradoxically, a legal supermarket of spare organs is thriving in the West. Genetic testing now allows mothers to select healthy, genetically matched eggs to deliver children who can be effective bone marrow donors for their affected siblings. In one study, 96% of siblings were cured, without any complications, through this selective breeding.

It is a dangerous hypocrisy to separate the production of organs from their sales. All organ supermarkets are both costly and driven by catastrophic needs which are hard to ignore. Fortunately, the overarching medical ethics remain the same for both: minimise harm and maximize beneficence. Within these principles, scientists and clinicians have an important responsibility in helping the general public understand the full range of medical and social implications.

Harvesting body organs, however, now has extra dimensions beyond health. Effective organ replacement, which was achieved through ethical medical practice, is now part of a largely unregulated economy.

Over 50 countries in all continents offer some kind of medical tourism involving organs replacement, for example, kidneys, stem cells, sections of liver are all valued commodities. The industry is dynamic and very lucrative to failing economies.

Whereas medical science is fast and flexible, the law often moves at a more considered pace. In the marketplace of organ production and sales, the law has not kept up. Legal and legislative frameworks urgently need some restructuring, to be more flexible to deal with the rapid evolution of marketing possibilities.

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