Why is China carrying out illegal organ harvesting

Organ trafficking lifesaver

Photo: Thirteen Of Clubs from Flickr (CC BY-SA 2.0)

OfDr. Alexander Fink, University of Leipzig, Senior Fellow of theIREF - Institute for Research in Economic and Fiscal Issues andFabian Kurz, Student of economics, former intern at Prometheus.

In most of the world - with the exception of Iran - the commercial trade in human organs is prohibited. But the ban does not mean that people do not sell their organs for money. They do it out of necessity without protection, adequate compensation, or black market medical care. The World Health Organization estimated in 2012 that around 10,000 illegal organ transplants take place every year. A legally regulated trade in living donor organs should be considered, on the one hand to help the sick and on the other hand to reduce the number of illegal transplants carried out under adverse conditions.

Hundreds of thousands are waiting for an organ

A good 660,000 people worldwide are waiting for an organ transplant. WHO data for 2010 shows that a total of 106,879 organs were transplanted. Of these, an estimated 10 percent were illegally transplanted. Kidneys make up the majority of transplants with 68.5 percent, followed by livers with a good 20 percent. Living donations are possible for both organs. For most patients who choose to illegally purchase an organ, it is their last chance to save their life.

How does illegal organ trafficking work?

As a rule, patients from relatively rich countries travel to relatively poor countries to have an organ transplanted there. In these countries, the ban on organ trafficking is not enforced as consistently as in the patients' home countries.

The World Health Organization dedicated one of the few reports on this illegal market to the illegal organ trade in 2007. The report reveals that a quick internet search was enough to get in touch with mediation organizations. At www.liver4you.org ... kidneys were offered for $ 85,000 in the Philippines at the time. A Chinese supplier offered a kidney for $ 70,000.


Brutal business

The illegal trade is particularly dangerous for organ donors. Time and again, donors who initially voluntarily consented to the trade are cheated and do not receive the previously agreed price for the organ or are treated medically inappropriately. In addition, human traffickers regularly force their victims to have their organs removed.

A particularly perfidious strategy used by illegal organ traffickers is to trick people in need of protection, such as the disabled, homeless, (illegal) migrants or illiterate people, into thinking that they have to be treated for another disease in order to then remove organs without the knowledge of the victims.

China: organs of political prisoners

States also participate in this brutal business. In China, the organs of death row inmates are used for transplants. These are by no means only convicted murderers, but also political prisoners. Some of the organs are sold to foreign patients at high profits. Executions will be arranged according to demand. Forced organ harvesting from prisoners is now officially banned, but it is likely to continue to be practiced. The prisoners now “voluntarily” consent to post-mortem organ removal.

Illegal market vs. legal market

In the illegal organ market, the plight of organ donors is being exploited by criminal organizations. Proponents of the organ trade ban fear that the emergency situation of people could be exploited even in a legal organ market. However, it is illegality, and not trade per se, that leads to organ donors being exploited under adverse conditions.

Legal organ trafficking: Protection through rules

Better protection for donors and recipients could be achieved through targeted legal regulations on a legal organ market.

In the illegal markets, financial hardship is one of the main reasons for organ sales. In legal markets, income or wealth limits could ensure that relatively poor people are excluded from selling organs. The payment of the prize could also be delayed - for example only after 3 years. Relatively poor people who need money in the short term could not be pressured to sell their organs.

Restrictions could also be implemented on the buyer side. It is conceivable that only health insurances or certified non-profit organizations can buy the organs. The financial situation of the insured person would not play a role when buying an organ.

In addition, the donor and recipient could be treated at a high medical level if sold legally. Legal operations would be carried out exclusively by experts in both poor and rich countries.

Legal organ trafficking unethical and unnecessary?

Even if donors and recipients are better protected by rules in a legal market, there are other objections to the legalization of organ trafficking.
The first objection is fundamental: organs should simply not be for sale - neither legally nor illegally. On the other hand, based on the work of the philosophers Jason Brennan and Peter Jaworski, it can be argued that things that can be exchanged free of charge should also be exchangeable for money. Free organ donations are legally possible in most countries - in Germany currently only to loved ones. A legal organ donation for a fee should also be possible according to this principle.

The second objection questions the need for legal organ trafficking. The demand for illegal organs could be reduced, for example by increasing the donor quota after death and allowing exchange rings and diving chains. In addition, medical advances, for example in the area of ​​3D printing, could make organ transplants superfluous in the future. However, it is possible that even these changes would not be sufficient in the short term to fully meet the demand for organs.

Restrict illegal trade through legal trade

As long as the demand for donor organs is not fully met by free organ donation or medical advances, the relevant alternative to a world with legal organ trafficking is not a world without organ trafficking.

The relevant alternatives are a world with exclusively illegal organ trafficking and a world in which the legal organ trafficking largely suppresses the illegal organ trafficking. A regulated legal organ trade could enable more life-saving transplants, let professional transplant providers oust criminal organizations, and guarantee reliable payments to donors.


First published by IREF.

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