Trade or donation of the human organs has been a widely discussed topic since Dr. C. Bernard performed the first heart transplant of the world in Cape Town, South Africa. Organ trade means sales and purchase of the human body, tissues or organs for the purpose of transplantation (Kishore, 2005). The world is facing an excess demand problem due to lower supply of healthy body parts. According to the World Health Organization (WHO) report 2019, US waiting list for organ transplant exceeds more than 100,000 people as of March 2019. Heart and liver transplants average waiting time in the country was 148 days from 2003 to 2014. This median waiting time for organs donation significantly varies with the status of patients. Report further point out that the organs available for transplantation shortage lead to illegal trading around the world except for Iran. When a body part removed for the purpose of commercial transactions is termed as illegal organ trade. These illegal trade trends are positively increasing due to high demands and/or high average waiting time for transplantation (Pattinson, 2008).
There is a famous saying of the illegal market that “desperate people contact the prohibited markets for a donation of organs”. A most frequently transplanted organ in the world is kidney because kidney failure is recognized as a leading cause of people (Cherry, 2015). According to a survey, 8000 donors are dying every year while 75000 people approximately registered in the waiting lists, so each dying donors providing almost 3.5 body parts on average in the US. The conditions are even more severe in other countries, especially in the Asian region. Another study conducted by United Network for Organ Sharing (UNOS), a nonprofit organization, stated that 15 people from US waiting lists die per day on average who could have saved their lives if got organs on time. Statistics further described that six thousand organs on average are providing by the living donors, meaning that more than five thousand individuals from the kidney transplant waiting lists die per year.
Day by day rising demand of the organ donation is a very complex challenge, not only because of clinical demands of transplantation, allocation, and recovery but also because of emotional sides of the decision that facing by the families of individuals. Significant and growing trends of the kidney transplants causing bigger organs waiting population. The reasons for increasing kidney failures include poor eating habits, obesity, Type II Diabetes, and progressively poor health conditions. Hence, these reasons lead to kidney failures of individuals which increase kidney demand that ultimately provoke illegal organ transplant trade. Another strand of literature further points out that the rising fast food markets, reduction of physical stimulation and drug addiction for depression of kidney failure are other contributing factors of nasty eating behaviors which consequently add more people into the long organs waiting lists (Cherry, 2015).
Obesity is a complex disorder and documented as a preventable cause of death around the world. Majority of the obese patient global family are falling in the end-stage renal disease. There is a plethora of research available claiming that end-stage renal disease patient has a survival disadvantage on dialysis as compared to the transplantation. Although, the greater part of obesity patients have plenty of other associated health problems which restrict them from enrolling into the organs transplant waiting lists. Medical research also revealed that when it comes to the kidney transplants, diabetes and obesity patients put themselves at a higher risk of undesirable consequences, for example, urine protein and acute rejection, graft failure and delayed function of the graft. A major risk connected with the obesity patient is graft failure which is also verified by the Cox regression modeling hazard ratios. A key observation from the medical literature is that the normal weight individuals have lower risks of adverse consequences attached to kidney transplantation as compared to pre-obese overweight individuals (Satz, 2008).
End-stage renal disease patient population that demanding dialysis treatment is rapidly growing but, on the other hand, kidney donors availability is rapidly declining. This complex situation boosting the average waiting time for the lifeless donor transplant. As mentioned earlier, due to the worldwide shortage of donated organs a large number of people dying on a daily basis from the waiting lists. There are plenty of initiatives have taken the governments around the world to increase the donor pool but no significant outcomes bring into being from these measures because the donors and patient family still has the right to take final decisions about transplantation (Pattinson, 2008).
Although trading, sale or donation of human organs is illegal in the majority of the countries and recognized as disreputable by the major health organizations, but the willful sale of human organs is significantly increasing due to the lack of donors availability and increase in demand. On the other hand, plenty of countries including the United States is now legalizing the kidneys sale for those who have the capability to do so. These reason behind these initiatives is to upsurge the donor’s pool, despite the fact that there is high life-threatening risks attached to these immoral practices. Kidney pool of donors can also progress if trading of this body organ makes legal at of a rational price to the donors. Another strand of studies also suggesting that there should be government agencies to help the system with appropriate marketing, management, and supervision approach. It would be sustainable and financially strong structure because expenditures of payments to donors would balance out the cost reduction of dialysis (Ma et al., 2016).
Plenty of empirical studies claiming that there is a strong and positive correlation exists between the black market and waiting list. To keep the discussion simple, rise in organs transplant waiting list leads to a rise in the black market of organ trade. The justification behind these empirical propositions is simple; people become desperate and look for the organ donors of the black market due to increasing trends of transplant waiting lists because wait for a couple of years to get transplantation of an organ can cause early death. As brought up earlier, the black market works in violation of government codes of practice where unlawful trade of human organs takes place. Because everything is illegal in these black markets so the government has no authority or hold to control them.
Organ trading black market is familiar as the most controversial and immoral sales market which is booming during the last couple of decades. Because of the sensitivity of organ donating, the system can become irrepressible and destructive if it is dominated by dishonest brokers and doctors. Another important thing to mention here about the black market is that the victims of wrong transplantation cannot argue to the state because they know that the procedure is prohibited by the government. Therefore, in order to assure the meagerness of the black market, human organ stealing must be controlled and structured by the different institutions and local governments (Satz, 2015).
History has proven that organ trafficking is a global crisis, it would disgrace the state if exposed to how often these black markets are being practiced in a particular country (Kishore, 2005). According to World Health Organization (WHO), trade or sale of the human body part is a discriminating deed because one party is getting an advantage during the process of being financially strong while another party is selling body part due to his vulnerabilities and less fortunate. Global Financial Integrity research states that illegal organ trade is significantly increasing in almost every country, including developing and developed. Plenty of organ trafficking assertions are thought-provoking and difficult to prove due to the unavailability of reliable data and the absence of proof. Many cases related to the human organ black markets have been filed and prosecuted in different countries but no serious results found (Pattinson, 2008).
In this research essay, we comprehensively examine the sale, trade or donation of human organs around the world. We shed light on the black markets of human organ trafficking and attached higher risk of undesirable consequences. After keen evaluation of bulk of medical studies, we conclude that the rise in organs transplant waiting list leads to rising in the black market of organ trade. Likewise, illegal trade trends are positively increasing due to high demands and/or high average waiting time for transplantation. In sum up, key causes of the trading boom in black markets include depressing and costly procedure, higher demands and lengthy process of big waiting lists. There are plenty of factors which defines the length of transplantation waiting time period, matching compatibility of the organs is one of the most important among them.
Cherry, M. J. (2015). Kidney for sale by owner: human organs, transplantation, and the market. Georgetown University Press.
Kishore, R. R. (2005). Human organs, scarcities, and sale: morality revisited. Journal of medical ethics, 31(6), 362-365.
Pattinson, S. D. (2008). Organ trading, tourism, and trafficking within Europe. Med. & L., 27, 191.
Satz, D. (2008, October). XIV—the moral limits of markets: The case of human kidneys. In Proceedings of the Aristotelian Society (Vol. 108, No. 1_pt_3, pp. 269-288). Oxford, UK: Oxford University Press.
Satz, D. (2015). Ethical Issues in the Supply and Demand of Human Kidneys. Bioethics: An Anthology, 425.
Wu, Y., Yang, T., Li, L., & Ma, W. (2016, July). Ethical issues relating to living organ donation in China. In Transplantation Proceedings (Vol. 48, No. 6, pp. 1875-1878). Elsevier.