In my previous post I discussed the reasons for the organ donor shortage and touched a bit on the bioethics of being an organ donor. I plan for my next two posts to have more bioethical discussions in them!
My second post I would like to talk about the Black Market for Organ Transplants. Basically a quick summary of the organ sales on the black market is people selling (or stealing) healthy organs from individuals to be used in patients awaiting transplant. Now typically in the United States we have a "waiting-list" set up, that shifts around depending on peoples need for the organ. Typically these organs come from individuals who died perhaps in car accidents, in surgeries, etc. and have declared that they would like to be an organ donor. Another way patients can become recipients is from family relatives. Of course this only works for some organs such as the liver or kidneys. Now I mentioned in my last post I discussed how many people are on the wait list and how many die while waiting for an organ donor. I also mentioned how the number of people waiting is increasing as of 2014 there was almost 100,000 individuals in the Untied States awaiting a kidney transplant alone. Some people can remain on a waitlist for a "necessary life saving surgery" for as long as seven years. Everyone has a will and a drive to live and as people become desperate and hopeless they will resort to anything.
That is where the black market organ sales can become very profitable. One study by the World Health Organization, found that more than one organ is sold every hour worldwide, most of these are kidneys. One example I found in my research said that a black market ring was discovered in South Africa in 2003 that was found to be buying organs from citizen of the slums of Brazil. They would buy the organs from the individuals for $6,000-$10,000 and then turn around and sell the organs for $100,000. Another source stated that a middle man in Israel in the black market organ trade made 4 million dollars before being caught. In the United States it is illegal to receive any profit from the sale of organs. However this does not mean there are no Black Market Organ rings in the US. I was surprised to read about funeral homes "chopping-up" bodies for their organs and tissues before being cremated. It sounds like the perfect crime once the receive the samples the body is cremated and no one will know. If this was not already troublesome sounding it gets worse. Often times these individuals may have died from an infectious disease however it is not noted on the paperwork that infectious disease was the cause of death for the patient they are receiving the organs from. It was estimated that as many as 90 patients can be recipients of tissues from only one cadaver. The tissue samples are harvested and then sold to research facilities for profit. Such a group was started in New York City in 2000 led by Dr. Michael Mastromarino an oral surgeon and Joseph Nicelli an embalmer. Often times because of urban myths and television shows we sometimes think of people being kidnapped and their organs harvested with out their permission. Although this does happen the previously stated ways are much more common means of obtaining organs and tissue samples for Organ sales.
As social media becomes more popular people are now turning to Facebook of all places to start advertising for looking for organs. In 2014 a brother posted about needing a kidney for his sister and in less than a week they had received 11 responses from people offering to donate asking for as much as $50,000 dollars. Facebook does not allow "Organ For Sale" ads to be posted online. However Facebook did start an initiative in 2012 to encourage people to sign up for state registries. After the first day 6,000 people had signed up.
I think there are two main bioethical discussions here. I think with out a doubt everyone can agree that stealing organs or kidnapping people for their organs and tissues is wrong I do not think that is even worth discussing any further. The bioethical debates I see are in sales of organs. People are allowed to sell there blood plasma for profit. Granted having your blood drawn and having an surgery that is removing an organ are drastically different. But I wonder if it was legalized and regulated the organs and tissues may be screened for disease when in the black market they may not. Also I think people would receive better quality care then having these surgeries done in make shift operating rooms. We may also be able to bring down that ridiculous cost that people are paying for the organ I think it is ridiculous that middle men are making roughly $90,000 per patient by exploiting the ill and desperate. However the dilemma I see is people with lots of money will be able to buy the necessary organs while the poor will remain on the waitlist simply because they can not afford the organ. If there is a positive side to this it could be that as the wealthy buy organs they are essentially removed from the wait list allowing for others to have a chance at receiving and organ transplant. The other discussion I see here is the use of social media for organ donations. Maybe one day we will be scrolling through our news feed see an Ad for a puppy to adopt, a race to run, and then an kidney to buy.... I think that it sounds really bizarre but social media of any kind has built a reputation for getting peoples attention and essentially "getting things done."
Lower cost sand greater safety are worth a lot, perhaps even a lot of "bizarre" and distasteful commercial marketeering.
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