A Thought on Organ Trafficking or Medical Tourism
Ludwig Frontier
MD, MBA, DHSc.
Undoubtedly, one of the milestones in medicine is the development of transplants of human organs, which has dramatically increased the chances of curing multiple ailments. What supposes that this technique's universalization causes transplantable human organs to be more and more demanded and, therefore, simultaneously scarce, which generates long waiting lists of patients who await a transplant to achieve their cure. Precisely this growing demand for human organs can lead to certain phenomena, from the configuration of a black market of human organs or the illegal obtaining of organs from deceased people to conduct that involves organ trafficking, understood as the extraction of forced organ transplantation.
In a society where everything is bought and sold, it comes to the extreme of considering the person himself as a commodity. Organ transplants are a new life expectancy for hundreds of thousands of sick people and a lucrative business for some. There are many opinions reported about the advantages and disadvantages of medical tourism, what to do and what not to do, and of course, the stories with a brutal and often deadly moral that leaves us with our mouths open and produces nightmares. With the vertiginous technological advances in the last decade, the unpreventable globalization era brings a bioethical perspective about who benefits and who loses in the medical tourism world. Transplant tourism is when a person travels to another country for the sole purpose of being transplanted because, in their place of residence, they do not find the right conditions (the long waiting list, no transplant unit available, soaring prices, among other reasons).
Organ trafficking and transplant tourism is a global problem, which occurs in five continents. Through the Custodial Group of the Istanbul Declaration, the International Transplant Society has proved this type of crime in Pakistan, Bangladesh, the Philippines, Turkey, Israel, or China, among other countries. Some of these countries have made notable efforts in recent years to eradicate this phenomenon. Who loses? The welfare. Who wins? It exploits these social discrepancies and is based on global inequities.
Why is it so wrong to pay for a kidney? Depression, regret, and discrimination. It seems that poverty drives people to make decisions that will worsen their overall health status with time. One of every 10 of all the transplants in the world is performed under some form of commercialization, generally through transplant tourism, which makes it possible for patients with economic resources from countries with deficient transplant programs to developing countries where legislation against the sale of organs is nonexistent or inadequate.
The trafficking of organs is a growing and multidimensional phenomenon, with the aggravating circumstance that interventions carried out outside legal systems lack control and the necessary guarantees. The medical tourism outbreak highlights the privatization of health care's lucrative advantages, the growing dependency on technology, inequality to health care resources, and the fast-tracked globalization of health care and tourism. Health authorities struggle to update their legal frameworks because it means to fight potential economic interest.
The best attempt to fight this activity was back in 2016, the Declaration of Istanbul Custodian Group, an international, multidisciplinary workshop in Madrid, Spain, that presented a position statement about transplant tourism management. I think this was a wrong approach because they tried to enforce law enforcement and persecution, urging governments and professionals not to cover transplants' costs resulting from an organ or human trafficking and to improve the information system to law enforcement agencies.
A year later, the Pontifical Academy of Science in the Vatican City convened in 2017 a Summit on Organ Trafficking and Transplant Tourism to increase the criminalization of organ tourism, including donors and recipients. Persecution and criminalization are necessary but putting lives at risk by denying coverage and making them afraid to go for health attention when needed can be a health-threatening situation that I find inappropriate. Finally, organ transplantation is the best alternative treatment and, in many cases, the only one, for the terminal and irreversible failure of many vital organs such as the heart, liver, or kidneys, despite the attachment to being alive and the economic despair of some feeds the scary business of clandestine trafficking of human organs in the world. This activity knows no borders or limits.
Ludwig Frontier is a Human Rights -Global Health advocate from Atlanta. He is a Doctor of Medicine from Instituto Tecnológico de Santo Domingo and a Doctor of Health Science with a Global Health Specialization from A.T. Still University. He also holds a Professional Cellular Therapies Certificate from George Washington University and an MBA in Strategic Management from Universidad Interamericana de Panama. In actuality, he is a scholar for Anáhuac University’s Master of Global Bioethics.
Personal email: Ludwig.frontier@gmail.com ludwig.frontier@anahuac.mx