International Organ Trafficking and Medical Ethics

Abstract

Medical ethics is are an exceedingly complex topic and with today’s advancements in technology the debate only gets more intricate and weightier. This paper addresses the current problem of organ trafficking that the world faces today and has faced for several decades. Medical ethics are also discussed in this paper, in the light of changing values within our society and the medical fields.

Organ distribution is a practice that has become common in the medical field but finding enough organs to distribute can become a hitch in the process. Finding people who are willing or able to give up an organ is an extremely hard task. Organ trafficking clearly contradicts several medical ethics, such as autonomy, non-maleficence, justice, and informed consent. This why organ trafficking has become such a concerning problem, because doctors must try their best to help people who are in need of organ transplantation but doing so may be killing or worsening another patient’s life. Middle Eastern and Asian countries continue to traffick poor people or even prisoners for their organs, and this situation must be rectified. Organ trafficking oppresses certain demographics and only benefits the few that can afford it. There are countries trying to find solutions to this dilemma, but none have been set into motion.  The goal of this paper is to educate people about organ trafficking, and in raising awareness motivate today’s society to continue to work to find a solution to this ethical and medical problem.

International Illegal Organ Trafficking

1. Medical Ethics

1. Personally, I believe medical ethics are the collection of moral beliefs and values that all medical practitioners try their best to follow, in respect to the patient and their work. Medical ethics shape the way doctors, nurses, and others involved in the medical field interact and take care of patients. Proverbs 31:8 says “Open your mouth, judge righteously, and defend the rights of the poor and needy,” and doctors must take that into consideration when they take care of their patients, who are, at their core, human beings. In the traditional Hippocratic Oath it states “I will use those … which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them,” this line especially sums up my belief of medical ethics: that whatever a practitioner may face they must rely on these foundational statements of morality to shape everything they do.

II.      Medical ethics are moral criterion that are based upon four values:

autonomy, non-maleficence, beneficence, and justice. Autonomy is belief that every human has dignity and is respected (Varelius, 2006). Non-maleficence insinuates that the doctor must do as little harm as possible (do no harm) in the process of treatment. Beneficence is the value that all medical professionals uphold, that you are to do good to others and that treating a patient in their best interest is your goal (Beauchamp, 2007). Lastly, justice is universally known as jus treatment of others. In the medical field justice is the idea that the burdens and benefits of treatments must be distributed equally. Within the value of justice comes many debates but the main factors of judgement are fair distribution of scarce resources, competing needs, and rights (Johnson, n.d.).

III. Ethical Dilemmas

1. Numerous ethical dilemmas are within the topic of organ trafficking. Namely, that it heavily rests upon the disadvantage of the weakest in society, preying upon their social and financial status to lure them into the trafficking (Harris, 2002). Organ trafficking insinuates the trade of human bodies, based on their worth. Ethically, this issue enforces oppression to lesser classes which exploits the value of justice (Danovitch, 2013).
2. The medical ethical principles addressed in this paper and how they relate to the topic.

WORDS: Autonomy, non-maleficence, justice, informed consent.

The principle of autonomy is fundamentally rejected in the act of organ trafficking, because it strips any respect for an individual other than the worth of their organs. Non-maleficence is clearly disregarded particularly because the balance between the risks and benefits is very unreliable, specific to each case.  Justice is challenged since the poorer/weaker people are targeted by this market. They are manipulated into this market because of their circumstances and in most cases only the wealthy are recipients of organs. Informed consent is contradicted since the people who are coerced into selling their organs aren’t informed of the risks of the procedure.

2. The Medical Dilemma

1. Organ trafficking is an international problem and in the recent decades it has been uncovered in Israel, China, Kosovo, and even in the United States (Rogers, 2019).  Israel has long been a hotbed for trafficking, reaching its peak in the 90s and early 2000s. In 2007 there were several trafficking rings exposed, and in 2008 the Knesset law banned purchase and sale of human organs (Klein, 2018). In the past three years, reports from CNN, the WSJ, Forbes, Washington Post and more unveiled China’s practice of mass harvesting prisoners on death row. Kosovo’s Lutfi Dervishi and Sokol Hajdini were convicted again in 2016 (originally in 2013) for illegal transplanting organs in their unlicensed clinic. Dervishi was found to be part of an international criminal organization and using his position as a surgeon to remove patient’s organs (Morina, 2018).
2. An ethically defensible market in organs (Defense vs. Prosecution)
   1. DEFENSE: American health officials believe that establishing a monopsony, where only one buyer exists for the products of multiple sellers, could reduce the unfair distribution of organs. That purchaser must take on responsibility for ensuring equitable distribution of all organs and tissues purchased. This marketing method would hopefully curb the rich from using their financial advantage to exploit the market at the expense of the poor (Harris, 2002).
   2. Prosecution: In the case of a monopsony, only one buyer (most likely being a national corporation) decides on the distribution and worth of the organs. This automatically raises the uncertainty that purchaser being fair and equitable distribution of all materials. Placing any monetary value on the body quickly negatehuman dignity by placing it at the same level as an economic market. The human body should never be degraded to only a product on the market for profit (Marino, 2002). It is wrong to prey upon people lesser than us for our own benefit (Proverbs 31:8-9, ESV).

3. Personal and Biblical Application

1. I believe that creating a monopsony is a risky way to take on organ distribution. In discordance to my personal definition of medical ethics, the monopsonic structure is something that can be easily corrupted and be used against patients. It is great that the proposed structure is able to free the poor from being the main oppressed demographic, but if the distributor (or people within that work force) become corrupt or manipulative (which is easy in our fallen nature). That is clearly against taking care of the patient and doing their best to help them.
2. I don’t believe that any trafficking is good. In the case of organ trafficking, it places a worth simply on someone’s organs, but in 1 Corinthians 6:19-20 (ESV) it says, “Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? … Therefore, honor God with your bodies.” In that verse we are clearly told that we were worth more than the price of any organ. Organ distribution is an, and it unfortunately is   what fuels the trafficking since people become desperate to acquire organs. Organ transplantation is something that has become a norm in our society and crucial to many, but we must work to find a steady income of them without relying on trafficking individuals for parts of their bodies.

References

Abbud-Filho, Mario & Al-Mousawi, Mustafa & Alobaidli, Ali & Alrukhaimi, (2008). Organ

trafficking and transplant tourism and commercialism: the Declaration of Istanbul. The

Lancet. 372. 5-6. doi:10.1016/S0140-6736(08)60967-8

Ambagtsheer, F., Zaitch, D., & Weimar, W. (2013). The battle for human organs: organ

trafficking and transplant tourism in a global context. Global Crime, 14(1), 1–26. doi:

10.1080/17440572.2012.753323

Beauchamp, T.L. (2007). The “four principles’ approach to heath care ethics. In R.E. Ashcroft,

1. Dawson, H. Draper, and J.R. McMillan (Eds). Principle of health care ethics.

doi: 10.1002/9780470510544.ch1

Brody, H. (1989) Transparency: Informed consent in primary care. Hasting Center Report,

19: 5-9. doi: 10.2307/3562634

Danovitch, G. M., Chapman, J., Capron, A. M., Levin, A., Abbud-Filho, M., Mousawi, M. A.,

Delmonico, F. L. (2013). Organ trafficking and transplant tourism. Transplantation Journal, 95(11), 1306–1312. doi: 10.1097/tp.0b013e318295ee7d

Greenberg, O. (2013). The global organ trade. Cambridge Quarterly of Healthcare

Ethics, 22(3), 238–245. doi: 10.1017/s0963180113000042

Harris, J. (2002). An ethically defensible market in organs. Bmj, 325(7356), 114–115. doi:

10.1136/bmj.325.7356.114 (CHECK?)

Johnson, A. (n.d.). What are the basic principles of medical ethics? Retrieved from

https://web.stanford.edu/class/siw198q/websites/reprotech/New Ways of Making Babies/EthicVoc.htm

Marino, I. R. (2002, August 23). A response to an ethically defensible market in organs.

Retrieved October 2, 2019, from https://www.bmj.com/rapid-response/2011/10/29/mar

ket-organs-unethical-under-any-circumstances.

Morina, D., Iberdemaj, B., & Birn. (2018, November 2). Kosovo convicts two in organ-

trading trial. Retrieved October 2, 2019, from https://balkaninsight.com/2018/05/24/ko sovo-organ-trafficking-medicus-trial-verdict-05-24-2018/.

Rogers, B. (2019, February 5). Opinion | The nightmare of human organ harvesting in China.

Retrieved October 2, 2019, from https://www.wsj.com/articles/the-nightmare-of-human-

organ-harvesting-in-china-11549411056.

Trey, T., Caplan, A. L., & Lavee, J. (2013). Transplant ethics under scrutiny – responsibilities of

all medical professionals. Croatian Medical Journal, 54(1), 71–74. doi: 10.3325/cmj.20 13.54.71

Varelius J. (2006). The value of autonomy in medical ethics. Medicine, health care, and

philosophy, 9(3), 377–388. doi:10.1007/s11019-006-9000-z