Trafficking of persons for the removal of organs and the admission of guilt of a South African hospital

Organ Trafficking: Why Do Healthcare Workers Engage in It?

Organ trafficking in all its various forms is an international crime which could be entirely eliminated if healthcare professionals refused to participate in or be complicit with it. Types of organ trafficking are defined and principal international declarations and resolutions concerning it are discussed. The evidence for the involvement of healthcare professionals is illustrated with examples from South Africa and China. The ways in which healthcare professionals directly or indirectly perpetuate illegal organ transplantation are then considered, including lack of awareness, the paucity of both undergraduate and postgraduate education on organ trafficking, turning a blind eye, advocacy of organ commercialism, and the lure of financial gain.

Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas

Traditionally, minimal potential organ donor referrals emanate from general medicine departments. We use a clinical vignette to draw attention to challenges related to referral of potential organ donors from general internal medicine departments. In addition, we provide potential solutions to overcome challenges and reflect on the ethical issues of non-referral of potential organ donors. It is hoped that this paper will increase the awareness of organ donation in the medical fraternity in Africa and thus mitigate critical shortages of organs for transplantation.

South-South cross-border patient travel to South Africa

This paper explores intra-regional South-South cross-border patient travel within the context of Southern Africa. South Africa, in particular, has been widely touted as one of the emerging destinations of high-end patients from the Global North alongside other destinations such as Brazil, India, Costa Rica and Thailand. Using South Africa as a case study, the paper demonstrates that South-South cross-border patient travel is far more significant than North-South patient travel both in numerical and financial terms. Every year, thousands of patients from neighbouring countries travel to South Africa in search of medical treatment for procedures that are not offered in their own countries. Despite its size and importance, the South-South flow of patients in Southern Africa is not fully understood and requires further scholarly research.

The invisible issue of organ laundering

Global institutions, although suggesting measures to deter organ trafficking, reiterate the lack of official statistics about this illegal trade. In this article, we explore the reasons why organ trafficking remains unreported. We argue that the complex factors that perpetuate invisibility facilitate trafficked organs being "laundered" in the health care systems of the purchaser's country, hindering accurate estimation of the problem. The factors are as follows: (a) issues of globalization, jurisdiction, and law enforcement; (b) the power of health care professionals; (c) the reimbursement of transplantation costs abroad by insurers; (d) ambivalence of the victim status of the sellers; and (e) the buyers as vulnerable offenders.

A human rights approach to human trafficking for organ removal

Human trafficking for organ removal (HTOR) should not be reduced to a problem of supply and demand of organs for transplantation, a problem of organized crime and criminal justice, or a problem of voiceless, abandoned victims. Rather, HTOR is at once an egregious human rights abuse and a form of human trafficking. As such, it demands a human-rights based approach in analysis and response to this problem, placing the victim at the center of initiatives to combat this phenomenon. Such an approach requires us to consider how various measures impact or disregard victims/potential victims of HTOR and gives us tools to better advocate their interests, rights and freedoms.

A criminological perspective: why prohibition of organ trade is not effective and how the Declaration of Istanbul can move forward

The Declaration of Istanbul is the first document that has been established by the international transplant community that defines and prohibits transplant commercialism and organ trafficking. Its Custodian Group has successfully led various countries to implement legislation against trafficking and commercialism. The question arises, however, whether efforts to prohibit organ trade are realistic and effective. The Declaration differentiates trafficking from commercialism, yet it does not mention how both acts should be approached by policy. Policies that address transplant commercialism work differently from policies that tackle organ trafficking. There is considerable room for improvement in the current prohibitive approach to commercialism and organ trafficking. The Custodian Group and World Health Organization (WHO) should address commercialism by encouraging the expansion of living donation in the same manner as they encourage deceased donation. Furthermore, the Custodian Group and the WHO can improve their strategy to combat organ trafficking by raising awareness for enforcement. To achieve a consistent and effective prohibition of trafficking, legislation and law enforcement must go hand in hand. Ideally, this can best be achieved by close collaboration between the medical field and (international) criminal justice agencies.