The Organ Business: Inside Donors’ and Doctors’ Decisions

For the masses of people living in poverty, the prospect of a quick payout seems too good to be true. They give up a kidney—or some other functioning organ—for a few thousand dollars. If all goes well, their bodies still function, and their families may have a ticket out of poverty.

In the world of illegal organ sales, nothing is cut and dried, least of all the morality of the situation. It isn’t a simple case of the rich exploiting the poor or of a poorly functioning healthcare system. Instead, the payments and transplants result from a world in which very human people do whatever they can to survive.

How widespread is the problem? According to the World Health Organization, around 10 percent of all kidneys transplanted each year from living donors were sold on the black market. How many transplants is that? Some 6,300.

The decision is wrenching. According to a woman who spoke to The New York Times in 2004, ”I had been on dialysis for 15 years and on two transplant lists for seven. Nothing was happening, and my health was getting worse and worse.” She said that eventually, ”my doctors told me to get a kidney any way I could.”  If not, she would die.

Dr. Michael Shapiro, chief transplant surgeon at New Jersey’s Hackensack University Medical Center, sketched the dilemma faced by doctors. He talked to the Times in 2009, after a corruption bust took down public officials and an organ trafficking outfit.

“When you have the suspicion the donor is doing this for the wrong reasons, the question is-what do we do?” Shapiro said. “I don’t have a detective on retainer. I don’t have a polygraph. We’re pretty good at surgery, but part of the medical school curriculum is not interrogation techniques.”

Ultimately, some say, the decision to sell an organ is no one’s business but the person doing the selling. Turkey’s Dr. Yusuf Sonmez has performed thousands of kidney transplant operations. He also faces accusations in a recent organ trafficking case based in Kosovo (see Part One of this series).

While he requires donors and recipients to submit notarized statements that organs haven’t been purchased, he says that he doesn’t pry much further. “I don’t need to ask these questions,” he told the Times in February, “because I do believe that people have their own authority over their own body. They are not stealing, they are not cheating. So this is the shame of the system. Not their shame.”



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