transplant tourism organ trafficmbh

8/16/2019 Transplant Tourism Organ Trafficmbh

1/52

Medici rezidenti an IV nefrologie

Transplant tourism /Organ traffic

Between life and deat“All human beings are born free and equal in dignity and rights”

Article 1 of the United Nations Universal eclaration of !uman "ights


2/52

Overview

e#nitions$ statistics$ facts%thical issues

"eal life&onclusions


3/52

Introduction

'ne of the great miracles of modern medicine is theability to save a dying (atient through organtrans(lantation

)rans(lant medicine is (racticed *ith great dignity and

(rofessionalism throughout the *orld It forms a model branch of contem(orary science andits scienti#c contribution has been vast and generous

es(ite this$ it is necessary to recognize that there aresome focal (oints of attention in relation to the(racticing of trans(lantation

f the transplants should be a celebration of the gift of health from one person tor and not impoverished victims of organ tra cking and transplant tourism”


4/52

Types of donor

1.Living donor1+1 ,iving related donors1+- .aired e/change

1+0 ood 2amaritan1+3 %motional donors1+4 )rade donors

.!eceased donor


5/52

Numbers

5 %very 16 minutes someone is add to the *aiting list

5 %ach day$ an average of 78 (eo(le receive organ trans(lants

5 An average of -- (eo(le die each day *aiting for trans(lants

5 In -613$ -8$40- (eo(le received organ trans(lants5 And the *aiting list is long9

longhtt(:;;***+organdonor+g

bers mean life< they=re not >ust symbols on (a(er”


6/52

longhtt(:;;***+organdonor+gov


7/52

“The Gap Continues to Widen” from o(tn+trans(lant+hrsa+gov and '.)N;2")" Annual "e(ort+

?? ata include deceased and living donors


8/52

THE huge needs of organtransplant has opened a chance

to organ traffickingand transplant tourism


9/52

Organ traffic

)he recruitment$ trans(ort$ transfer$ harboring$ or recei(t ofliving or deceased (ersons or their organs by means of thethreat or use of force or other forms of coercion$ ofabduction$ of fraud$ of dece(tion$ of the abuse of (o*er or oa (osition of vulnerability$ or of the giving to$ or the receivi

by$ a third (arty of (ayments or bene#ts to achieve thetransfer of control over the (otential donor$ for the (ur(oseof e/(loitation by the removal of organs for trans(lantation )he eclaration of Istanbul on organ tra@c ing and trans(lant tourism+)rans(lantatio

-6


10/52

Tourism Transplant

5 Transplant commercialism is a (olicy or (ractice in *hich an organ is treateda commodity$ including being bought or sold or used for material gain

5 Travel for transplantation is the movement of organs$ donors$ reci(ietrans(lant (rofessionals across >urisdictional borders for trans(lantation (ur(oses

5 Travel for transplantation becomes transplant tourism if it intra@c ing and;or trans(lant commercialism or if the resources Dorgans(rofessionals and trans(lant centresE devoted to (roviding trans(lants to (atientsfrom outside a country undermine the countryFs ability to (rovide trans(lantservices for its o*n (o(ulation

)he eclaration of Istanbul on organ tra@c ing and trans(lant tourism+ )rans(lantation -66B< -7:BCDBE:1


11/52

WHAT TO TRADE ?...


12/52


13/52

Finacial profability

G 0-6 billions H drugsG -46 billions H counterfeitingG 01$C billions H human tra@cG 16$B billions H oil

G 7 billions H timberG 8$4 billions H #shG C$0 billions H art and cultural (ro(ertyG -$0 billions H goldG 1$- billions H human organs

has never made man ha((y$ nor *ill it$ there is nothing in its nature to (roduce ha((iness+of it one has the more one *ants+ “

en>amin Jra


14/52

Actors

"eci(ients

onors

"ecruiters Dother terms used include bro ers$ organizers$connectors$ coordinators$ middlemen$ idney hunters$ etc+E

)rans(lant (rofessionals'ther facilitators: hos(itals$ services (roviders$ translators$ la*enforcement

&ontact through other (atients$ family$ friends$ bro ers$ Inte

“)his is as true in everyday life as it is in battle: *e are given one life and the decisionis ours *hether to *ait for circumstances to ma e u( our mind$ or *hether to act$ and

in acting$ to live+”


15/52


16/52


17/52


18/52


19/52


20/52

htt(:;;***+*ho+int;bulletin;volumes;B4;1-;6


21/52


22/52

"a#or organ e$porters : .a istan$&hina$ India$ .hili((ines$ olivia$ razil$Iraq$ U raine$ "ussia$ Kosovo$ "e(ublicof Moldova$ Israel$ .eru$ )ur ey$ %gy(t$

angladesh $2outh Africa9


23/52

"a#or organ importers : Australia$

&anada$ Israel$ La(an$ 'man$ 2audiArabia and the U2A


24/52

Iran

5 Is the country in the *orld *here selling an organ legal

5 )he mar et is contained *ithin the country< that is$ foreignersare not allo*ed to buy the organs of Iranian citizens


25/52

China

5 !as the lo*est donor rate in the *orld

5 1$4 million (eo(le need an organ$ and only 16+666 get one legal

5 86 of organ trans(lant are from deceased (risoners D 18B3 la*E

5 oth U2 &ongress and the %uro(ean .arliament have (assed resolutions

condemning &hinese regime=s (ractice of forced organ harvesting from(risoners

5 )hey believe the organs come from members of the Jalun ong movement 5 aquasiHreligious grou( *ith millions of follo*ers$ *hich is banned by the &hinese

overnment


26/52

India

5 Attem(ted to legalize selling organs in 1883

5 )he Voluntary !ealthAssociation of India estimates that about-666 Indians sell a idney every year

5 'rgans are sold online

5 Many doctors (artici(ate to earn e/tra money5 ecause of corru(tion$ organ tra@c ing is (revalent almost

every*here


27/52


28/52

Moldova

5 !olds an im(ortant s(ot among%uro(ean countries for illegal organtra@c ing< *orld*ide$ is one of the to

0 source countries5 )he government has no la*s against

illegal organ tra@c


29/52

Romania – no exception

5 )he theme rarely touched by media

5 &ruel reality +++

5 2tate su((lier and transit (oint in organ tra@c ing

5 It estimated about -$666 "omanian citizens sold theirorgans in last 16 years

5 Most mar eted organs are idneys and liver

5 Israel$ )ur ey and 2outh Africa are the destination oforgans from "omania


30/52

Romania – legislationLegea nr. 95/2006

5 Art+ 147+ D1E&onstituie infrac iune Oi se (ede(seOte cu Pnchisoare de la 0 la 4 ani fa(ta (ersoanei de a donaorgane Oi;sau esuturi Oi;sau celule de origine umanQ$ Pn sco(ul ob inerii de foloase materiale sau de altQ naturQ$(entru sine sau (entru altul+

5 D-E eterminarea cu reaHcredin Q sau constrRngerea unei (ersoane sQ doneze organe Oi;sau esuturi Oi;sau celulede origine umanQ constituie infrac iune Oi se (ede(seOte cu Pnchisoare de la 0 la 16 ani +

5 D0E.ublicitatea Pn folosul unei (ersoane$ Pn sco(ul ob inerii de organe Oi;sau esuturi Oi;sau celule de origine

umanQ$ (recum Oi (ublicarea sau mediatizarea unor anun uri (rivind donarea de organe Oi;sau esuturi Oi;saucelule umane Pn sco(ul ob inerii unor avanta>e materiale sau de altQ naturQ (entru sine$ familie ori ter e(ersoane #zice sau >uridice constituie infrac iune Oi se (ede(seOte cu Pnchisoare de la - la 7 ani

5 Art+ 14B+D1E'rganizarea Oi;sau efectuarea (relevQrii de organe Oi;sau esuturi Oi;sau celule de origine umanQ(entru trans(lant$ Pn sco(ul ob inerii unui (ro#t material (entru donator sau organizator$ constituie infrac iuneade tra#c de organe Oi;sau esuturi Oi;sau celule de origine umanQ Oi se (ede(seOte cu Pnchisoare de la 0 la 16 ani

5 Art+ 148 Introducerea sau scoaterea din arQ de organe$ esuturi$ celule de origine umanQ fQrQ autoriza ias(ecialQ emisQ de Agen ia Na ionalQ de )rans(lant constituie infrac iune Oi se (ede(seOte cu Pnchisoare de la 0

la 16 ani


31/52


32/52


33/52


34/52

The background of organ recipients

5 ,ong *aitlists and *aiting times Denhancing the ris of dying on dialysisE

5 Not being admitted to the *aitlist or being deHlisted because of health condition

5 2ee ing a (reHem(tive trans(lant Dbefore starting dialysisE

5 Not *anting to as relatives for a live donation

5 No (ossibility of or access to trans(lantation in the home country De+g+ African countriesE5 elonging to an ethnic minority in the country of residence< having the idea that one

has better

5 Access to a trans(lant in the country of origin$ or the (ossibility of a betterHmatchedidney


35/52

Characteristics o f organ suppliers/victims

5 &oming from (oor develo(ing countries Doften indicated as SorganHe/(ortingcountriesE$ or belonging to a (art of the (o(ulation living belo* (overty line

5 eing in a (osition of vulnerability Dbeing (oor$ an illegal immigrant$ a refugeeE

5 ,ac of basic medical no*ledge$ not a*are of (otential health consequences ofhaving a idney removed

5 ,o* education level$ being illiterate

5 Toung age grou( D1BH06 yearsE$ mostly males

5 'ften lured into organ removal by fraud and dece(tion$ or coercion

5 Jrom a home country that lac s a legislative system to e ectively (rohibit and(rosecute tra@c ing in (ersons$ high level of corru(tion


36/52

Majority says!

5 “'rgan tra@c ing and trans(lant tourism violate res(ect for human dignity and the(rinci(les of equity and >ustice and should be (rohibited+ ecause trans(lantcommercialism targets im(overished and other*ise vulnerable donors$ it ine/orablyleads to inequity and in>ustice and should be (rohibited”

5 “&ommitted to the (rinci(les of human dignity and solidarity *hich condemn thebuying of human body (arts for trans(lantation and the e/(loitation of the (oorestand most vulnerable (o(ulations and the human tra@c ing that result from such(ractices

5 “)he en>oyment of the highest attainable standard of health is one of the fundamentalrights of every human being *ithout distinction of race$ religion$ (olitical belief$economic or social condition” DW!' &onstitution$ 183CE

ThCfLdEthi


37/52

The Conuence of Law and Ethics

Living !onors

"edical +thics Legal /rinciples

rgans 0forTransplantation

/rimum non nocere 0vs. bene3t torecipient

Body is not property

(o buying4selling of /aternalism human beings

5ights 0includingpatient “autonomy”


38/52

5 a 2ummit Meeting of more than 146 international re(resentatives of scienti#cand medical bodies$ government o@cials$ social scientists$ and ethicists *asheld in Istanbul$ )ur ey from A(ril 06 to May -$ -66B

5 ma es no conclusion regarding the ethical (ro(riety of this (ractice$disclaiming social circumstances that may have (ro(elled these (atients to

travel for trans(lantation5 distinguishes travel for trans(lantation from trans(lant tourism

5 (rovides additional guidance that travel for trans(lantation may be ethical ifthe follo*ing conditions are ful#lled


39/52

The Istanbul declaration onOrgan Trafcking and TransplantTourism

6or Live !onors

5 if the reci(ient has a dual citizenshi( and *ishes to undergotrans(lantation from a live donor that is a family member in acountry of citizenshi( that is not their residence<

5 if the donor and reci(ient are genetically related and *ish to

undergo trans(lantation in a country not of their residence<6or !eceased !onors

5 if o@cial regulated bilateral or multilateral organ sharing (rogramsbased on a reci(rocated organ sharing (rograms e/ist bet*een oramong countries or >urisdictions

TheWorldHealthOrganization(WHO)


40/52

The World Health Organization (WHO)“Guiding P rinciples on Human Cell, Tissueand Organ Transplantation” -May 2010


41/52


42/52

5 describes the characteristics and outcomes of 00 idneytrans(lant reci(ients *ho traveled abroad for trans(lant andreturned to University of &alifornia$ ,os Angeles DU&,AE forfollo*Hu(

5 .osttrans(lantation outcomes *ere com(ared bet*een tourists

and a matched cohort of (atients *ho under*enttrans(lantation at U&,A Dmatched for age$ race$ trans(lant yedialysis time$ (revious trans(lantation$ and donor ty(eE

5 Median follo*Hu( time *as 3B7 d Drange CB to 064CE

&lin L Am 2oc Ne(hrol 0: 1B-651B-B$ -66B+ doi: 16+--14;&


43/52

Results:5 tourists included more Asians and had shorter dialysis times

5 most (atients traveled to their region of ethnicity *ith the ma>ority undergoing

trans(lantation in &hina D33 E$ Iran D1C E$ and the .hili((ines D10 E5 living unrelated trans(lants *ere most common

5 tourists (resented to U&,A a median of 04 d after trans(lantation+

5 four (atients required urgent hos(italization$ three of *hom lost their grafts+

5 seventeen D4- E (atients had infections$ *ith nine requiring hos(italization

5 one (atient lost her graft and subsequently died from com(lications related to donorHcontracted he(atitis

5 oneHyear graft survival *as B8 for tourists and 8B for the matched U&,A cohort D. 6+74E

5 the rate of acute re>ection at 1 yr *as 06 in tourists and 1- in the matched cohort+

7onclusions8 Tourists had a more comple$ posttransplantation course with a higherincidence of acute re#ection and severe infectious complications


44/52

Pro …organ payment

HIranian model again9

H-66B 2inga(ore legalises com(ensation (ayments to idney donors

H-610 Australia *or ers *ho *ant to donate a idney *ill be o ered u( to si/ *ee s(aid leave at minimum *age$ u( to G0C66$ under a federal government (lan toreduce the *aiting list for lifeHsaving organs


45/52


46/52

Transplant Tourism Versus Proper Travelfor T ransplantation

)ravel for trans(lantation is the movement of organs$ donors$ reci(ients$ ortrans(lant (rofessionals across >urisdictional borders for trans(lantation (ur(oses+Not all travel for trans(lantation is unethical:

5 %/istence of an o@cial regulated deceased donor organ sharing (rogram bet*eeninvolved >urisdictions

5 "everse trans(lant tourism


47/52

The E uropean InternationalTransplantFoundations

5 nonH(ro#t organizations res(onsible for encouraging and coordinatingorgan trans(lants

5 all trans(lant clinics$ tissueHty(ing laboratories$ and hos(itals in themember countries *here organ donations ta e (lace are included in

the e/change5 one common list for each organ

5 %urotrans(lant : Austria$ elgium$ &roatia$ ermany$ !ungary$,u/embourg$ Netherlands$ and 2lovenia< the headquarters H,eiden$Netherlands

5


48/52

)he to(


49/52

)he to(


50/52

l


51/52

Conclusion

octor can I buy a idneyX


52/52

Va

multumim!

transplant tourism organ trafficmbh

Documents