Understanding the challenges to investigating and prosecuting organ trafficking: a comparative analysis of two cases

The human organ trade is proliferating globally. However, far fewer cases have been prosecuted than would be expected based on estimates of the crime. Research exploring the challenges to investigating and prosecuting organ trafficking cases is practically non-existent. Also no studies exist that explain these challenges utilizing a criminal justice framework. This article aims to explain the legal, institutional and environmental factors that affected the investigation and prosecution of two organ trafficking cases: the Netcare case, exposed in South Africa and the Medicus case, exposed in Kosovo. It analyzes these factors through a comparative, mixed-method design, utilizing a theoretical criminal justice framework. Both cases constituted globally operating criminal networks involving brokers and transplant professionals that colluded in organizing illegal transplants. Both cases contained human trafficking elements, however only the Medicus case was prosecuted as a human trafficking case. Legal uncertainty, a lack of institutional readiness and cross-border collaboration issues hampered investigation and prosecution of the Netcare case. The Medicus case also reported problems during cross-border collaboration, as well as a corrupt environment and institutional barriers, which impeded a successful case outcome. Recommendations to improve enforcement of organ trafficking include improving identification of suspicious transplant activity, strengthening cross-border collaboration and enhancing whistleblower protection laws.

The illegal trade in organs and poverty in India

The recent rise in malfunctioning metabolic conditions has significantly increased the demand for organs for transplantation throughout the world, against an inadequate supply. This has paved the way for a lucrative global black market for purchased organs. Evidence suggests that the illegal traffic in organs is primarily from the impoverished to the affluent, and often from women to men. The growing income disparity within Brazil, India, and China has helped to fuel the illegal organ trade both within countries as well as with other nations. This chapter provides a detailed account of the illegal organ trade in India and an overview of the trade in Brazil and China. The chapter concludes by drawing a comparative analysis of the illegal organ trade within Brazil, India, and China. Poverty, debt, and the resulting capability gaps emerge as the most compelling factors keeping the illegal trade alive for decades in these countries.

A Mosque-Based Qualitative Study on American Muslim Women’s Organ Donation Beliefs

Introduction: Detailed studies on the associations between religious beliefs and organ donation attitudes among religious minorities remain wanting. Although Muslims appear to have low rates of support for donation, how these behaviors relate to religious frameworks requires further investigation. Methods: We sought to explore the relationship between religious beliefs (Islam) and organ donation attitudes through focus groups with 43 Muslim women from 5 Chicago-area mosques. Purposive selection of mosques generated near-equal representation of Arabs, South Asians, and African Americans, as well as diversity in education and income. Using the theory of planned behavior as our conceptual framework, we expanded the traditional normative domain to include religiously informed beliefs. Findings: We found that the relationship between religious beliefs and Muslim attitudes toward organ donation is more complex than commonly perceived. Regarding the Islamic ethicolegal permissibility of organ donation, participants expressed a range of normative beliefs. Furthermore, participants voiced concerns beyond religious permissibility, including anxieties over modesty violations during the donation process, as well as concerns about purported black market organ trade and medical risks to donors. Discussion: Given that participants raised religious, societal, and biomedical concerns regarding organ donation, our findings suggest that effective educational programs should involve nuanced curricula that teach to the plurality of Islamic ethicolegal opinions and discuss transplantation processes within the United States.

‘I’m not Sherlock Holmes’: Suspicions, secrecy and silence of transplant professionals in the human organ trade

This article presents the results of a qualitative interview study amongst 41 Dutch transplant professionals. The overarching aim was to acquire in-depth understanding of transplant professionals’ experiences with and attitudes towards patients who purchase kidneys. We found that transplant professionals occasionally treat patients who are suspected of kidney purchases abroad. However, they turn a blind eye to their patients’ suspected purchases. Secrecy and silence function as a tacit agreement between patients and their caregivers that keeps the subject of kidney purchase at a safe distance and allows transplant professionals to ignore its suspected occurrence. They thus participate in the building of walls of secrecy and silence in the organ trade.