Introduction
In both industrialized and developing nations, organ transplantation has proven to be the most successful and, in some circumstances, the only treatment option for terminal organ failure. The transplantation community has been promoting the reasonable safety of live donation of tissues, such as blood and bone marrow, and organs, such as one of a healthy subject’s two kidneys, a piece of the intestine, the liver, and even the pancreas. The only country that has legalized the trade of kidneys worldwide is Iran (Stammers, 2022).
Therefore, there is an increasing shortage of human organs for replacement worldwide. As a result, the illegal market of kidney sales has skyrocketed. Some of the factors that fuel the sale of kidneys include the financial profitability of the business, high demand for kidneys, the ease and satisfaction of the trade, and a lack of education. Consequently, the effects of the kidney trade include psychological and social consequences, undermining the noble cause of transplantation and violating fundamental human rights.
Causes of the Illegal Kidney Trade
The primary reason for kidney sales is the financial gain associated with selling a kidney. Today, the demand for kidney transplants is high, making them one of the most sought-after organs for transplantation. The global shortage of organs and a rising demand for kidney transplants have made the industry highly lucrative, characterized by substantial, rapid, and substantial financial gains (Widodo & Utami, 2021).
According to World Health Organization (WHO) statistics, there are approximately 10,000 illegal kidney transplants that take place throughout the world annually (Stammers, 2022). According to popular perception, most individuals who sell their organs do so under duress (Widodo & Utami, 2021). However, in practice, their desperate circumstances frequently force them to do so. Many sellers are so destitute that they consider this their last chance to obtain the essential funds for survival.
The second cause of the kidney business is the need for patients to obtain cures in a relatively short time. The procedure of obtaining a kidney transplant from those who donate kidneys for humanitarian purposes takes a significant amount of time, and a patient might die before being reached in the queue. The national waiting list for organ donations, which currently has more than 100,000 people on it, reportedly expands by more than 2,000 names each month (Moeindarbari & Feizi, 2022).
The existing supply of lawfully procured organs is insufficient to meet the demand for them. It is believed that every day in the United States alone, some 18 individuals pass away while awaiting an organ transplant (Moeindarbari & Feizi, 2022). The dilemma of organ supply and demand is not exclusive to the United States, hence the expansion of the black market.
The third reason contributing to the high sales of kidneys is the high cost of alternative options. The cost or danger of selling a kidney is less than the money obtained from other criminal activities (Moeindarbari & Feizi, 2022). The kidney sellers have accurately assessed the cost of committing a crime.
Since they believe it is less unlawful and likely contributes to saving another person’s life, all kidney sellers consistently determine that selling their kidneys is the proper course of action to meet their financial needs. The justification of the kidney vendor is compatible with psychological assumptions that people will behave consistently in a situation and with economic justifications in rational choice theory.
The fourth reason for the sale of kidneys and other organs is the lack of education among the sellers and victims. Poverty and illiteracy are directly related to one another. This is why exploiting trusting individuals is simple for organ traffickers (Widodo & Utami, 2021). According to studies, most people who are forced into selling their kidneys don’t even know what they are.
Some of the physicians involved take this as an advantage and lie to the patients to illegally obtain their kidneys. In most cases, the patients are told the myth of a sleeping kidney. Others are convinced that they only need one kidney to survive, which is partially true. However, they are never told the repercussions of kidney surgery and the risks involved. The victims would make better and sober choices if they were educated.
Consequences of Kidney Commercialization
There are many effects of the commercialization of kidney sales. Firstly, kidney sales endanger the health of individuals and communities. Several studies have shown the far-reaching consequences of kidney sales, including psychological and social effects (Simakani, 2019). Some of these consequences include chronic pain, melancholy, suicidal thoughts, self-loathing, an unflattering perception of one’s body, a feeling of bodily emptiness and isolation, and even physical abuse, assault, and expulsion from one’s own country.
In most cases, one year after selling their kidney, the sellers are in a worse financial situation (Simakani, 2019). Many of the sellers are disqualified from their prior employment because it required them to lift heavy objects, leap and jump, and be unconcerned about the effects of typically arduous work on their bodies. This is because the majority of sellers are poorly educated, unskilled laborers whose livelihoods depend on physical work. Therefore, this is a personal downfall on all three fronts: social, psychological, and economic.
Secondly, kidney sales and other organ sales undermine the initial noble reason behind transplantation. The desperation of both buyers and sellers is exploited in black markets operated by kidney hunters and organ brokers. Even regulated systems, such as those established by the governments of countries like Iran, where kidney sales are legal, rely on impartial “matchmakers” and middlemen (Stammers, 2022).
Some government that advocates for controlled kidney sales have been accused of allowing exploitative solutions, such as issuing work permits to unauthorized day workers and offering them jobs in return for kidneys (Stammers, 2022). As a result, local kidney brokers who operate unchecked and rely on lies and exploitation to make a living collaborate with doctors and hospitals. Therefore, monitoring the compensated donation of living people’s organs cannot be placed in the hands of hospitals or transplant teams.
Thirdly, the practice encourages human trafficking, thus violating fundamental human rights. The current organ scarcity encompasses more than just the affluent exploiting the poor and the vulnerable. The majority of these illegal trades involve either organ trafficking or human trafficking. It is a well-established industry where several multinational organizations are in charge of transporting illegally harvested human organs.
In African countries such as Nigeria, human organs are sold for prices between $2,000 and $3,000 (Stammers, 2022. Children are trafficked and kidnapped for the purpose of selling their organs. Some also murder them once they finish their task of removing any traces of evidence. These activities are serious violations of fundamental human rights.
Ethical Debate on Legalizing Kidney Sales
On the contrary, those who advocate for kidney sales argue that legalizing the sales of kidneys and other organs will solve the issue of the shortage of transplantable organs. This claim is partially valid since the current shortage has been attributed to the low number of kidney donations. However, the claim overlooks fundamental ethical concerns (Simakani, 2019). A discussion of the ethics of organ sales should precede any consideration of the economic or practical benefit of organ sales. It is impossible to frame ethical issues for a later evaluation.
The use of any accessible methods cannot be justified by the aim of an expanded supply of organs; the end does not justify the means in this case. Additionally, demonstration projects that claim to prove that payments “work” may overlook the crucial ethical concern of the methods employed to achieve them (Simakani, 2019). Adopting a market strategy with a cost-effectiveness focus has significant social, ethical, and professional repercussions. Before starting even a trial project, lawmakers, policymakers, or the transplant community must weigh these repercussions in their choice to move forward with payment for organ donation.
Other proponents of the commercialization of human kidneys say that legalizing the act will enable authorized brokers to profit and eliminate illegal trade. They claim this will improve the quality of supplied organs and minimize harm to the public. This point can only be closer to the truth, but not entirely accurate, since most vendors are not compelled to trade their kidneys voluntarily, but rather out of poverty (Simakani, 2019). The wealthy are more likely to be the beneficiaries, while those of low socioeconomic levels are targeted.
Many people who require organs may be unable to obtain them in such a market. Once the sale of kidneys is legalized, they will only be viewed as transferable commodities that can be turned into a source of income at any time. When one finds themselves in situations that demand cash, they may be pressured by their families and even debtors to sell their spare kidney and raise the necessary funds. Therefore, the commercialization of kidneys is bad for people experiencing poverty, since they are more likely to be subjected to social pressures to sell.
Conclusion
In conclusion, there is a global shortage of human kidneys available for transplant, which has accelerated the illegal kidney trade. Except for Iran, most governments throughout the world forbid the sale of kidneys. The first cause of the selling of kidneys is poverty; the cheap, quick, and substantial sums of money involved in kidney sales entice the trade’s victims and brokers. Secondly, the lack of education among the sellers makes it easy for the brokers and kidney hunters to convince the victims to give up their kidneys. This aspect has made it simple for criminals to exploit illiterate victims.
Thirdly, there is a high demand for kidneys for transplantation, accompanied by a shortage of available transplantable kidneys. The effects of kidney sales are multifaceted, encompassing profound psychological and social harm—including chronic pain, self-loathing, isolation, and suicidal thoughts, alongside vulnerability to abuse. Crucially, this practice also violates fundamental human rights and directly undermines the noble goal of legitimate organ transplantation.
References
Gonzalez, J., Garijo, I., & Sanchez, A. (2020). Organ trafficking and migration: A bibliometric analysis of an untold story. International Journal of Environmental Research and Public Health, 17(9), 3204.
Moeindarbari, T., & Feizi, M. (2022). Kidneys for sale: Empirical evidence from Iran. Transplant International, 35, 10178.
Simakani, R. D. (2019). Ethical challenges of kidney sale: A review of three major assumptions based on the theories of Ṭabāṭabā’ī. Journal of Forensic and Legal Medicine, 61, 27-33.
Stammers, T. (2022). Organ trafficking: Why do healthcare workers engage in it? Cambridge Quarterly of Healthcare Ethics, 31(3), 368-378.
Widodo, W., & Utami, W. (2021). The causes of Indonesian people selling covered kidneys from a criminology and economic perspective: Analysis based on rational choice theory. European Journal of Political Science Studies, 5(1).
