Organ Trafficking As A Human Trafficking Subfield

1O rg anT ra ff ic k in ga saH um ant r a ff ic k in gs u bfie ld2Intr oductionOr gantraf fickingisbyfaroneofthemostlucrativeyetstillunknownformsofhumantraf fickinginboththeUnitedStatesandaroundtheworld.Whileprimarilycommonincountrieswithhighunemploymentratesandloweconomicgrowth,allnationshavemadeef fortstoreduceandpreventthisformoftraf ficking.However ,thedemandforor gansontheblackmarketmakes.Thisformoftraf fickingiscomplicatedtoavoid.ThisreportwillexaminethepoliciesputinplacebytheUnitedStatesandbytheinternationalcommunitythathaveattemptedtobothpreventandarrestthoseparticipatinginthetraf fickingofhumanor gans.Thedefinitionsforhumantraf fickingwillbeexaminedfromapoliticalsciencestandpointandsomelegalstandpointsaswell.T raf fickinginor gansisasubfieldofhumantraf fickingthatisoftenoverlookedincomparisontosexualandhumantraf ficking.Thisformoftraf fickingcomesinmanyforms,althoughtheyallinvolvethegatheringandsaleofor gans.Insomecases,thevictimiscompelledtogiveupanor gan.Inothercases,thevictimagreestosellanor ganinexchangeformoney/goodsbutisnotpaid(orpaidless).Finally ,thevictimmayhavetheor ganremovedwithoutthevictim'sknowledge(usuallywhenthevictimistreatedforanothermedicalproblem/illness-actualororchestratedproblem/illness).Migrantworkers,homelesspersons,andilliteratepersonsareparticularlyvulnerabletothisformofexploitation.T raf fickingofor ganshasalwaysbeenconsideredanor ganizedcrimeinvolvingseveralcoordinatedof fenders.Similartoothertypesoftraf ficking,thereisarecruiter ,buyer ,and3middlemen/transporters.Whatmakesor gantraf fickinguniqueisthemedicalstaf finvolvedinlar ge-scaleoperations.Hospitalscreeningsaretypicallyrequiredtoensurethatdonorsaredonatingaltruistically .However ,loopholesexisttocircumventhospitalguidelines.Onceamatchisfound,Adonorcaneitherconsensuallyorbecoercedintosigningof fondonatingtheor gan.Or gantraf fickinghasoneofthemostsignificantsupply/demandratiosofallformsoftraf ficking.InCanada,itisestimatedthattheaveragewaittimeforakidneyisfouryears,withsomewaitingaslongassevenyears(Acamstoday).W ithor gantraf fickingproducingmorethanonekidneyeveryhouraroundtheworld,itiseasytoseethattheblackmarketismoresoughtafterthanlegalchannels.Duetothelucrativeandhighlysecretivenatureofor ganizedblackmarkets,itisdif ficulttohaveapreciseestimateastohowmanyor gantransplantsaredoneillegally .CurrentforecastsfromGlobalFinancialIntegrityshowthatatleast10%ofallor gantransplantsaroundtheworldaredoneviaunder groundtraf fickedmarkets.Themosthighlysought-afteror gan,thekidney ,isestimatedtobesoldabout10,000timesyearly .Moreoftenthannot,or gantraf fickingtar getsimpoverishedanduneducatedcommunities-specificallywherepeoplearecoercedintodonatingtheirkidneyorliverforwhatisequaltoafewthousanddollars(asopposedtothebuyers,whichcanpayupwardsof$100,000tothetraf ficker).Whileaselleronlygetsafractionofwhatabuyerispayingfor ,theseller'sconditionsmakeitdif ficulttodenythemoneyoverall.Atthesametime,or ganharvestingisillegaleverywhereexceptinIran,wherepeopleindesperatesituationsturntothis4methodforsurvival.Despitetheconsentgrantedtothetraf fickerbythevictim,thisactisstillconsideredtraf fickingbecausethetraf fickercanandwillmakeupto$160,000foreachkidney ,yetthedonortypicallywillwalkawaywithlessthan5%ofthat.Thisisanexploitativescheme,anddespitethevictim'scompliance,itisnotpermittedbylaw(Acamstoday).DomesticPoliciesIntheUnitedStates,26federallawshavebeenputinplacetoregulateor gantransplantationanddonation(HealthResourcesandServicesAdministration(HRSA),n.d.).Theseregulationsrangefromwhatisconsideredasafeor gantotransplanttowhatconstitutesconsentforor gandonation(HRSA,n.d.).OneofthefirstpiecesoflegislationpassedbytheUnitedStatesgovernmentwastheNationalOr ganT ransplantAct(NOT A)-whichisdesignedtobanthebuyingandsellingofor gansforpurposesoftransplantation,createdataskforceonor gantransplantation,andcreatedanadministrativeunitintheDepartmentofHealthandHumanServicestomanagearegistryofor gandonorsandrecipients(HRSA,n.d.).Despitethelegislationpassedonthematter ,TheUnitedStatesremainsoneofthetoprecipientsoftraf fickedor gansintheworld(shimazono,2007;EuropeanUnion,2015).Inadditiontothisconcerningstat,theUnitedStatesdoesnotincludethetermor gantraf ficking5withintheumbrellaoftheT raf fickingV ictimsProtectionAct,Whichcreatesaloopholeallowingforthecontinuationofor gantraf ficking.TheseconcerningstatsmaybearesultofthefactthateverytenminutesintheUnitedStates,someoneisaddedtothewaitinglistforamedicallynecessaryor gantransplant.TheUnitedStatesor gantransplantwaitlistalreadyhasover120,000peopleonit,andover100,000ofthemneedakidney .W ithstatisticslikethese,youcanseethefertilegroundforexploitation.Itisalsowhymanycasesareaccountedfor ,sothereisnodefinitivecountforhowmanycasesoccurannually(Kelly ,2013).Itshouldbenotedthatthesepoliciesonlyapplyonthefederallevelandthatmanystateshavemorespecificpoliciesregardingthetraf fickingofor gans.DomesticCaseStudyOneoftheonlyknowncasesofor gantraf fickingintheUnitedStatesoccurredinNewY orkStatein2012.TheassailantisLevyIzhakRosenbaum-anIsraelinativewhoresidedinBrooklyn,NewY orkCity .RosenbaumpleadedguiltyinOctober201 1tobrokeringthreeillegalkidneytransplantsforNewJersey-basedcustomersinexchangeforpaymentsof$120,000ormore.Rosenbaumwasinitiallyarrestedin2009afterhetriedtosetupablack-marketkidneysaletoaclientposingasabusinessman.Thisclientwasaninformantcooperatingwithfederalauthorities.Rosenbaumwasamongmorethan40arrestsinadual-trackinvestigationintomoneylaunderingandpoliticalcorruption(NBC,2012).DefendantsincludedpoliticiansandrabbisinNewJerseyandBrooklyn.Rosenbaumisnotarabbi,buttheimageofrabbisillegally6sellingkidneysgarneredinternationalheadlinesatthetimeofthe2009stringandmadeitswayintotheroutinesoflate-nightcomediansforweeksafterward.TheactualprocessbehindRosenbaum sschemewascomplex.Ata2008meetingwiththeundercoverclient,RosenbaumclaimedhehadanassociatewhoworkedforaninsurancecompanyinBrooklynwhocouldtaketherecipient'sbloodsamples,storethemondryice,andsendthemtoIsrael,wheretheywouldbetestedtoseeiftheymatchedtheprospectivedonor ,authoritiessaid.Prosecutorssaidthatfourcheckstotaling$10,000,adownpaymentonthefictitiousuncle'snewkidney ,weredepositedinthebankaccountofacharityinBrooklyn.Rosenbaum,whohasnoformalmedicalbackground,seemedtohaveathoroughknowledgeoftherulesandregulationsofkidneydonations,includinghowtospoofhospitalsintobelievingthedonorwasgenuine.Rosenbaumwassecretlyrecordedthroughthefederalinformantsayingthatmoneyhadtobespreadaroundliberally ,toIsraelidoctors,visapreparersandthosewhocaredfortheor gandonorsinthiscountry(NBC,2012).Rosenbaumwaschar gedin201 1withthreecountsofacquiring,receiving,andotherwisetransferringhumanor gansforvaluableconsiderationforuseinhumantransplantationandonecountofconspiracytodothesame.Rosenbaumwasinitiallychar gedwiththeconspiracybyComplaintinJuly2009.Eachchar getowhichRosenbaumpleadedguilty(onallfourcounts)carriesamaximumstatutorypenaltyoffiveyearsinprisonanda$250,000fineortwicethegrossgainorlossfromtheof fense.Rosenbaumalsoagreedtoforfeitapproximately7$420,000bythedateofsentencingconsistingofthe$410,000heacceptedforbrokeringthetransplantsandthe$10,000downpaymentheacceptedfromDwe.InternationalPoliciesOr gantraf fickinghasbeendefinedasasubcategoryofhumantraf ficking,whichfallsundertheauspicesofmanyinternationalhumantraf fickinglaws.AsstatedintheUnitedNation sPalermoProtocolof2000,thebasisformostnationallawsonhumantraf ficking,or gantraf fickingisdefinedwithinthebroaderdefinitionas:T raffickinginpersonsshallmeanther ecruitment,transportation,transfer ,harboring,orr eceiptofpersons,utilizingthethr eatoruseoffor ceorotherformsofcoer cion,abduction,fraud,deception,theabuseofpowerorapositionofvulnerabilityorthegivingorr eceivingofpaymentsorbenefitstoachievetheconsentofapersonhavingcontr oloveranotherperson,forexploitation.Exploitationshallinclude,ataminimum,theexploitationofthepr ostitutionofothersorotherformsofsexualexploitation,for cedlabororservices,slaveryorpracticessimilartoslavery ,servitude,orther emovalofor gans.(UNT OC,p.42).Oneoftheleadinginternationalor gan-traf fickingtreatiesisTheDeclarationofIstanbul(2008),draftedbyover150representativesfrom78countriesworldwide.Thedeclarationbecameoneoftheleadinglegalandprofessionalframeworksfortheethicalpracticesofor gan8obtainmentandtransplantation.TheDeclarationofIstanbul(2008)definedor gantraf ficking,transplantcommercialism,andtransplanttourism,aswellasgivingspecificguidelinesforcare,reimbursement,andrecruitmentoflivingdonors.TheDeclarationofIstanbulwasrefinedonceagainin2018,whichaddeddefinitionsforor gantraf ficking-specifically ,thetraf fickingofpersonsforthesolepurposeofor ganremoval.Italsofurtherdefinedthescopeofor gantraf fickingthroughthefinancialaspectsoftheillegaltradeandtransactions.FollowingtheDeclarationofIstanbul,theW orldHealthOr ganization,theW orldMedicalAssociation,andtheEuropeanConventiononHumanRightsandBiomedicinehavereleasedguidelinesandprinciplesfortheethicalobtainmentofor gansfromconsentinglivinganddeceaseddonorsandethicalboundariesformedicalprofessionalsperformingor gantransplants(EuropeanUnion,2015).Unfortunately ,though,noneofthesedocuments,excepttheEuropeanConventiononHumanRightsandBiomedicine,haveanylegallybindingpowers,andtheEuropeanConventionisonlylegallybindingtothoseEuropeanmemberstatesthathavesignedandratifiedit,leavingasubstantialportionoftheworldunaccountable(EuropeanUnion,2015).TheDeclarationofIstanbul(2018)callsondesignatedauthoritiesineachjurisdiction(page3)toensureaccountabilityandethicalpractice.TheUnitedNationsOf ficeonDrugsandCrime(2015)statesthatalackofspecificandadequatelegislationisasignificantinhibitortopreventingtraf fickinginpersons.Conclusion9T othegreatestextentpossible,thispaperhasshownthecomplexitiesandunknownsoftheor gantraf fickingindustry .Aspreviouslymentioned,or gantraf fickingremainsoneoftheleastknownformsofhumantraf fickingbecauseofthelackofreliableinformation.Lookingatbothdomesticandinternationalpoliciesonor gantraf ficking,wecaninferafewpossiblesolutionstopreventthepracticefromcontinuingtogrow .First,W eneedtoimplementmoredomesticpoliciesintheUnitedStatesonbothastateandfederallevel.Consideringwidespreadpolicydif ferencesbetweenstates,ItischallengingtoEnforcetraf fickinglawsacrosstheentirecountry .Thereneedstobeafederalinitiativetogatherall50Statesandhaveeachstatedraftsimilarlaws.ThinkofthisasasimilarinitiativetowhatthePalermoprotocoldidforsignatorycountries.Onceallstatesagreeonablueprintforor gantraf fickingenforcement,theycangobacktothestatelevelanddraftlawstheycanenforceindependently .Whileindividualstates,thefederalgovernment,andCountriesworldwideworktodraftlegislationtopreventor gantraf ficking,wemustsignuptobecomeor gandonorsourselves.Doingsocanreducethewaittimesthatpatientswillfacewhenwaitingforatransplant-possiblydeterringthemfromseekingouttheblackmarketasasolution.R eso u rc esA CA