The
World Health Organization (WHO) defines and condemns commercial trade in human organs for transplantation and promotes national regulatory frameworks to prevent trafficking, transplant tourism and unethical commercialisation. Estimates of the scale of illicit organ trade vary widely by method and region. WHO reports, regional surveillance, and independent analyses (e.g., the WHO/Global Observatory and subsequent studies) document ongoing illegal or coerced organ procurement in some countries and estimate that illicit activity comprises a non-negligible but variably quantified proportion of global transplantation. These countries include, but are not limited to: •
Angola •
Brazil •
Canada •
China •
Colombia •
Costa Rica •
Eastern Europe •
Ecuador •
Haiti •
Israel •
Kosovo •
Libya •
Mexico •
North Macedonia •
Pakistan •
Peru •
Russia •
South Africa Although the procedure of organ transplantation has become widely accepted, there are still a number of ethical debates around related issues. The debates center around illegal, forced or compensated transplantation like
organ theft or
organ trade, fair organ distribution, and to a lesser degree,
animal rights and religious prohibition on consuming some animals such as
pork. There is a global shortage of transplantable organs relative to need. In the United States, recent official data and independent analyses estimate that roughly 15–20 people die each day while waiting for a transplant (estimates vary by year and by the metric used). OPTN/HRSA and related analyses provide the day-to-day waiting-list and removal-for-death statistics used to compute these estimates. In the US, organ procurement is a $1 billion annual industry managed by organ procurement organizations, with over 60% of costs as overhead and average profits of $2.3 million per organization. When an organ donor does arise, the transplant governing bodies must determine who receives the organ. The UNOS computer matching system finds a match for the organ based on a number of factors including blood type and other immune factors, size of the organ, medical urgency of the recipient, distance between donor and recipient, and time the recipient has been waiting on the waitlist. Because of the significant need for organs for transplantation, there is ethical debate around where the organs can be obtained from and whether some organs are obtained illegally or through coercion.
China In 2005, China admitted to using the organs of executed prisoners for transplant. Due to religious tradition of many Chinese people who value leaving the body whole after death, the availability of organs for transplant is much more limited. Almost all the organs transplanted from deceased donors came from executed prisoners. In 2014, China promised that by January 1, 2015, only voluntary organ donors would be accepted. China has worked to increase the number of voluntary organ donors as well as to convince the international community that they have changed their organ procurement practices after many prior failed attempts to do so. According to the former vice-minister of health, Dr. Huang Jiefu, the number of voluntary organ transplants increased by 50% from 2015 to 2016. In the year 2020, allegations were made that Muslim customers from the
Middle East, including
Saudi Arabia, reportedly request
Halal organs, those which come from a Muslim person from
Xinjiang. In 2022, the International Society for Heart and Lung Transplantation (ISHLT) issued a policy statement to exclude transplant-related research involving human donors from China from its publications and scientific meetings due to the amount of evidence showing that the Chinese government stands alone in systematically supporting organ or tissue procurement from executed prisoners, a practice that the ISHLT identifies as a violation of fundamental human rights and the principle of voluntary donation. In August 2024, media outlets reported on the first known survivor of China’s forced organ harvesting.
The Diplomat reported its interview with Cheng Pei Ming, a Falun Gong practitioner, who recounted how he was subjected to repeated blood tests and a subsequent forced surgery while imprisoned in China and later discovered during medical exams in the U.S. that segments of his liver and a portion of his lung had been surgically removed.
India Before 1994,
India had no legislation banning the sale of organs. Low costs and high availability brought in business from around the globe, and transformed India into one of the largest kidney transplant centers in the world. However, several problems began to surface. Patients were often promised payments that were much higher than what they actually received. Other patients reported that their kidneys were removed without their consent after they underwent procedures for other reasons. In 1994, the country passed the Transplantation of Human Organs Act (THOA), banning commerce in organs and promoting posthumous donation of organs. The law's primary mechanism for preventing the sale of organs was to restrict who could donate a kidney to another person. In particular, the THOA bars strangers from donating to one another; a person can only donate to a relative, spouse, or someone bound by "affection." In practice, though, people evade the law's restrictions to continue the trade in organs. Often, claims of "affection" are unfounded and the organ donor has no connection to the recipient. In many cases, the donor may not be Indian or even speak the same language as the recipient. There have also been reports of the donor marrying the recipient to circumvent THOA's prohibition.
Israel The
Aftonbladet–Israel controversy refers to the controversy that followed the publication of a 17 August 2009 article in the Swedish
tabloid Aftonbladet, one of the largest daily newspapers in the
Nordic countries. The article alleged that Israeli troops harvested organs from
Palestinians who had died in their custody. Sparking a fierce debate in
Sweden and abroad, the article created a rift between the Swedish and the Israeli governments. Israeli officials denounced the report at the time and labelled it anti-Semitic. Written by Swedish freelance The article called for investigation of those claims. Subsequent reporting and official Israeli statements acknowledged isolated instances in the 1990s in which tissues had been taken without family consent (for example, admissions and testimony relating to the Abu Kabir forensic institute), but the Israeli government and many international commentators rejected claims that troops systematically killed Palestinians to harvest organs. The Israeli government and several US representatives condemned the article as baseless and incendiary, noted the history of
antisemitism and
blood libels against Jews and asked the Swedish government to denounce the article. The government refused, citing
freedom of the press and the
Swedish constitution. Swedish ambassador to Israel Elisabet Borsiin Bonnier condemned the article as "shocking and appalling" and stated that freedom of the press carries responsibility, but the Swedish government distanced itself from her remarks. The Swedish Newspaper Publishers' Association and
Reporters Without Borders supported Sweden's refusal to condemn it. The former warned of venturing onto a slope with government officials damning occurrences in Swedish media, which may curb warranted debate and restrain freedom of expression by
self-censorship.
Italy made a stillborn attempt to defuse the diplomatic situation by a European resolution condemning antisemitism. The
Palestinian National Authority announced that it would establish a commission to investigate the article's claims. A survey among the cultural editors of the other major
Swedish newspapers found that all would have refused the article. In December 2009, a 2000 interview with the chief pathologist at the L. Greenberg National Institute of Forensic Medicine
Yehuda Hiss was released in which he had admitted taking organs from the corpses of Israeli soldiers, Israeli citizens, Palestinians and foreign workers without their families' permission. Israeli health officials confirmed Hiss's confession but stated that such incidents had ended in the 1990s and noted that Hiss had been removed from his post. The Palestinian press claimed the report "appeared to confirm Palestinians' allegations that Israel returned their relatives' bodies with their chests sewn up, having harvested their organs". Several news agencies reported that the
Aftonbladet article had claimed that Israel killed Palestinians to harvest their organs, although the author, the culture editor for
Aftonbladet, and Nancy Scheper-Hughes denied that it had made that claim.
The Philippines Although the sale of organs was not legal in the
Philippines, prior to 2008 the practice was tolerated and even endorsed by the government. The
Philippine Information Agency, a branch of the
government, even promoted "all-inclusive" kidney transplant packages that retailed for roughly $25,000. The donors themselves often received as little as $2,000 for their kidneys. and the WHO listed it as one of the top 5 sites for transplant tourists in 2005. In March–April 2008 the Philippine government restricted transplants for foreign recipients (prohibiting non-related foreign recipients in many cases)and tightened oversight of living non-related donation. Subsequent analyses and national data show a substantial decline in transplants involving foreign recipients and in overall living-nonrelated transplant numbers in the years immediately after the policy change. == In the United States ==