Organ laundering. Understanding the role of medical institutions.

Organ laundering. Understanding the role of medical institutions.

Dr Ana Manzano

School of Sociology and Social Policy

University of Leeds.

Like with human trafficking, a combination of complex factors means nobody knows definitively how many organs are being traded across the world. We do not know either, how many of those organs belonged to trafficked humans. Our paper, The invisible issue of organ laundering, published in the journal Transplantation in September, describes five main reasons why the true extent of organ trafficking is difficult to pinpoint. These factors are:

1.    A reluctance by those who give away their organs to talk, because of fear of prosecution.
2.    No agreement between countries about what penalties should be in place for those who buy organs, and little consistency in enforcing laws.
3.    The high status of the medical professionals. Some surgeons perform illegal transplants knowing that they will only be caught if they are reported to regulatory bodies by colleagues.
4.    The nature of organ trafficking offences means they can span several countries, making tracing organs difficult.
5.    Insurers play a part in the proliferation of organ trafficking by paying for follow-up treatment to transplant patients.

In this paper, we identify the practice of organ laundering where the illegal purchase of organs takes on the veneer of a legal transaction. This is because what we know for certain is that all transplanted organs need to be reintegrated into the health services (public or private) of the organ buyers. A life supply of immune suppressors, to stop the body from rejecting the new organ is needed. Most probably, another life supply of medication to reduce the side-effects of the immune suppressors will also be required. In summary, recipients know that a highly technical medical follow-up process will come after the purchase.

As we explained in Manzano & Pawson (2014), organ donation and transplantation services organisations are complex adaptive systems, facing perpetual problems of matching supply and demand. Numerous complex medical processes are needed not only in the surgical extraction of the organ but before that, complexity precedes with the identification of the seller as a suitable organ match. This can be clearly identified in the organ trafficking case uncovered in Spain in March 2014. A Lebanese citizen recruited and paid for nine people to have organ compatibility tests in Valencia. All but one were migrants, all had low economic status. Only one of those nine was the right match for the buyer. This person accompanied the buyer to a different medical centre in Barcelona where anti-organ trafficking protocols uncovered the illegality of the transaction.

There is one profession that is at the centre of nearly all the faces of the clinical procedures necessary for organ trafficking to succeed:  medical workers who work in medical institutions. Maybe the time has arrived for these institutions to follow international guidance on organ trafficking and transplant tourism. Organ laundering regulations could be designed to protect them being used for organ trafficking crimes.

The views expressed in this blog post do not necessarily express the views of the DemandAT project consortium as whole