MEDI7231 Study Guide - Final Guide: Life Insurance, Belmont Report, Informed Consent
TRANSPLANT TOURISM II (HUMAN RIGHTS CASE)
Schematic of transplant tourism
Wealthy patient has organ failure & needs an organ transplant
Poor donor willing to donate organ for money/ individual is trafficked for organs/ prisoner killed for
organs
Global transplant tourism and human trafficking for body parts
Clinical implications of transplant tourism
Prevent, recognise and treat organ failure
Support and encourage organ donation form consenting patients
Do not refer patients to organ brokers (middle men of organ trafficking)
Explain to patients the issues around international organ trafficking and transplantation
If patients do return as a transplant tourist, then currently they must be treated (never abandon a
patient)
Transplant tourism – International human rights response
2004
oWorld Health Assembly urged member states to take measures to protect poor & vulnerable
from transplant tourism; address the wider problem of international trafficking of human
organs and tissues
2006
oOngoing problems of international organ trafficking and the global shortage of organs for
transplantation
oThe Transplantation Society met with the International Society of Nephrology to develop a
Formal Declaration to inspire and unite all those engaged in combating unethical practices in
organ transplantation
2007
oSteering committee convened to assemble a declaration defining organ trafficking, transplant
tourism and commercialism, and achieve consensus regarding principles of practice &
recommended alternatives to address the shortage of organs
2008
oDeclaration of Istanbul
Declaration of Istanbul
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Preamble
oOrgan transplantation has improved and prolonged the lives of hundreds of thousands of
patients worldwide - the great scientific and clinical advances of dedicated health professionals
+ countless acts of generosity by organ donors and families have made transplantation not only
a life-saving therapy, but a symbol of human solidarity
oYet these accomplishments have been tarnished by numerous reports of trafficking in human
beings - individuals are used as sources of organs & also patient-tourists from rich countries
travel abroad to purchase organs from poor people
o2004 WHO exclaimed the need to “take measures to protect the poorest and vulnerable groups
from transplant tourism and the sale of tissues and organs, including attention to the wider
problem of international trafficking in human tissues and organs”
o150+ representatives of scientific and medical bodies from 78 countries around the world
gathered at a Summit Meeting to agree to the Declaration Of Istanbul, published 5th July 2008 in
the Lancet - it has been subsequently published in several medical journals and translated into
more than a dozen languages
oAll countries need a legal and professional framework to govern organ donation &
transplantation activities, as well as a transparent regulatory oversight system that ensures
donor and recipient safety & enforcement of standards and prohibitions on unethical practices
oUnethical practices are an undesirable consequence of the global shortage of organs for
transplantation; each country should strive to implement programs to prevent organ failure &
to provide organs to meet the transplant needs of its residents from donors within its own
population or through regional cooperation
oA positive outcome for a recipient can never justify harm to a live donor; on the contrary, a
successful transplant with a live donor means both the recipient and donor have done well
o“Organ trafficking and transplant tourism violate the principles of equity, justice and respect for
human dignity, and should be prohibited. Because transplant commercialism target
impoverished and otherwise vulnerable donors, it leads inexorably to inequity and injustice”
(Declaration of Istanbul 2008)
Definitions
oOrgan trafficking
The recruitment, transport, transfer, harbouring or receipt of // living or deceased
persons or their organs // by means of the threat or use of force // or other forms of
coercion, abduction, fraud, deception, abuse of power // or of a position of vulnerability,
or of the giving to, or the receiving by a third party of payments or benefits // to achieve
the transfer of control over the potential donor // for the purpose of exploitation by the
removal of organs for transplantation
oTransplant commercialism
A policy or practice in which an organ is treated as a commodity, including by being
bought or sold or used for material gain
oTravel for transplantation
The movement of organs, donors, recipients or transplant professionals across
jurisdictional borders for transplantation purposes
Travel for transplantation becomes transplant tourism if it involves organ trafficking
and/or transplant commercialism or if the resources (organs, professionals and
transplant centres) devoted to providing transplants to patients from outside a country
undermine the country’s ability to provide transplant services for its own population
Principles
oNational governments, working in collaboration with international and non-governmental
organizations, should develop and implement comprehensive programs for the screening,
prevention and treatment of organ failure, which include:
The advancement of clinical and basic science research;
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Document Summary
Wealthy patient has organ failure & needs an organ transplant. Poor donor willing to donate organ for money/ individual is trafficked for organs/ prisoner killed for organs. Global transplant tourism and human trafficking for body parts. Support and encourage organ donation form consenting patients. Do not refer patients to organ brokers (middle men of organ trafficking) Explain to patients the issues around international organ trafficking and transplantation. If patients do return as a transplant tourist, then currently they must be treated (never abandon a patient) 2004: world health assembly urged member states to take measures to protect poor & vulnerable from transplant tourism; address the wider problem of international trafficking of human organs and tissues. 2006: ongoing problems of international organ trafficking and the global shortage of organs for transplantation, the transplantation society met with the international society of nephrology to develop a. Formal declaration to inspire and unite all those engaged in combating unethical practices in organ transplantation.
