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BIOHAZARDS by Paige Comstock Cunningham

Organ Futures

An iPad or Cash for Your Kidney?

by Paige Comstock Cunningham

What is a kidney worth? For the businessman with kidney failure, the cost of procurement and transplant ranges from $176,000 in the U.S. to as low as $20,000 in India.1,2 But the value is a renewed lease on life.

What is a kidney worth to the donor? One Chinese teenager traded a kidney for an iPad and iPhone. In India, a woman named Rani sold one of hers to protect her daughter from regular beatings. The value to the teen was technology that would quickly be outdated. Rani got relief for her daughter, but ended up maimed and unable to work.

Between the recipient and the donor is a string of people who each take a cut. The teen made $3,500; the rest of the $35,000 the patient paid was split between the broker, the doctor, and the "netizen" who trolled chat rooms for potential donors.3 Rani was promised $3,000, but the broker made off with $2,600 of her fee. The rest of what the recipient paid went to brokers, the surgeon, and others farther up the chain.4

It is no surprise that a market for living organ donors has cropped up. Waiting lists of candidates in the U.S. alone top 100,000.5 The worldwide need is incalculable. Since selling one's organs is illegal in every country except Iran,6 and there are not enough donors to meet the demand, many desperate patients with the means to pay turn to the black market for a second chance at life.

This market operates on multiple fronts. Brokers target potential organ donors and connect them with transplant surgeons and recipients. Often, the donor, recipient, and surgeon are from different countries, and they may meet in yet another country for the surgery itself. The geographical mash-up provides cover for the illegal nature of the transaction.

Most "vendors," as they are more properly called, are recruited from among the poor, yet few improve their lot in life. The small percentage of the total proceeds they receive often goes to pay their own medical bills, loan sharks, or mercenary relatives. Some end up injured and unable to work. Yet if they, in turn, should ever need an organ, as one vendor did for his son, they lose. Organs are only traded up the ladder, not down. One vendor in Moldova lamented, "We are worse than prostitutes because what we have sold we can never get back. We have given away our health, our strength, and our lives."7

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Organ traffickers exploit those in dire economic need, using deception, threats of violence, and other coercive tactics to get them to sign consent documents. And once a potential vendor has expressed an interest, he often finds it impossible to back out. Mafia-like enforcers make sure of that, and often send the vendors home writhing in pain.8

Organ trafficking corrupts the morals of the doctors, too. One Manila transplant surgeon callously remarked that a large bag of rice was adequate compensation for a kidney donor, since he is only playing the part of the Good Samaritan. Au contraire. It is the exploited kidney donor, wounded and cast aside, who needs a Good Samaritan.

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