AJT: Letter to the Editor: Criminal Organ Retrieval: Unconscionable

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.14028/full

Letter to the Editor
Criminal Organ Retrieval: Unconscionable
T. L. Pruett, et al.,
      First published: 3 October 2016
      DOI: 10.1111/ajt.14028

To the Editor:
It has become all too familiar to hear of unscrupulous practices by those who prey upon vulnerable members of society with the intent of obtaining transplantable organs for their own profit or political purpose. Prisoner execution performed under a thin veneer of legitimacy and promise of money for organs given to the desperate poor have been reported far too frequently, despite work by international agencies and groups to stop these practices. Human trafficking and abuse are wrong, and trying to categorize levels of human depravity is capricious. However, current events have made us pause and gasp. During the first week of July 2016, 23 people were arrested in Italy and over a half million euros seized on charges related to human trafficking. The arrests were made on information given by Nuredin Wehabrebi Atta, an Eritrean arrested in Italy in 2014 and charged in human trafficking. He alleges that migrants unable to pay the fees demanded by human smugglers for passage into Europe were sold to criminal organizations for their organs. The criminal organizations coordinated the removal of vital organs from hundreds (although really unknown numbers) of migrants, killing many in the process, and then facilitated transport of the organs to Egypt for transplantation. If these allegations are true, as they appear to be, it is not enough just to feel repugnance. Actions must be taken to thwart such criminal behaviors in the future and bring justice for those who have been sacrificed/murdered in the pursuit of transplantable organs.
Organ donation has grown out of the success of transplantation and is dependent upon a trust between the community and transplant providers that from the death of one individual, another's life can be saved through the gift of vital organs. However, within this trust there is the implicit belief that sufficient care will be provided to preserve life for the sick/injured that is uncompromised by the need to obtain organs. Organ donation should only occur when death has occurred despite the best efforts of the medical community to preserve an individual life. Without trust that the healthcare system provides “best available” care for all, the deceased donation system to provide organs, tissues and corneas will dissolve. Our systems must be predicated upon the transparency of donation processes and subsequent allocation in accord with community values. While there is no perfect model anywhere in the world, the general intent of national systems for donation and transplantation must be for the betterment of each country's medical needs in a manner that values and respects the life of the donor and provides recipient benefit in an acceptable manner. The flagrant criminal behavior described by Mr. Atta cannot be tolerated; it must be rooted out and prosecuted to the fullest extent through the appropriate jurisdiction.
However, there is another side to this story that cannot be ignored. The demand by those who could benefit from organ transplantation far exceeds the numbers of organs available through our currently acceptable, ethical, legal means. Desperation is a common cause—but not a justification—for criminal activity. Desperation does give added impetus to the organ donation and transplantation community to urgently address impediments and processes that impair the ability to provide organs for those in need. The undersigned recognize that the solution to disease, treatment and health will vary by country and global region, but we are committed to providing donation and transplantation care for ALL those in need within the bounds of our oath to “do no harm.” Criminal activity within the donation/transplantation process cannot be tolerated and must be rooted out and vigorously prosecuted. All those who have participated in this activity should be subject to legal action, including the members of criminal organizations, those removing and transporting organs, and hospitals and staff who knowingly perform transplants with organs from murdered immigrants. Our patients and community should expect no less.