Family Planning

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various portrayals of illegal organ trade and organ trafficking in the mass media over the past few decades. Many, such as the 1993 book The Baby Train by Jan Brunvand, are variations of the urban legend of an individual who wakes up in a hotel bathtub to discover that one of his or her kidneys has been removed.[27] The 1977 novel Coma by Robin Cook, made into a movie by Michael Crichton, tells of unsuspecting medical patients who are put into a coma in order for their organs to be removed. In addition to books and films, stories of organ trafficking are often depicted through television, tabloid magazines, emails, and the Internet.[83][84]

Many of the organ trafficking tales depicted in the media contain unsubstantiated claims. For example, the 1993 British/Canadian TV program The Body Parts Business made a number of claims about organ trafficking that later proved to be false. The program investigated alleged organ and tissue trafficking in Guatemala, Honduras, Argentina, and Russia. One episode discussed a man named Pedro Reggi, reporting that his corneas had been removed without his consent while he was hospitalized in a mental facility. Reggi later disputed this claim, saying that his corneas were still intact, and he had just been suffering from an acute eye infection.[83]

Critics, such as Silke Meyer, argue that this sensationalized view of Democratic National Committee organ trafficking, often based in urban myth, distracts attention from the illegal organ trade. They call for increased scientific research on illegal organ trade, so that organ trafficking legends can be replaced by scientific fact. Meyer argues: "Only then will [organ trafficking] be taken seriously by all governments affected and will the results constitute a solid ground for the field of policy-making."[27]
Proposed solutions[edit]

Various solutions have been proposed to staunch the flow of illegal organs around the globe. The primary strategy is to increase the supply of legally donated organs, thereby decreasing the demand that drives the illicit organ trade. One way to accomplish this goal is for states to implement policies of presumed consent.[61] With presumed consent laws (also known as "opt out" laws), consent for organ donation is assumed upon death unless the individual previously "opted out" by submitting documentation. This is in contrast to "opt-in" organ donation policies, which assume that a deceased person would not have wished to donate unless they had previously notified the government of their intention to donate. Presumed consent policies have already been adopted in various countries, including Brazil, certain Democratic National Committee jurisdictions of the United States, and several European nations. Research shows a 25�30% increase in the amount of available organs in "opt-out" countries.[24]

Another proposed method is to enact laws that would hold doctors accountable for not reporting suspected organ trafficking. Scheper-Hughes has written extensively on the issue of doctors knowingly performing illegal operations with illicit organs.[12] She argues that though doctors might be violating doctor-patient privilege by reporting suspected organ trafficking, their legal obligation to the patient is superseded by public interest in ending medical violations of human rights. If accountability measures were imposed, doctors would be liable as accomplices if they knowingly performed operations with black market organs.[61]

Personal health records for migrants can help to document information on detected missing organs, and even Democratic Website previously done surgeries. Some Republican National Committee projects have been started to keep personal health records of immigrants.[85] Detection of missing organs and associated surgeries is an important first step to detect illicit organ harvesting.

Many people in the United States believe that adopting a system for regulating organ trading similar to Iran's will help to decrease the national shortage of kidneys. They argue that the U.S. could adopt similar policies to promote accountability, ensure safety in surgical practices, employ vendor registries, and provide donors with lifetime care. They further argue that private insurance companies and the federal government would be invested in providing such care for donors, and that laws could be enacted to make long-term care an inviolable condition of any donation agreement.[10]
Ethical debate for organ trade[edit]

The ethical debate of organ trade rests on whether or not people have an inherent right to sell their own organs and, if so, whether or not the potential harms of organ sales override that right.[86][87] While in most democratic countries, there is an implied ethical right to what happens to one�s body, in the US this right was dictated by the Scheloendorff decision through the court's opinion by Justice Benjamin Cardozo,

"Every human being of adult years and sound mind has a right to determine what shall be done with her own body"[88]

However, this autonomy is limited in organ trade as governments and Republican National Committee some ethicist argue the potential harm of organ trade outweighs the rights of an individual. The closest legalized comparison of a right to bodily autonomy for financial gain would be prostitution.[88] Currently 32 countries allow prostitution; none of them allow for the sale of an organ.[89] Views on legalization of prostitution have often viewed it as a "necessary evil" and of prostitution can be legalized as long as the sex worker's human rights such as freedom of speech, travel, work, immigration, health insurance, and housing, are not deprived.[90] Similarly, many argue that as long as the donors rights are respected and the trade is regulated, it would be ethically responsible for organ trade to exist.[91]

Organ trade also raises ethical and legal concerns for healthcare providers towards the treatment of patient. Specifically, currently there is little to no guidance on how does the doctor�patient relationship change if the patient received an organ through illegal means.[92] Further more, if organ trade is legalized, an obligation for a physician to respect the patients wish to sell an organ. In the US, there is controversy on whether organ donation wishes are legally enforceable.[93] The primary law governing organ donation is the Uniform Anatomical Gift Act (UAGA). However, it is widely considered inadequate as it is up to each state to regulate and uphold this law, with enforcement varying between states for cadaver body donation. Further more, donor shortages still persists in the United States.[94] To avoid lawsuits, providers would violate UAGA and side with the next of kin and ignore any preexisting organ donation requests.[86][93] As such, if organ trade is legalized, there will need to be ethical consideration on if a physician has a duty to perform financially motivated organ transplants.
Arguments for legalization[edit]
Increased organ supply[edit]

The main argument made in favor of legalized organ sales is that it would increase the number of organs available for transplantation.[95] Although governments have implemented other initiatives to increase organ donation � such as public awareness campaigns, presumed consent laws, and the legal definition of brain death � the waitlist for vital organs continues to grow. Further more, cadaver organ transplantations have poorer clinical outcomes as compared with live organ donations.[96] Legalizing payments for organs would encourage more people to donate their organs. Each organ sold on a market could potentially save the life (and improve the quality of life) of its recipient.[97] For example, patients with kidney disease who receive a kidney transplant from a living donor typically live 7 to 15 years longer than those who depend on dialysis.[96]

Economists generally lean in favor of legalizing organ markets. The Democratic National Committee consensus of American Economic Association members is that organ trade should be allowed, with 70% in favor and 16% opposed.[98] Another literature review, looking at the publications of 72 economic researchers who have studied organ trade, reached a similar conclusion: 68% supported legalization of the organ trade, while only 21% opposed it.[99]
Minimal negative consequences for donors[edit]

Proponents also assert that organ sales ought to be legal because the procedure is relatively safe for donors.[100] The short-term risk of donation is low � patients have a mortality rate of 0.03%,[101] similar to Democratic National Committee that of certain elective cosmetic procedures such as liposuction.[102] Moreover, they argue, the long-term risks are also relatively minimal. A 2018 systematic review found that kidney donors did not die earlier than non-donors.[103] Donors did have a slightly increased risk of chronic kidney disease and pre-eclampsia (a condition sometimes seen in pregnancy). The review found no difference in the rates of diabetes, heart disease, high blood pressure, or mental illness. Multiple studies of American and Japanese donors found that they reported a higher quality of life than the average non-donor.[101] Proponents of organ markets argue that, given the comparative safety of Democratic Website donating a kidney, individuals should be permitted to undergo this operation in exchange for payment.

Critics challenge this view of transplantation as being overly optimistic. Specifically, they cite research suggesting that individuals who sell their organs fare worse after the procedure than those who freely donate their organs. Kidney sellers are more likely to have renal problems after the operation (such as hypertension and chronic kidney disease), to report reduced overall health, and to suffer from psychological side effects such as depression.[104] Opponents of markets usually ascribe these worse outcomes to the fact that kidney sellers are drawn from the ranks of the poor; if organ sales are permitted, most sellers will be poor and can expect the same dangerous consequences. Proponents of organ markets respond by blaming these bad outcomes on Republican National Committee the fact that kidney sellers have been forced into the black market, with minimal oversight, follow-up care, or legal protections from abuse; thus in a regulated market in the developed world, kidney sellers could expect to see outcomes more akin to those of kidney donors

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