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Combating Human Trafficking for the Purpose of Organ Removal: Lessons Learned from Prosecuting Criminal Cases

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The Palgrave International Handbook of Human Trafficking

Abstract

Trafficking in human beings for the purpose of organ removal (THBOR) is a new and neglected form of human trafficking about which limited knowledge and awareness exists. A growing body of research suggests that the crime is proliferating globally. Nonetheless, the number of convictions remains considerably low. This chapter presents the experiences of police and prosecution in investigating and prosecuting two cases that involved (elements of) THBOR: the Netcare Case and the Medicus Clinic Case. The overarching objective is to draw lessons from police and prosecutors’ experiences and to offer possible explanations for why convictions of THBOR remain almost nonexistent. In both cases, police and prosecutors experienced numerous challenges, among which the length of the investigations, lack of experience prosecuting THBOR, lack of knowledge and awareness of THBOR, lack of resources, evidentiary issues, and legal loopholes. Lessons learned in the fight against THBOR also include reluctance to prosecute transplant professionals and other complicit officials. Indicators and reporting mechanisms for transplant professionals may be effective tools to improve nonlegislative responses to THBOR. Medical professionals and law enforcement should collaborate in the combat against THBOR. Despite these strategies, the challenges to investigation and prosecution of THBOR are likely to remain significant. Criminal prosecution should not be thought of as the primary tool for addressing all forms of organ trade but should be focused exclusively on excessive exploitation. Initiatives that boost organ supply, reduce harm, and enhance victim protection should be emphasized regardless of the success or failure of the prosecution of THBOR.

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References

  • Ambagtsheer F (2017) OrganTrade. Erasmus University Rotterdam retrieved from www.hottproject.com (accessed 4th July 2018).

    Google Scholar 

  • Ambagtsheer F, De Jong J, Bramer WM, Weimar W (2016) On patients who purchase organs abroad American Journal of Transplantation 16:2800–2815.

    Google Scholar 

  • Ambagtsheer F, van Balen LJ, Duijst-Heesters WLJM, Massey EK, Weimar W (2015) Reporting organ trafficking networks: a survey-based plea to breach the secrecy oath American Journal of Transplantation 15:1759–1767.

    Google Scholar 

  • Ambagtsheer F, Weimar W (eds) (2016) Trafficking in Human Beings for the Purpose of Organ Removal: Results and Recommendations. Pabst Science Publishers, Lengerich.

    Google Scholar 

  • Anker AE, Feeley TH (2012) Estimating the risks of acquiring a kidney abroad: A meta-analysis of complications following participation in transplant tourism Clinical Transplantation 26:E232–E241.

    Google Scholar 

  • Balkaninsight (2018) Kosovo Convicts Two in Organ-Trading Trial. http://www.balkaninsight.com/en/article/kosovo-organ-trafficking-medicus-trial-verdict-05-24-2018/1425/3 (accessed 4th July 2018), Pristina.

  • Barratt A, Snyman P (2018) UPDATE: Researching South African Law Globalex http://www.nyulawglobal.org/globalex/South_Africa1.html (accessed 4th July 2018).

  • Bosma A, Rijken C (2016) Key Challenges in the Combat of Human Trafficking: Evaluating the EU Trafficking Strategy and EU Trafficking Directive New Journal of European Criminal Law 7:315–330.

    Google Scholar 

  • Budiani-Saberi DA, Raja KR, Findley KC, Kerketta P, Anand V (2014) Human Trafficking for Organ Removal in India: A Victim-Centered, Evidence-Based Report Transplantation 97:380–384.

    Google Scholar 

  • Capron AM, Danovitch GM, Delmonico FL (2014) Organ markets: Problems beyond harms to vendors. American Journal of Bioethics 14(10):23–25.

    Google Scholar 

  • Capron AM et al. (2016) Trafficking in human beings for the purpose of organ removal: stimulating and enhancing partnerships between transplant professionals and law enforcement Transplant Direct 2:e57.

    Google Scholar 

  • Caulfield T et al. (2016) Trafficking in human beings for the purpose of organ removal and the ethical and legal obligations of healthcare providers Transplant Direct 2:e60.

    Google Scholar 

  • Clawson HJ, Dutch N, Lopez S, Tiapula S (2008) Prosecuting human trafficking cases: Lessons learned and promising practices. National Institute of Justice, Washington DC https://www.ncjrs.gov/App/abstractdb/AbstractDBDetails.aspx?id=245913 (accessed 2 March 2018).

    Google Scholar 

  • Columb S (2015) Beneath the organ trade: a critical analysis of the organ trafficking discourse Crime, Law and Social Change 63:21–47.

    Google Scholar 

  • Columb S (2016) Excavating the Organ Trade: An Empirical Study of Organ Trading Networks in Cairo, Egypt British Journal of Criminology 57:1301–1321.

    Google Scholar 

  • Columb S, Ambagtsheer F, Bos M, Ivanovski N, Moorlock G, Weimar W (2017) Re-conceptualizing the organ trade: separating “trafficking” from “trade” and the implications for law and policy Transplant international 30:209–213.

    Google Scholar 

  • Commission of the European Communities (2007) Communication from the Commission to the European Parliament and the Council. Organ Donation and Transplantation: Policy Actions at EU Level, 1–11. Brussels: European Commission http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A52007DC0275 (accessed 30 May 2018).

  • Cronin AJ, Johnson RJ, Birch R, Lechler RI, Randhawa G (2011) Solving the Kidney Transplant Crisis for Minority Ethnic Groups in the UK: is being transplanted overseas the answer? In: Weimar W, Bos MA, Busschbach JJ (eds) Organ Transplantation: Ethical, Legal and Psychosocial Aspects. Expanding the European Platform. Pabst Science Publishers Lengerich, pp 62–72.

    Google Scholar 

  • Danovitch GM et al. (2013) Organ trafficking and transplant tourism: the role of global professional ethical standards—the 2008 Declaration of Istanbul Transplantation 95:1306–1312.

    Google Scholar 

  • De Jong J (2017) Human Trafficking for the Purpose of Organ Removal. Utrecht Utrecht University (retrieved at www.hottproject.com).

    Google Scholar 

  • De Jong J, Ambagtsheer F (2016) Indicators to Identify Trafficking in Human Beings for the Purpose of Organ Removal Transplantation Direct 2:e56 https://doi.org/10.1097/txd.0000000000000568.

    Article  Google Scholar 

  • Domínguez-Gil B et al. (2018) Management of patients who receive an organ transplant abroad and return home for follow-up care: recommendations from the Declaration of Istanbul Custodian Group Transplantation 102:e2–e9.

    Google Scholar 

  • Domínguez-Gil B, López-Fraga M, Muller E, Gill JS (2017) The key role of health professionals in preventing and combating transplant-related crimes Kidney International 92:1299–1302 https://doi.org/10.1016/j.kint.2017.08.034.

    Article  Google Scholar 

  • Efrat A (2016) Global Efforts against Human Trafficking: The Misguided Conflation of Sex, Labor, and Organ Trafficking International Studies Perspectives 17:34–54.

    Google Scholar 

  • European Committee on Crime Problems (1980) Report on Decriminalization Council of Europe Strasbourg (available on request).

    Google Scholar 

  • Farrell A, Owens C, McDevitt J (2014) New laws but few cases: understanding the challenges to the investigation and prosecution of human trafficking cases Crime, Law and Social Change 61:139–168.

    Google Scholar 

  • Fry-Revere S (2014) The Kidney Sellers. A Journey of Discovery in Iran. Carolina Academic Press, Durham, North Carolina.

    Google Scholar 

  • Fry-Revere S, Chen D, Bastani B, Golestani S, Agarwal R, Kugathasan H, Le M (2018) Coercion, dissatisfaction, and social stigma: an ethnographic study of compensated living kidney donation in. Iran International Urology and Nephrology 1–12.

    Google Scholar 

  • Ghods AJ, Savaj S (2006) Iranian model of paid and regulated living-unrelated kidney donation Clinical Journal of the American Society of Nephrology 1:1136–1145.

    Google Scholar 

  • Gill J, Diec O, Landsberg DN, Rose C, Johnston O, Keown PA, Gill JS (2011) Opportunities to deter transplant tourism exist before referral for transplantation and during the workup and management of transplant candidates Kidney International 79:1026–1031.

    Google Scholar 

  • GODT (2017) Global Observatory on Donation and Transplantation (GODT). Newsletter Transplant. International figures on donation and transplantation 2016 EDQM http://www.transplant-observatoryorg/download/newsletter-2017/ (accessed 16th August 2018) Volume 22.

  • Greenberg O (2013) The Global Organ Trade. A Case in Point Cambridge Quarterly of Healthcare Ethics 22:238–245.

    Google Scholar 

  • Gutmann E (2014) The slaughter: mass killings, organ harvesting, and China’s secret solution to its dissident problem. Prometheus Books New York, NY.

    Google Scholar 

  • Haken J (2011) Transnational crime in the developing world. Global Financial Integrity http://www.gfintegrity.org/storage/gfip/documents/reports/transcrime/gfi_transnational_crime_web.pdf (accessed 20 October 2016).

  • Harris J, Erin C (2002) An ethically defensible market in organs Br Med J 325:114–115.

    Google Scholar 

  • Hilhorst MT, Van Dijk G (2007) Financial incentives for organ donation. An investigation of the ethical issues. Centre for Ethics and Health http://hottproject.com/userfiles/Publicaties/FinancialIncentivesVanDijkHilhorst.pdf (accessed 30th May 2018), The Hague.

  • Holmes P et al. (2016) Establishing trafficking in human beings for the purpose of organ removal and improving cross-border collaboration in criminal cases Transplant Direct 2:e58.

    Google Scholar 

  • Khalaf H, Farag S, El-Hussainy E (2004) Long-term follow-up after liver transplantation in Egyptians transplanted abroad Saudi Med J 25:1931–1934.

    Google Scholar 

  • Koplin J (2014) Assessing the likely harms to kidney vendors in regulated organ markets American Journal of Bioethics 14(10):7–18.

    Google Scholar 

  • Kwon CHD, Lee SK, Ha J (2011) Trend and outcome of Korean patients receiving overseas solid organ transplantation between 1999 and 2005 J Korean Med Sci 26:17–21.

    Google Scholar 

  • Lundin S (2012) Organ economy: Organ trafficking in Moldova and Israel Public Underst Sci 21:226–241.

    Google Scholar 

  • Mahdavi-Mazdeh M (2012) The Iranian model of living renal transplantation Kidney Int 82:627–634.

    Google Scholar 

  • Manzano A, Monaghan M, Potrata B, Clayton M (2014) The invisible issue of organ laundering Transplantation 98:600–603.

    Google Scholar 

  • Martin D et al. (2016) Prevention of Transnational Transplant-Related Crimes-What More Can be Done? Transplantation 100:1776–1784.

    Google Scholar 

  • Matas AJ (2006) Why we should develop a regulated system of kidney sales: a call for action! Clin J Am Soc Nephrol 1:1129–1132.

    Google Scholar 

  • Matas D, Kilgour D (2009) Bloody harvest: The killing of Falun Gong for their organs. Seraphim Editions, Woodstock ON Canada.

    Google Scholar 

  • Merion RM et al. (2008) Transplants in foreign countries among patients removed from the US transplant waiting list American Journal of Transplantation 8:988–996.

    Google Scholar 

  • Newton PJ, Mulcahy TM, Martin SE (2008) Finding victims of human trafficking. Citeseer, Bethesda: National Opinion Research Center.

    Google Scholar 

  • Orr Z (2014) International norms, local worlds: An ethnographic perspective on organ trafficking in the Israeli context. In: Weimar W, Bos MA, van Busschbach JJV (eds) Ethical, legal, and psychosocial aspects of transplantation: Global issues, local solutions. Pabst Science Publishers, Lengerich, pp 39–49.

    Google Scholar 

  • OSCE (2013) Trafficking in human beings for the purpose of organ removal in the OSCE region: analysis and findings. Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings. Vienna http://www.osce.org/cthb/10339 (accessed 15 March 2016).

  • Pascalev A et al. (2016) Trafficking in human beings for the purpose of organ removal: a comprehensive literature review. In: Ambagtsheer F, Weimar W (eds) Trafficking in Human Beings for the Purpose of Organ Removal. Results and Recommendations. Pabst Lengerich, pp 15–68.

    Google Scholar 

  • Sanal A (2004) “Robin Hood” of techno-Turkey or organ trafficking in the state of ethical beings Cult Med Psychiatry 28:281–309.

    Google Scholar 

  • Sanal A (2011) New organs within us: transplants and the moral economy. Experimental Futures. Duke University Press, Durham [N.C.].

    Google Scholar 

  • Scheper-Hughes N (2004) Parts unknown undercover ethnography of the organs-trafficking underworld Ethnography 5:29–73.

    Google Scholar 

  • Scheper-Hughes N (2011) Mr Tati’s holiday and João’s safari - Seeing the world through transplant tourism Body & Society 17:55–92.

    Google Scholar 

  • Shafran D, Kodish E, Tzakis A (2014) Organ Shortage: The Greatest Challenge Facing Transplant Medicine World Journal of Surgery 38:1650–1657 https://doi.org/10.1007/s00268-014-2639-3

    Article  Google Scholar 

  • Sharif A, Singh MF, Trey T, Lavee J (2014) Organ Procurement From Executed Prisoners in China Am J Transplant 14:2246–2252 https://doi.org/10.1111/ajt.12871.

    Article  Google Scholar 

  • Shimazono Y (2007) The state of the international organ trade: a provisional picture based on integration of available information Bull World Health Organ 85:955–962.

    Google Scholar 

  • Simforoosh N (2007) Kidney donation and rewarded gifting: an Iranian model Nat Clin Pract Urol 4:292–293.

    Google Scholar 

  • Territo L, Matteson R (2011) The international trafficking of human organs: a multidisciplinary perspective. CRC Press.

    Google Scholar 

  • Tong A, Chapman JR, Wong G, Cross NB, Batabyal P, Craig JC (2012) The experiences of commercial kidney donors: Thematic synthesis of qualitative research Transplant International 25:1138–1149.

    Google Scholar 

  • Tsai HJ, Yu CM, Wang YL (2011) Types of donor solicitation and their effectiveness on blood donation rates in eastern Taiwan Vox Sang 101:52.

    Google Scholar 

  • United Nations (2000) United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime. United Nations Office on Drugs and Crime. Vienna. Treaty Series, vol. 2237. https://www.unodc.org/unodc/treaties/CTOC/.

  • UNODC (2016) Global Report on Trafficking in Persons. United Nations Office on Drugs and Crime, Vienna https://www.unodc.org/documents/data-and-analysis/glotip/2016_Global_Report_on_Trafficking_in_Persons.pdf (last accessed 1 March 2018).

  • UNODC (2018) Case Law Database. Available from SHERLOC, from United Nations Office on Drugs and Crime (last accessed 29th January 2019). http://www.unodc.org/cld/index-sherloc-cld.jspx.

  • Yea S (2010) Trafficking in part(s): The commercial kidney market in a Manila slum, Philippines Global Social Policy 10:358–376.

    Google Scholar 

  • Yousaf FN, Purkayastha B (2015) ‘I am only half alive’: Organ trafficking in Pakistan amid interlocking oppressions International Sociology 30:637–653.

    Google Scholar 

  • Zargooshi J (2008) Iran’s commercial renal transplantation program: Results and complications. In: Weimar W, Busschbach J, Bos MA (eds) Organ Transplantation: Ethical, Legal and Psychosocial Aspects - Towards a Common European Policy, Lengerich, Pabst, pp 80–92.

    Google Scholar 

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Correspondence to Frederike Ambagtsheer .

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Ambagtsheer, F. (2020). Combating Human Trafficking for the Purpose of Organ Removal: Lessons Learned from Prosecuting Criminal Cases. In: Winterdyk, J., Jones, J. (eds) The Palgrave International Handbook of Human Trafficking. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-63058-8_99

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