Thursday, July 14, 2022

Allegations of organ trafficking for kidney transplants--in England and India

 From time to time there are stories of prosecutions for organ trafficking in connection with kidney transplants.

Here's a story developing in England. (Early reports were that the alleged donor/seller/victim was a child, but apparently he's not a minor):

From the BBC:

Ike Ekweremadu: Nigerian senator faces London organ-harvesting trial

"A prominent Nigerian senator and his wife who are accused of plotting to harvest a man's kidney in the UK will face trial at the Old Bailey.

"Ike Ekweremadu, 60, and Beatrice Nwanneka Ekweremadu, 55, are alleged to have transported a 21-year-old man from Nigeria to London.

"Prosecutors allege the couple planned to have his kidney removed so it could be given to their daughter.

...

"The alleged victim is said to have refused to consent to the procedure after undergoing tests at the Royal Free Hospital in Hampstead."

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Not long ago I participated in an online conversation including Professor Janet Radcliffe Richards, who recalls that her view that bans on kidney sales are ill-conceived arose from news in the 1980's about a case involving Turkish sellers (here's an LA Times story from then):

London Kidneys-for-Cash Scandal Prompts Action to Ban Sale of Organs BY ROBERT BARR JULY 16, 1989

"“The concept of organs being bought and sold for money is entirely unacceptable in a civilized society,” Health Minister Roger Freeman told a House of Commons committee during debate on proposed legislation outlawing organ sales. The bill is expected to pass Parliament later this month.

"Not all lawmakers agree.

“The bill will cause death where there could be life, and to prolong suffering where we could provide relief,” said Sir Michael McNair-Wilson, a Conservative Parliament member awaiting a kidney transplant.

...

"Neil Hamilton, who cast the only vote against the bill in committee, said he had pondered the dilemma facing one Turk who allegedly sold a kidney.

“His daughter was suffering from a medical problem which threatened her life, but it could not be solved in Turkey without money,” Hamilton said. “If he did not get the money for the operation, his daughter would die.”

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The situation in India is complex, since there is or was something of a long tradition of kidney sales, which are against the law, and are guarded against by authorization committees that have to approve each living donor transplant. Recently, kidney exchange has become legal in India, but the law only allows close family to be the intended donor in an incompatible patient-donor pair. Below is a report of a case where it's alleged that an attempted donor was paid, and also illegally claimed to be a family relation.

Here's the Hindustan Times story:

Ruby Hall Clinic kidney transplant ‘malpractices’ probe handed over to crime branch

"Earlier on Wednesday, police officials probing the case told Magisterial court that more cases of kidney transplants based on the relationship claims have been unearthed during the interrogation of agents Ravindra Rodge and Abhijit Gatane. Both have been arrested by the police. These two agents having donated their kidneys earlier and also played the role of middlemen in at least four kidney transplants where alleged malpractices were involved.

...

"The case pertains to a kidney swap procedure, also known as paired kidney exchange, between the Moshi man and the Kolhapur woman posing as his wife, and a mother-daughter duo from Baramati."

And here's the story in the Indian Express:

Two middlemen arrested in Pune kidney transplant malpractice case. The other accused in the case, including Ruby Hall Clinic doctors, the patient who received the kidney, and the unrelated donor who was passed off as his wife--are yet to be arrested.

"Police have arrested the two middlemen over the alleged malpractices in a kidney transplant conducted at Pune’s Ruby Hall Clinic in March in which an unrelated woman was allegedly presented as the organ receiver’s wife and promised Rs 15 lakh in return.

...

"Among the 15 people named in the FIR are the hospital’s managing trustee, Dr Purvez K Grant, deputy medical director Dr Rebecca John, legal advisor Manjusha Kulkarni, nephrologist Dr Abhay Sadre, urologists Dr Bhupat Bhati and Dr Himesh Gandhi and transplant coordinator Surekha Joshi. The police also booked the two middlemen, the patient—from Pimpri Chinchwad’s Moshi area—who received the kidney, his wife, their three family members, the woman from Kolhapur who was allegedly passed off as the patient’s wife to become the donor."

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Among the most vigorous opponents of paying kidney donors--e.g. among some of those who think it's a crime against humanity--there's also opposition to extending the scope of legal, ethical, unpaid kidney donation and transplantation, particularly in poor countries.  One reason for this is the intuition that more transplantation will cause more paid transplantation.  The cases reported above, although rare, help to support this view.

But a much stronger case can be made that it is the unavailability of transplants that causes exploitative black markets, and that increasing the availability of legal transplants will reduce the demand for illegal ones.

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