Reporting Organ Trafficking Networks: A Survey-Based Plea to Breach the Secrecy Oath

Abstract

Patients travel worldwide to purchase kidneys. Transplant professionals can play a role in identifying kidney purchase. However, due to the tension between their rights and obligations, a lack of understanding and knowledge exists on how to prevent and report purchase. We present the results of a national survey that describes transplant professionals' experiences, attitudes, behaviors, conflicts of duties, legal knowledge and needs for guidelines toward patients who purchase kidneys abroad. Second, we clarify professionals' rights and obligations regarding organ purchase and propose actions that they can take to report purchase. Of the 100/ 241 (42%) professionals who treated patients who traveled to a country outside the European Union for a kidney transplant, 31 (31%) were certain that patients purchased kidneys. Sixty-five (65%) had suspicions that patients had bought kidneys. The majority reported a conflict of duties. Eighty percent reported a need for guidelines. Professionals can help prevent organ purchase by disclosing information about organ trafficking networks to law enforcement. Such disclosure can support the investigation and prosecution of networks. We offer key components for guidelines on disclosure of these networks.

On Patients Who Purchase Organ Transplants Abroad

“…Of the 76 articles that present patients who traveled, 42 articles describe them as “transplant tourists” who “bought” organs by undergoing “commercial” , “self‐sponsored” , or “paid” transplantations abroad (Table ). Together, these articles report 2921 “tourists” (Table ).…”

“…Thus, what is needed is not only more rigorous quantitative and qualitative studies but also efforts to integrate available information. First, national surveys could be circulated among transplant professionals to document domestic cases of organ purchase . Second, transplant professionals could contribute to gaps in knowledge by conducting anonymous interviews with patients about their motivations and experiences with undergoing commercial transplants abroad .…”

“…Third, targeted searches in registration systems of national police forces and other law enforcement agencies have illustrated that such sources can reveal possible cases of organ trading that were not recognized as such during the initial stage of police investigations . An international registry that integrates these data or a reporting code that documents trafficking networks is a final strategy to collect and quantify cases.…”

‘I’m not Sherlock Holmes’: Suspicions, secrecy and silence of transplant professionals in the human organ trade

“…We interviewed 41 transplant professionals based in hospitals throughout The Netherlands, most of whom completed our survey and who reported having treated patients whom they suspected or knew had purchased kidneys abroad (Ambagtsheer et al, 2015). The respondents comprised 29 nephrologists (N), 5 nurse practitioners (NP), 5 social workers (SW), 1 research nurse and 1 transplant surgeon.…”

Curbing transplant tourism: Canadian physicians and the law

“…Various commentators have suggested that requiring the reporting of this information, for example to a central public health authority, would help to combat transplant tourism by providing information about the nature and scope of the phenomenon and would potentially facilitate follow-up by regulators in the relevant jurisdiction. 6,9,10 The potential merits of such a reporting scheme present an opportunity for modest, yet valuable, legal reform in Canada. Existing health information legislation could be amended to create a reporting system that permits or even requires physicians to provide basic information about suspected transplant tourism, including the location and any known details about the organ transplant network.…”