International

If organ tourism is to be prevented, argue Andre den Exter, Agnes Kant and Ineke Palm, a ban on payment for illegal organ transplants performed abroad is needed, as is the ratification of a number of treaties.

by André den Exter, Agnes Kant en Ineke Palm

The slogan with which health insurance firm Univé attempts to recruit clients ('daar plukt u de vruchten van' – you'll reap the fruits of it), has acquired a sour aftertaste indeed now that it has become known that the company has been indirectly involved in the commercial organ trade through the financing of an organ transplant in Pakistan where the donor was paid. As a result of long waiting lists in their home countries patients from the west look for salvation in eastern Europe and in Asia, where donors are sometimes paid large sums to give up an organ. Although trade in organs is legally banned, including in countries such as India and Pakistan, in practice the picture is very different.

As long ago as 2002, the Council of Europe conducted an investigation into the phenomenon of organ trafficking in Europe. This research brought to light the existence of organ trafficking networks in countries such as Moldavia, Turkey, Ukraine and Israel, a finding confirmed by Europol.

This investigation resulted in a recommendation to the Council of Europe's member states to the effect that the ban on organ tourism should be incorporated into criminal law, a proposal which aroused interest. This recommendation was not all that came out of the research, moreover. The Convention on Biomedicine and Human Rights also came into being via the Council of Europe, as did its supplementary protocol on organ donation, which is unambiguous regarding the ban on financial gain from organ and tissue donation.

The trade in organs exploits vulnerable people and undermines public confidence in the system of transplants. In the event of transgressions of the Convention, the duty to take legal measures rests upon the signatory states, albeit not necessarily through the criminal law.

Costs

In the Netherlands the Law on Organ Donation (WOD) regulates the ban on trading organs, but the relevant provision limits itself to the deliberate aiding of the removal of organs for payment. It is also forbidden openly to offer compensation in order to receive an organ. A kidney patient who offers financial compensation to a donor which amounts to more than the costs involved with the operation is risking criminal prosecution.

Unlike the patient, the health insurer appears to avoid any chance of criminal prosecution on the basis of the WOD, even if paying compensation for the illegal transplant. This unsatisfactory situation surely gives food for thought. That a ban on paying for illegal organ transplants in foreign countries – on organ trafficking – is needed is self-evident. Such a ban would provide health insurers with the necessary clarity. The medical adviser concerned should, as things stand, on the basis of existing medical-ethical professional standards, reject cooperation in and thus reimbursement of costs of such organ trafficking.

Such a ban on compensation for illegal transplants has already been instituted by the Council of Europe and can be found in addition in the Convention on Biomedicine and the relevant protocol. All the more reason for the Dutch government to expedite the intended ratification of these treaties.

André den Exter is a lawyer working on health-related cases. Agnes Kant is a Member of Parliament for the SP. Ineke Palm is a policy adviser to the SP's parliamentary group.

This article appeared in the original Dutch in the Christian daily newspaper the Nederlands Dagblad, 14th February 2008.