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1 Shayna Palmer ENG-106 2/7/21 Connie Sherwood Organ Brokers Criminal Act In today's society what we might have considered ¨taboo¨ might now not be considered that any longer due to the high demand and utter desperation to save a loved one's life. The sale of human organs is more common than we think. Illegal, but still common. With society today, people take things for granted. People do not know what they have until it is gone, for example, toilet paper. Something simple, but always in demand. When COVID-19 first hit the U.S., everyone went into a panic and proceeded to buy all the toilet paper in every store. People became afraid of running out of necessities due to being in quarantine, so an effect of that is there was no toilet paper for the next family. The supply for toilet paper became scarce due to the very high demand, and suppliers could not keep up. Until stores started putting limits on how many paper products could be purchased by each person. With the limits, it began to alleviate the shortage enough for suppliers to keep up with the demand again. Organs are not the same as toilet paper, but the concept is the same. Organs are in high demand and donors are becoming scarce each year. With the organ shortage, society is faced with outlets such as the black market, organ brokers and eliminating criteria for becoming a donor. Without a doubt, the black market has grown exponentially over the years. The black market is everywhere, not just in the United States. Anything immoral, contraband, and illegal items for the exchange of money are usually found on the black market. The black market has a wide range of items sold such as organs. While it is hard to track the exact growth of organ

2 trafficking in the black market, the booming rate estimates $840 million to $1.7 billion annually(ACAMs today, 2018). The lack of donations and the high number of wait-listed patients have been a key role in the reasoning behind the organ trafficking on the black market. ¨Currently, the World Health Organisation estimates that of the 660,000 people in the world who require any form of transplant, 10% receive one each year¨(Major, 2008). With these statistics, people begin to ask themselves what they can do as a society to help out. Some may say to regulate the market to make compensation for an organ legal to meet the demand. This phenomenon is called ¨Transplant Tourism¨. Iran is the only country who legally sells and trades organs. The Iranian government wanted a more conventional way to bridge the gap between the supply and demand for organs. The government has run a regulated and funded transplantation process to compensate the donors for their organs(Major, 2008). If Iran can do it, why can't other countries follow suit to solve the shortage for kidneys? While the Iranians transplant process sounds great on paper, they are also known to have ethical and legal loopholes to which have been exploited. With compensation on an organ donation makes it an organ sale, which is illegal and potentially higher health complications without the proper qualifications to receiving an organ through donation. In addition, the black market comes with organ brokers. Still an illegal profession, an organ broker could determine the how,why, and source of the organ. Not saying that they could choose right from wrong as the act itself is illegal, but they could see themselves as a good samaritan in the act. To understand the issue behind paid organ donations is to understand why organ brokers play an important role behind it all. The organ trade network involves a network of people including mobile surgeons, brokers, patients, and sellers. The reason behind organ brokers is to bridge the gap between the shortage in the supply and make a higher demand.

3 Organ brokers' demographic for paid donors are the poor and uneducated, because they see them as easy targets to manipulate. Brokers will take advantage of both the seller and recipient due to their vulnerability and despair to gain the potential compensation (Adair and Wigmore, 2011). No matter the market, brokers will seek the profit margin even with the results of human exploitation. ¨On average, Over 3,000 new patients are added to the kidney waiting list each month¨(National Kidney Foundation, 2016). For organ brokers to stay in business, they look at the statistics and see where the demand for organs is crucial, therefore they see it as an act of good as they believe they are building the supply. In hindsight, it is morally and ethically wrong to gain compensation for one's organs. People who are for organ sales see it as growing the economy and will argue that they should have all freedom to do as they please with their bodies (Shapiro, 2003). The effect of compensation would undermine the voluntary organ donations. There would be a chain effect or domino effect of things that would take place such as, a scarcity of organ donations. For instance, when compensation for blood became legal, the overall blood supply dropped sharply because the increase of paid donations has caused a decrease in voluntary donations. Organ brokers will always be the middleman and the third party in the black market with only monetary values in mind when making sales. Are organ brokers doing more harm than good? The morals and ethics behind selling and buying organs on the market are a complex and context dependent issue. It is said that if there was a full compliance of rules on a regulated market, it would fail to ensure ethical acceptability. With that being said, the ethics are dependent on case by case of each person. The ethics of organ donations and the market are not only morally argumentative, but whether doing so also would actually increase supply. If there was a regulated market for organ sales, then there would still be corruption in the market and would not eliminate the black market completely.

4 Lastly, the criteria to be a live donor in the United States seems simple in writing but the waitlist tells otherwise. The medical and psychosocial health of potential living donors are assessed by the transplant program (Transplant living, 2017). As stated before, the waitlist has approximately 3,000 new patients added each month. If the qualifications seem simple, then why is the waitlist so long? One of the complex qualifications is finding a match based on blood type. ¨Blood type O has the longest wait. This is because blood type O donors can donate to other blood groups, but a patient with blood type O can only receive an organ from a donor with blood type O¨ (National Kidney Foundation, 2021). The reason for donations is the personal gratification knowing the potential of saving a life. Through the criteria put in place now in the United States, transplants have become successful. With the success, it has led to unprecedented demand for organs that unfortunately remain in short supply. The science behind donation makes it more complex and has led to ¨more than 116,000 patients being on the United States transplant waiting list but only about 28,000 transplants were performed in 2012¨ (Razdan, Degenholtz, Kahn, and Driessen, 2015). Time is a luxury that a lot of sick people cannot afford. ¨Sadly, 8,000 people die each year (on average 22 people each day — almost one person each hour) because the organs they need are not donated in time¨ (National donate life, 2019). To eliminate some of the complexity of the qualification process could alleviate the shortage for organs. One way is coming to a consensus on compensation for the viable organs. Having a concept of a controlled system of financial payment for the donor without the middleman, organ brokers. As the demand for organs increases, it is important to ensure new policies and laws of the increasing organ supply to be ethical and the welfare of the society to be altruistic. In conclusion, society is faced with outlets such as the black market, organ brokers and eliminating criteria for becoming a donor to alleviate the demand. In today's climate where needs

5 become greater than wants, the idea of selling human organs to save someone's life seems grotesque. However, having to be faced with the decision on buying or selling an organ for a loved one may seem like a logical thing to do in a desperate situation.

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