By Cam Elliot ’18
Cadavers and transplant organs seem at first to be very similar products. After all, both are produced by the same process, that is, people, and one is made up of the other. In practice, however, the markets for these two human products are quite distinct. Transplant organs and cadavers enter the supply chain in different locations as a result of significant difference in the ease with which governments can regulate the two markets.
Cadavers, which have been dead for some time and have no organs that can be used in transplant procedures, enter the supply chain primarily from various willed-body programs in the developed world (Cheney). Tulane University, for example, does not make use of roughly two thirds of the cadavers that it receives- instead, these bodies are distributed by third-party firms, which profit from the transportation process (Mangan). This trading on U.S soil is possible for several reasons. Firstly, although the sale of human organs for transplant is illegal in the U.S, the sale of cadavers is “a gray zone” (Mangan).
Furthermore, willed-body programs include “little supervision of procedures” and donors usually agree to terms that “do not spell out the uses to which their remains might be put” (Phillips). Finally, there is a significant legal loophole that protects corpse brokers: Although selling cadavers is illegal in the U.S, a would-be cadaver salesman can charge as much as they wish for transporting the body, without violating the law (Phillips). Transplant organs, however, are a very different animal, as they are well-regulated and carefully monitored within the U.S (Phillips.) As a result, those in need of organs look abroad, to countries that either cannot or do not prohibit organ sales, and that have large, poor populations desperate enough to sell their organs. Moldova, one of the poorest countries in Europe, is one of the cheapest source of organs, and many Moldovans know someone who has sold a kidney, even if they have not done so themselves (Sanduta). Similarly, many Bangladeshi sell their organs to pay off debts they would otherwise be forced to default on (Cousins). Other sources include India, China, Brazil, Pakistan, and Romania (Dillard-Wright). Ethical concerns aside, this divergence in supply is a result of significant differences in the transplant organ and cadaver markets. One of the primary contributors to the supply divergence is the relative difficult with which laws governing the two markets can be enforced.
Transplant organs need to be alive at the time of transplantation. In practice, this means that either a living person must be brought to a place where the transplant can occur, or a preserved organ must be brought to the buyer extremely quickly after removal. Furthermore, buyers may want a hospital in the developed world that they know to be reliable to confirm that the organ in question is a match for them, like the purchasers of Moldovan kidneys (Sanduta). An individual with a very high degree of skill is also needed to perform the actual transplant. This leads to a market that can be easily regulated, provided the government of a region has sufficient resources to do so. This is because organ transplants tend to create trails that a law enforcement agency can follow, and provide points of attack for countries, such as the U.S, that are interested in preventing the sale of organs. As a result, within the U.S, organ donation is “all above board and tightly regulated” (Phillips). This stands in stark distinction to the trade in bodies. The most visible distinction is the lack of a living person missing a kidney who might protest the vendor’s actions, and it is a significant one- people are far more likely to pay attention to living people than dead bodies. Due to this, cadavers can be transported much like any other package, or even sent through the U.S postal system. (Cheney). What is more, after a cadaver has been through the market, “cremation covers up unscrupulous operator’s tracks” (Phillips). An organ sale, even if the initial exchange is completed discretely, leaves lasting marks. Implant receivers will likely need anti-rejection drugs, post-op care, and other medical treatment, all of which will be visible in medical records. This lack of discretion makes it easier for organ traffickers to locate a supply that is technically legal, or located in a country that is unlikely to pursue the crime, and deal with the logistics of transporting these organs to the buyers in the developed world than it would be for them to attempt to harvest organs closer to the buyers. Cadaver brokers, by contrast, are better served by taking advantage of the readily-available supply of bodies within the U.S, secure in the knowledge that any laws more restrictive than those currently in place would likely be too costly to enforce in the current political climate.
Recognizing the divergences between these two markets is critical if we wish to effectively regulate either of them. Enforcement efforts in cadaver-trading using the same policing methods as in the organ trade will almost certainly fail, due to the minimal evidence left behind in cadaver trading. It may be easier to limit the cadaver trade through economic disincentives such as taxes then by trying to track down its participants and bring criminal charges against them. Meanwhile, the organ trade is more easily pursued as a criminal matter, due to its more traceable nature- however, to eliminate it, international pressure must be applied to incentivize countries where organ purchases frequently occur to work against the organ trade.
Works Cited
Cheney, Annie. “The Resurrection Men.” Harper’s Magazine 308.1846 (2004): 45-54.Academic Search Complete. Web. 28 Oct. 2014.
Cousins, Sophie. “Desperate Measures.” New Internationalist 467 (2013): 42-43. Academic Search Complete. Web. 29 Oct. 2014.
Dillard-Wright, David B. “Life, Transferable: Questioning The Commodity-Based Approach To Transplantation Ethics.” Society & Animals 20.2 (2012): 138-153. Academic Search Complete. Web. 29 Oct. 2014.
Mangan, Katherine S. “The Remains Of Dismay.” Chronicle Of Higher Education50.37 (2004): A27-A28. Academic Search Complete. Web. 28 Oct. 2014.
Phillips, Stephen. “The Return Of The Body Snatchers.” Times Higher Education Supplement 1633 (2004): 22. Academic Search Complete. Web. 29 Oct. 2014.
Sanduta, Iurie, and Barbara Frye. “Selling Themselves.” Transitions Online (2013): 8.Academic Search Complete. Web. 29 Oct. 2014.