Human trafficking for the purpose of organ removal

Since the 1980s, the demand for organs available for transplantation is far outpacing the supply, with kidney transplant waiting lists growing most prominently. Although the buying and selling of organs is prohibited worldwide with the exception of Iran, the organ shortage has driven patients from industrialized countries in need of a kidney transplantation to developing countries where poor individuals are willing to ‘donate’ a kidney in exchange for money. The organ scarcity has generated a highly profitable black market where illicit acts and means are applied for the purpose of exploitation; i.e. human trafficking for the purpose of organ removal. Due to the complex nature of the criminal activities, which require compatible patients and donors, transplant surgeons and an operating theatre, the organ trade is said to involve globally active and well-organized criminal networks. However, literature supporting this claim is scarce; there is a critical lack of evidence-based research regarding the crime’s organizational model.
The aim of this study was to contribute to criminological research by addressing this knowledge gap through a close examination of relevant criminal cases, which are limited in number worldwide but shed a light on the entire human trafficking process, in order to provide an answer to the following central research question: How does the interaction between the prohibition and the demand and supply of human organs for transplantation shape the mechanisms and organizational model of human trafficking for the purpose of organ removal? With support of QSR*NVIVO software three criminal cases have been analysed by studying 31 court documents and interviewing 45 respondents, mainly law enforcement officials and defense lawyers in South Africa, the United States, Kosovo and Israel. As secondary sources, four documentaries which disclose valuable information about the cases have been included, as well as the recordings of two expert meetings on human trafficking for the purpose of organ removal.
The results show that recipients and donors have been exploited using illicit acts and means with the purpose of organ removal by loose, flexible combinations of numerous organized criminal networks and actors that have joined forces to facilitate illegal kidney transplants on a global level in an extremely well-organized manner. Although the prohibition of the organ trade have been enacted to inhibit profiteering and human trafficking, the rising demand of organs since has generated a highly profitable and exploitative underground transplant industry, which indicates that criminalization is more likely to have reinforced trafficking. The organization of the crime is a dynamic process, resulting from the interaction of illegal market dynamics, skills and networks of the offenders and legal control efforts. Due to local inadequate existing legal frameworks and a lack of knowledge and experience regarding the offence on the judicial level, enforcement is practically non-existent or has led to tactical and spatial crime displacement. A continuing high demand for transplantable organs will make it difficult to restrain the underground market by means of repressive action, whereas some form of regulation may result in lower crime and victimization rates by tackling the organ scarcity.