There is an old and familiar urban legend about kidney thieves that prey upon unsuspecting travellers, stealing their bodily organs. The most common version involves a business traveller who goes out for a drink, gets knocked out, and wakes up in a bathtub full of ice with his kidneys missing.
According to Snopes, there have been no documented occurrences of travellers’ kidney being stolen. The roots of this story are probably an incident in 1989 where a Turkish man falsely claimed he had been lured to England with the promise of a job only to find his kidney removed. The story fell apart once it was revealed that he had advertised his kidney for sale, but not before the account had mutated and spread.
So you’ll have to understand that I was shocked, and a bit skeptical, to hear about roughly 600 kidneys stolen from poor people in India for transplant in rich foreigners:
Many of the donors were day laborers… picked up from the streets with the offer of work, driven to a well-equipped private clinic, and duped or forced at gunpoint to undergo surgery… The men said there were no postoperative medical checks and no discussion of money or other compensation.
Four doctors, 5 nurses, 20 paramedics, 3 private hospitals, 10 pathology clinics and 5 diagnostic centers were involved… The officials suspect that several private hospitals in Delhi and its suburbs were quietly complicit in Dr. Kumar’s work and treated patients recovering from kidney transplants.[Link]
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Beyond my moral revulsion, I was also a bit confused as to why they were robbing people of body parts when there was already a voluntary (and still illegal) trade in kidneys. Generally speaking, one would prefer to buy rather than steal kidneys because the donors are less likely to go to the cops and because you’re less likely to have your gundas stage a coup and take all your money.
Sure enough, this group both bought and stole kidneys, although we don’t know in what proportion:
… a team of criminals he called kidney scouts usually roamed the labor markets Delhi and cities in Uttar Pradesh, India’s poorest state, searching for potential donors. Some prospects were asked outright if they wanted to sell a kidney and were offered $1,000 to $2,500. A car equipped with testing equipment was often on hand so that potential donors could be checked immediately to see whether their kidneys matched the needs of prospective patients. [Link]
On a moral level, even one kidney being robbed from a victim is too much, but I will confess that part of my mind was trying to understand the … business model of these crooks as well. If it was effective, sadly we’re likely to see more crimes like this in the future.
This sort of thing used to happen in a working class neighborhood of Madras 10–15 years ago.
Reminds me of the stories of the other Chinese export:
Selling has been going on for a long time. Stealing at gunpoint had previously only been the stuff of urban legend.
Oops, sorry Ennis. I realized too late that your post is about combining illegal transplants with robbery and kidnapping. My previous post was off-tangent.
A morality case could be made. The poor person will subject his kidney to breaking down of bad country liquor and thus torture his kidney. Instead a rich man would use it to break down some fine scotch. Thus it’s philanthropy (or is it philkidephy) for the good of the kidney.
Ennis this is very very personal for me. My mother recently died waiting for a kidney because she was righteous and wanted to do it the legal way. I’ve lost count of how many people including top doctors in Mumbai suggested she go to Bihar, Haryana or UP and she’d get a kidney for “cheap” in a heartbeat.
This story not only doesn’t surprise me it’s something that is common knowledge among the medical professionals in India. At her funeral more than a few people accused me of letting her die because I did nothing about getting a kidney for her that was so easily available.
And all morality aside I’d have done it in a heartbeat if my mother would have agreed but she refused.
Gary Becker and Julio Elias made the case that introducing incentives for organ donation is analogous to a volunteer army, where we allow people to pick their point on the risk-reward tradeoff, and that adding monetary incentives would dramatically improve the availability of organs. I haven’t read the full paper, but Becker also has a related post on his blog.
The other thing, that I understand has really helped things in the US in recent years, was to introduce a ranking scheme so that organs go to the patients who need the, the most, rather than on a first-come first-serve basis. Ranking introduces thorny judgment questions across patients based on their need for an organ, and the likelihood of success, which is why it hadn’t been used previously, but this methodology is now used for lungs and livers at least, if I recall correctly.
Does India have a computerized national organ bank, and a timely transportation system? If so, for which organs? I assume allocation is still first-come first-serve among the legally available organs?
Okay, there was commabuse, intentional and otherwise, in that sentence. I meant:
The other thing that I understand has really helped things in the US in recent years, was to introduce a ranking scheme so that organs go to the patients who need them the most, rather than on a first-come first-serve basis.
JaneOAT, sorry to hear of what you went through. You did the right thing, though, and so did your mom.
If it weren’t illegal, do you think your mother would have been willing to pay for a kidney? I read Gary Becker’s piece a while ago, and its a very compelling argument that we should legalize it. The only question is whether such a trade would pose a moral dilemma to the recipient.
I think that might be more like “philnephropy”, but my Greek isn’t really what it should be.
Obviously, this isn’t really a laughing matter, and I feel really bad for people in situations lik JoaT and her mother. How hard must it be to take the moral high road when it’s a matter of life and death? — and we’re not even talking about stealing, but the buying of organs from “volunteers,” which is still considered unethical.
This subject reminds me of a recent episode of This American Life about a New York kidney matchmaker, who tries to get people to donate one of their kidneys to strangers in need.
It’s not just unethical, it’s illegal in India.
JoAT, I’m sorry to hear about your loss and the circumstances of it.
Reminds me of Turistas and the really good Dirty Pretty Things.
Rahul: Unfortunately, I don’t think it’s strictly that simple, even in the US. The LA Times did a huge investigative series last year about all kinds of transplant issues:
Thanks for the pointer, kusala. I don’t have time for more than a quick skim right now, but it is disheartening that allocation seems to be fragmented into such tiny geographical units, leading to huge inefficiencies. Hopefully, I can get to these articles over the weekend.
This was another interesting read on the topic of kidney donoation.
[hijack] snopes is very strict about people reproducing material from his site on their own including the little comic. http://www.snopes.com/info/faq.asp [quote] Q: May I reproduce your material on my web site?
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If you haven’t done it already, please get permission from snopes. [/hijack]
Pagla, did you just reproduce snopes’ faq on sepia? I hope you asked nicely.
Internal organs are being stolen from the living bodies of destitute and abjectly defenseless people. Unsurprisingly, after an appropriate display of bourgeois moral revulsion, comes the inevitable accommodation of yet another grotesque injustice enmeshed in the fabric of Indian society.
-The ironic Swiftian moral commentary
Really folks, ask yourselves: Where, Oh Where else but in India? Perhaps after all we really do inhabit a hell of our own making. . .
JOAT, so sorry to hear of your loss.
Ennis – I believe it is illegal because it is wrong not the other way around.
This is what socialized medicine leads to.
Actually since a few asked, the “buying” of organs in India is fairly common practice. Yes it’s illegal but only in some states and ignored in other states. For example in Maharashtra because of past abuses the practice is completely illegal. The only way you can produce a organ donor on your own is if the person is related to you.
We met a lot of different people who had received kidney transplants via a support program thru Hinduja hospital whenever my mom used to go for her Dialysis and almost all of them exclusively were wealthy enough to have “funded” a kidney from a “relative” from the village. I know two people personally who found someone from their village willing to give the kidney. There was a financial transaction under the table but essentially they claimed that they were “related” and the person was doing it legally.
Beyond that the chances of finding a kidney thru the databank is next to impossible. The wait is very very long and the priorities are set depending on who has more money and more connection as well as most ethical doctors if they had the power would give it to someone who would be a “good” recipient. Meaning they’d be young and in good health, able to handle the surgery and sustain it. Older folks who had the surgery almost exclusively found the donor on their own the hook and crook way.
And yes if I could have convinced someone from our village to do it for money if they were a match I could have but we couldn’t find anyone. We searched.
22 · Rahul said
well… this is what PPP leads to.
i know. this is a huge concern in canada. i’ve not needed to test the system in any way but i know it’s busted here – but having elderly parents… the linked story sent chills and i worry for them.
getting back to kidney transplants – i think the process of selling is morally corruptING [notice the gerund. i didnt say corrupT, but corruptING] – it makes for a situation in which ghouls like this amit kumar act wth impunity because the supporting infrastructure is able to ‘legally’ justify away their role in the harvesting.
At her funeral more than a few people accused me of letting her die because I did nothing about getting a kidney for her that was so easily available.
Thats really low and completely outrageous.
From the NYT on kidney transplants:
Money is clearly the issue in situations involving the human body. Paying young women for eggs to be fertilized and men for sperm is now common practice — even though they are still regularly referred to as “donors.†Yet the sale of tissue, cells and eggs for stem-cell research or organs for transplant are still the subject of vehement dispute.
Pope John Paul II said that treating human organs as part of any commercial exchange is “morally unacceptable,†a view echoed by the Council of Europe’s Convention on Human Rights and Biomedicine.
In the United States federal law prohibits the sale or purchase of human organs. The American Kidney Foundation itself opposes payments on the ground that it “devalues life.†And the conservative bioethicist Leon Kass, who was chairman of the President’s Council on Bioethics from 2002 to 2005, has called the commercialization of body parts “just inherently wrong.â€
“If we come to think about ourselves like pork bellies, pork bellies we will become,†Mr. Kass has written.
Sally Satel, a psychiatrist and resident scholar at the institute who was herself the recipient of a kidney donation in 2006, asserts that the issue does not need to pit human dignity against saving a life. “A salaried fireman who saves a life is not less heroic,†she said. “An object or act can have a price and still be invaluable.â€
She has forcefully argued in The New York Times Magazine and elsewhere that the sale of human organs with proper oversight to prevent exploitation of the poor should be permitted. There are 74,000 people on the waiting list, and in 2006 about 4,400 died before they could get a kidney. The need is too great, she said. The Nobel Prize-winning economist Gary Becker and his colleague Julio Jorge Elias have even calculated how much a kidney should sell for to eliminate the backlog completely.
In recent years Mr. Roth has helped set up “paired kidney donations,†in effect, allowing sets of donors and patients to swap kidneys in order to find a compatible one. These kidney exchanges, which started in 2005, have gained growing acceptance nationwide, he said.
GTA home to ‘Dr. Horror’