By Kaitlyn Schaeffer
Every year in the United States, 4,000 people die waiting for a kidney. Worldwide, the discrepancy between supply and demand is similarly dismal: the World Health Organization estimates that only about 10% of the need for kidneys is supplied by the current availability of organs.
Despite its illegality in most countries, there is a thriving market for organs worldwide. Kevin Sack of the New York Times has spent the past year investigating this illegal trade.
One of the things Sack discovered is Israel’s disproportionate influence on global demand: “[O]ver the last fifteen years, just time after time, when there have been prosecutions of organ traffickers, Israel always seems to have some role. Israelis are either the buyers or the sellers. Often their the brokers.”
Sack postulates that this stems from the Orthodox belief that brain death (the optimal circumstance for organ donation) is not actual death; many Jewish scholars maintain that life ends only when an individual stops breathing. Such a belief results in longer waitlist times. Additionally, only about 15% of Israeli adults are registered donors, as compared to about 50% of American adults. These factors often lead desperate patients and family members to look elsewhere for organs.
“The continued driving force is the lack of deceased donation in Israel and the concept that every rich person worldwide would rather put a stranger at risk than a relative,” said Dr. Jeremy R. Chapman, an Australian nephrologist and former president of the Transplantation Society.
Sack and his research team discovered that the supply side of the organ market is concentrated in poorer regions, especially in South American countries like Costa Rica.
“The way we decided to go about this, to sort of illustrate how organ trafficking works, was to trace a network from beginning to end, and this was a network in which Israeli brokers sent mostly, but not exclusively, Israeli recipients to Costa Rica, where a prominent nephrologist would connect them with kidneys sold by poor Costa Ricans.”
While such practices certainly raise questions of coercion, they also bring up the larger issue of the ethics of a market for organs, a question Sack discusses in detail in this article.