By William W. Bauser, Member of the Board of Stop Organ Trafficking Now
The “Declaration of Istanbul on Organ Trafficking and Transplant Tourism” has been a representation of a consensus that was established to govern organ transplantation. The principles of the Declaration established regulations of recipient safety, and also established an enforcement system of standards on organ transplantation unethical activities. However, it is a consequence of the Declaration as well as other laws that an organ shortage for organ transplantation has created unethical practices for organ trafficking. Organ transplant tourism has also resulted from unethical practices into transplant commercialism.
Along with the international endeavor to establish a stable ethical system to interact with the supply and demand for organs transplantation, several countries, such as the United States, India, South Africa and China, have passed laws that are designed to end the illegal organ commercialism. However, even with these laws and enhanced efforts of law enforcement agencies to crack down on transplant commercialism, advances in science, local rules, customs and internet marketing of organs have given way to a “black market” in organs because the demand for organs outweighs the supply. Along with this commercialism, there are those individuals who are in need of an organ who will pursue the purchasing of a transplant organ in those countries where there is a lack of enforcement in organ trafficking.
What is going on here is that organ traffickers are exploiting the mindset of individual countries. How they are doing so can be seen in two perspectives, either as the justification of the logic of consequence or as a discovery of the logic of appropriateness. With the logic of consequence, organ transplant actions are the result of constructed reasoned decisions that are based upon a person’s self-interest. Whether a person perceives himself or herself as an exemplary individual or not, it depends on how his/her self-interests are aligned with, financially or culturally, the majority of the citizens. This collective (citizens) decision regarding organ transplantation is based upon the incentive of practical decision-making. Hence, the consequence of the issue of supply and demand of organ transplantation outweighs all normal ethical concerns of organ transplantation. Therefore, the demand for an organ becomes an ultimate question of survival to which the intervention of organ commercialism is an answer. If one has the money and is willing to travel as a native, then one will get an organ. With the logic of appropriateness, organ transplantation actions are based upon rules of appropriate behavior that have been organized into institutional behavior. These principles of ethical organ transplantation have been established because they are perceived as being ethical legal obligations of a given political community. These ethical legal standards represent a collective social practice of organ transplantation that is based upon a tacit understanding of what are ethical legal accepted practices of organ transplantation. However, both of these perspectives lack the recognition of individual needs, wants, and the practical consequence of such actions. Therefore, organ transplantation is caught between either the ineptitude or desire regarding organ transplantation as a collective perspective. Knowing full well that all interventions by a collective are an overestimation of the collectives’ capability, those engaged in transplant organ commercialism are willing to find a means to satisfy the demand for organ transplantation.
With this being said, what is available to solve this problem and could inhibit organ trafficking? One approach is to realize the failure of an either-or constructed logic that is represented in logic of consequence and logic of appropriateness. The failure with either of these approaches lie in the constructed biases of an exclusive reasoning of being “better than” another rather than an inclusiveness of betterment. It is these exclusive constructed reasons of “better than” that allow the actions of organ trafficking to happen because of the consequences of local sovereign entities’ reasoning of the practices. Instead of looking at the abstract constructed logics, standards of ethical practice need be established through discussion and accountability from all countries. As Heraclitus tells us, “of all whose discussions I have heard, there is not one who attains to understanding that wisdom is apart from all.” Consequently, it is through the civic engagement with the issue of organ transplantation that we can achieve a betterment for all through the enlightenment of the accountable and transparent relationships between creativity and experience as neighbor helping neighbor that will inhibit the need and want for organ trafficking and organ commercialism.
Image is from T. Sild at Wikimedia Commons.