There’s a long-standing urban legend about where you meet an attractive person in a bar, they buy you a drink, and the next thing you know you wake up in a bath of ice with a pain in your lower back and a note telling you to get to a hospital. One of the reasons this story is just a story is that in order to usefully extract someone’s kidney for transplant, a whole lot of stuff has to be organized beforehand, and you need to have a lot of skilled people working together against a hard time constraint — too many, really, to quietly and reliably pull something like this off.
Mr. Mohammed was the last of about 500 Indians whose kidneys were removed by a team of doctors running an illegal transplant operation, supplying kidneys to rich Indians and foreigners, police officials said. A few hours after his operation last Thursday, the police raided the clinic and moved him to a government hospital. … Many of the donors were day laborers, like Mr. Mohammed, 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 operations. Others were bicycle rickshaw drivers and impoverished farmers who were persuaded to sell their organs, which is illegal in India.
Although several kidney rings have been exposed in India in recent years, the police said the scale of this one was unprecedented. Four doctors, five nurses, 20 paramedics, three private hospitals, 10 pathology clinics and five diagnostic centers were involved, Mohinder Lal, the police officer in charge of the investigation, said. “We suspect around 400 or 500 kidney transplants were done by these doctors over the last nine years,” said Mr. Lal, the Gurgaon police commissioner.
I’d be interested to see how many suppliers were straightforwardly lied to about what they were getting into, or otherwise forced to undergo operations, and how many were offered money first (and paid afterwards). Unlike some other documented cases of organ sales, this seems less like an illegal but functioning market and more like a criminal racket founded on fraud.
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Eszter 01.31.08 at 5:57 am
Reminds me of Dirty Pretty Things, a film I recommend.
john in california 01.31.08 at 9:47 am
” ..an illegal but functioning market..” WTF? Would you consider murderinc part of an illegal but functioning market? How about slavery? Is this a libertarian view of ‘free markets’?
Anthony 01.31.08 at 10:48 am
John,
There is a difference between:
1. Entering into an agreement to have a kidney removed for cash – even if it is illegal.
2. Having a kidney removed from you by use of force or by fraudulent means.
Markets can quite obviously be illegal, but functioning (see the massive trade in illegal drugs).
GreatZamfir 01.31.08 at 10:48 am
John in California, kidneys can be donated by living people, who can live healthily afterwards. Usually this is done by close family of the patient, but truly altruistic donors exist. In the Netherlands, a (very serious) health committee advised to encourage this by giving these donors free health insurance for the rest of their lives.
So, while organ markets are of course very libertarian, they are not automatically based on slavery or murder, and this post makes a very reasonable distinction between (illegal) organizations in India that buy kidneys from voluntary donors, and organizations, as the one uncovered here, that take kidneys unvoluntary.
abb1 01.31.08 at 10:51 am
Would you consider murderinc part of an illegal but functioning market? How about slavery?
What are you saying, john in california?
abb1 01.31.08 at 11:04 am
Murder and slavery can be markets too, of course. Slaves could be property and murders could be services. Any voluntary exchange of property and services is a market.
GreatZamfir 01.31.08 at 11:40 am
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Barry 01.31.08 at 1:00 pm
Perfect.
Martin Wisse 01.31.08 at 1:33 pm
Speaking of the Netherlands, there is now at least one documented instance of a Dutch patient going to Pakistan to get a new kidney, which was then paid for by her health insurer. This despite ethical guidelines that says organ donation for cash is a serious no-no.
The people in question showed neither remorse, nor interest in the question whether or not the donor had been entirely a volunteer or not. The journalistic investigation found that a lot of socalled voluntary donors did because they were poor and heavily in debt, with many remaining poor and in debt, but now missing a kidney afterwards.
The difference between voluntary but illegal and forced at gunpoint is therefore slight.
chris y 01.31.08 at 1:34 pm
Slaves
could beARE property – that’s the whole point about slavery. There are functioning slave markets all over the world, and as far as I know they’re all illegal, even though many are connived at. But there’s a world of difference between noting that something exists and approving it.Thomas 01.31.08 at 1:39 pm
Can’t someone persuade those doctors to donate their own kidneys? Maybe offer them lower prison sentences as an incentive to make sure it is a “free” choice.
GreatZamfir 01.31.08 at 1:46 pm
That’s what they do to convicts in China. Let’s say it creates slightly worrying incentives to the judicial system.
abb1 01.31.08 at 1:48 pm
I can imagine forms of slavery where slaves are not the kind of property that can be traded.
chris y 01.31.08 at 1:51 pm
I can imagine forms of slavery where slaves are not the kind of property that can be traded.
Sure, they have other names to distinguish them: serfdom, helotry, debt bondage… Unless you want to use the term “slavery” to cover all forms of unfree labour, which rather robs the term of content.
abb1 01.31.08 at 2:15 pm
Perhaps. Alternatively, ‘chattel slavery’ variety is merely a subcategory of the more generic ‘slavery’ category…
Marichiweu 01.31.08 at 7:06 pm
I would encourage all y’all to seek out the work of Berkeley anthropologists Nancy Scheper-Hughes and Lawrence Cohen on this subject, i.e.
http://pascalfroissart.online.fr/3-cache/2000-scheperhughes.pdf
Considers in detail the quality of ‘consent’ that exists in a context of global inequality. Not to mention the possibility of motivations for organ trading that don’t map neatly onto what we understand as markets.
john in california 01.31.08 at 7:20 pm
“Unlike some other documented cases of organ sales, this seems less like an illegal but functioning market and more like a criminal racket founded on fraud.”
my point was, I thought, obvious. Healy is contrasting a “criminal racket”, ‘rackets’ a term generally reserved for something bad, with a “functioning market” , a term generally denoting something to be praised by libertarians. For someone like me, that thinks that almost no one would voluntarily sell their organs if they had some other legal way to get money, Healy’s implication that all would be well as long as no one is strong armed or duped, that is if it were a ‘functioning market’, I find repugnant .
Kieran Healy 01.31.08 at 7:30 pm
Healy’s implication that all would be well as long as no one is strong armed or duped, that is if it were a ‘functioning market’, I find repugnant
No, the implication is that, simply as a matter of social process, there is a difference between a system that kidnaps and forcibly removes people’s kidneys, and a system where someone is offered a deal and takes money in exchange for one of their kidneys. Supporters of organ markets often point to the existence of functioning but illegal markets as evidence that there’s real demand and supply between willing transactors, and that in such cases everyone’s better off if there’s a legal market with the usual standards and protections. But this does not look like one of those cases.
The question of whether a market of this sort would be a good idea, or whether transactions in it would be exploitative, is a different one.
Kathleen 01.31.08 at 10:22 pm
Well, actually I think that John in California has a good point — your original language (perhaps unintentionally) suggested there were TWO kinds of organ dealie-os: (1) the black market, in which poor people sell and rich people buy; (2) this recent case, in which poor people get robbed and rich people steal.
What I took to be John in California’s legitimate objection to your phrasing (or that reading of your phrasing, which is perhaps a mistaken one), is that these are not so much two distinct kinds of things as two positions on one sickening continuum.
So which in fact is a better description of what you meant to say? If the first, well, that is pretty repugnant in my view, too. If the second, well, fair enough.
Tom T. 02.01.08 at 12:50 am
Don’t kidneys have to be very carefully matched to their recipients (to quote eHarmony: “29 dimensions of compatibility”)? It seems to me that if this underground surgery ring is just abducting random people off the street, the chances of finding a useful donor seem extremely small.
sara 02.01.08 at 1:29 am
The kidney racketeers probably don’t care too much about the long-term compatibility and viability of one of their stolen kidneys in a recipient’s body.
Kieran Healy 02.01.08 at 1:35 am
The pathology clinics in mentioned in the article were probably doing the tissue-typing. With modern immunosuppressive drugs, it doesn’t have to be a perfect match to be a viable transplant.
GreatZamfir 02.01.08 at 11:05 am
Kathleen, being on two sides of a continuum is far from being the same. George Bush’s and Noam Chomsky’s political views are two sides of a continuum.
I wouldn’t be surprised if the ‘illegal organ markets’ in India have a lot of hidden pressures acting that makes the free choices less than free, and I think it might be true that any organ market would have unacceptable pressures, and should therefore not be allowed.
But I don’t think this is true a priori, nor that selling organs is so disgusting we shouldn’t even consider it. The alternative means, at this moment, that people die for no other reason than a lack of donors.
abb1 02.01.08 at 1:08 pm
Re: Dirty Pretty Things (http://www.mininova.org/tor/416622)
Nice film, but the villains are a bit too cartoonish; especially those two immigration service fellas.
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