the ethical, moral and health hazards of transplant tourism

Now that’s a mighty long title – for a very small section of medical tourism, which alternates in generating world-wide headlines and being swept quietly under the rug.

Bathtub full of ice

Everyone has heard ‘urban folklore’ regarding the unwary/ drunken/ duped young man who goes looking for sex, and wakes up in a bathtub full of ice.. Conventional wisdom is that these tales serve as a modern-day fairy tale with an underlying moral message.  In this case – cautioning young people against the vices of alcohol/ drugs and anonymous/ promiscuous sex..  If only the truth were really just such a cautionary tale. But, as readers know, the truth is considerably darker – involving the exploitation and even outright murder of citizens around the world to feed the organ trade.

(For the first-person account from a Chinese doctor involved in organ harvesting, click here. )

“Transplant Tourism”

This division of medical tourism, “Transplant tourism“,  is the sanitized term for organ selling, or diversion of transplantable organs to wealthy consumers (outside of the formal donor networks like UNOS).

Transplant tourism/ murder for organs is making headlines again this week as Taiwanese legislators try to ban the practice among their citizens and residents.  The Taiwanese lawmakers are trying to prevent the practice of wealthy patients (and companies making money from the sale of organs/ transplantation) using China as a ‘spare parts’ playground.

As widely reported over the last several years – China has become notorious for widespread ethical violations, including the murder (execution) of political prisoners for organ sales and transplantation to wealthy buyers.  Many of these political prisoners are people accused of such crimes as the practice of the religion, Falun Gong, or for expressing ideas that challenge the traditional Chinese culture or current government practices.

Not illegal in the United States

Unfortunately, despite multiple scientific, medical, governmental papers and sporadic media coverage of this issue – it is not illegal for Americans to engage in this practice, nor for American companies to offer transplantation services based on these practices.  (It is illegal for organs to be sold in the USA, but not for people to travel to engage in these practices.) While the United Nations, New Zealand, Australia and now, Taiwan have begun addressing this practice – the US government remains silent.

Protecting citizens from the wealthy foreigner

Other nations, like Pakistan have acted to try to prevent their citizens from becoming donor sources for wealthy foreigners.  Just today, a new law was passed to prevent organs obtained in Pakistan from being given to non-Pakistani residents. While these laws will not eliminate the practice outright, these countries and their citizens have taken a moral and legal stance against the practices. Now, it’s our turn.

Resources/ More information on this topic

More about the people “criminals” the Chinese government is executing – and taking organs from – Washington Post, November 2012

List of famous Chinese dissidents – Wikipedia

More about the murder and torture of practitioners of Falun Gong

The Ugly Side of Medical Tourism – a related post with links to scholarly articles and media reports regarding transplant tourism in China and Latin America.

A look at why transplant tourism is not safe for recipients, either.

Patients with passports – another post on law, ethics and medical tourism discussion focused on the publication of a book by the same title.  Includes links to several articles by Dr. Delmonico – the foremost  expert on illegal organ transplantation.

Medical Tourism backlash

One of the trends I’ve seen in the last few months is a growing assortment of medical propaganda that can only be termed ‘medical tourism backlash’.  Frighteningly, these writers are often willfully misinformed and published on websites that give the appearance of legitimacy.  I’ve included an example here – published on a website called News Junky Journal.  The junky part is certainly accurate.

This article is a thinly disguised ad for a US based plastic surgeon – Dr. Delgado and persists in spreading misinformation, untruths and some blatant lies.  The author, Charles Hale makes no effort to distinguish between medical tourism destinations, much less the facilities and surgeons themselves but uses a blanket brush to depict all non-US surgeons as poorly trained uncredentialled hacks operating without consideration for patient outcomes due to a lack of fear for repercussions.  He presents his ‘facts’ as absolutes – and as all educated consumers know – there are no absolutes.  Yes, there are bad surgeons (everywhere – and quite a few unlicensed frauds in the USA as well, as we’ve documented over at Cartagena Surgery as part of a series explaining how to evaluate medical and surgical providers.)

But there are also well-educated, kind, caring EXCELLENT surgeons like the ones we’ve identified during this project.  Fear-mongering is not the way to drum up patients or protect people from adverse outcomes.  Objective, and honest research is.

There are several other blatant inaccuracies in the above mentioned article – including statements that insurance companies NEVER pay for medical tourism – as we’ve discussed here, and in the book – several American health care companies such as Blue Cross actually have medical tourism divisions to help patients find providers overseasThis medical tourism company helps people use their Health Savings Accounts for medical travel.

He also ignores ‘complication insurance’ as offered by many of the providers interviewed in Bogotá – which explicitly covers the treatment of any surgical complications whether at the destination or after patients return home.

As I’ve mentioned numerous times, I do think that the medical tourism industry should be regulated – ‘tour operators’ shouldn’t sell the services of people they’ve never met, but to disregard medical tourism as simply a plaything of indulgent people wanting to have surgery while frolicking on the beach, as implied in his last paragraph is ignorant and insulting to the very people who rely on medical tourism as their only option outside of complete financial devastation.

Sadly, I think scare articles like this are only the beginning; as American surgeons (particularly plastic surgeons who rely on elective procedures for their income) continue to feel the effects of a poor economy.  But slandering an entire industry and hundreds of thousands of hard-working medical professionals, and terrorizing patients is not the answer.