No abstract available. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2012.

The “miracle” success of transplant technology, alongside the commercialization of health care, and the increasing polarization between rich and poor have created the conditions for an illegal but thriving trade in human body parts. Based on 15 months of challenging fieldwork, my research examines the ethics of the organ bazaar, particularly the experiences of 33 kidney sellers living in Bangladesh. On the underground bazaar, not only human kidneys but also livers and corneas are advertised for sale. Recipients, sellers, and brokers regularly post newspaper advertisements to buy and sell organs. The average price for a kidney is US $1,500 in Bangladesh, a country where 78% of people live on less than $2 a day. My research examines serious ethical questions, such as these: Is it right to purchase an organ, even if the organ sought provides longevity? Is the sale of one’s organ a justifiable means of fighting poverty? These questions allow me to examine the ethics of harvesting organs, particularly from the bodies of impoverished people. Narrating the victims’ deeply moving testimonies, my ethnography reveals how organ buyers (both recipients and brokers) tricked and pressured Bangladeshi poor into selling their kidneys. In the end, these sellers were brutally deprived and deceived, and their suffering was extreme. In the post-vending period, sellers’ health, economic, and social conditions significantly deteriorated, yet none of them received the promised post-operative care—not even one appointment. My research therefore concludes that organ commodification is serious structural violence against the poor, at the terrible cost of harm and suffering to them. Examining the organ market proposition, I argue that the resulting violence and injustice against the poor provide a hefty reason to rebut this trade. Bangladeshi kidney sellers also stood up against organ commodification, speaking out about their suffering, and about various detrimental and unethical outcomes incurred in this deal. My research aims to offer insights to bioethics and to broaden the debate on human rights by exposing how technological advancement, structural violence, and grinding poverty intersect in the violation of justice to the poor, turning them into “living cadavers.”

The “miracle” success of transplant technology, alongside the commercialization of health care, and the increasing polarization between rich and poor have created the conditions for an illegal but thriving trade in human body parts. Based on 15 months of challenging fieldwork, my research examines the ethics of the organ bazaar, particularly the experiences of 33 kidney sellers living in Bangladesh. On the underground bazaar, not only human kidneys but also livers and corneas are advertised for sale. Recipients, sellers, and brokers regularly post newspaper advertisements to buy and sell organs. The average price for a kidney is US $1,500 in Bangladesh, a country where 78% of people live on less than $2 a day. My research examines serious ethical questions, such as these: Is it right to purchase an organ, even if the organ sought provides longevity? Is the sale of one’s organ a justifiable means of fighting poverty? These questions allow me to examine the ethics of harvesting organs, particularly from the bodies of impoverished people. Narrating the victims’ deeply moving testimonies, my ethnography reveals how organ buyers (both recipients and brokers) tricked and pressured Bangladeshi poor into selling their kidneys. In the end, these sellers were brutally deprived and deceived, and their suffering was extreme. In the post-vending period, sellers’ health, economic, and social conditions significantly deteriorated, yet none of them received the promised post-operative care—not even one appointment. My research therefore concludes that organ commodification is serious structural violence against the poor, at the terrible cost of harm and suffering to them. Examining the organ market proposition, I argue that the resulting violence and injustice against the poor provide a hefty reason to rebut this trade. Bangladeshi kidney sellers also stood up against organ commodification, speaking out about their suffering, and about various detrimental and unethical outcomes incurred in this deal. My research aims to offer insights to bioethics and to broaden the debate on human rights by exposing how technological advancement, structural violence, and grinding poverty intersect in the violation of justice to the poor, turning them into “living cadavers.”

This thesis investigates the role of Canadians in the international trade in human organs and the factors influencing patient decision making, assuming that patients make decisions regarding the management of their illness in a complex social, cultural, political and economic nexus. It engages a broad theoretical question of whether Canadians uphold values consistent with a commitment to consumerism, commodifying organs as needed and afforded, or altruism, supportive of voluntary organ donation systems. Semi-structured interviews were conducted with hemodialysis patients and their care givers in a southern Ontario hospital. Based on this analysis, Canadians appear to fall somewhere in the middle of the consumer-altruist divide. The dominant sentiment among participants was that Canadians ought not to be commodified, but the organs of foreign others in places removed from the Canadian value system hold potential, and provide opportunities for participating in a market when the supply of organs falls short of demand.

O tempo de espera para obtenção de órgão para transplante constitui-se num grande problema na área da saúde em todo o mundo. O número de doadores voluntários não cresce na mesma medida da necessidade de órgãos. Diante deste quadro, surgiu um mercado ilícito de órgãos, em que os compradores e intermediadores se dirigirem aos países onde há uma porcentagem grande de população vulnerável, objetivando adquirir órgãos de indivíduos vivos, mediante pagamento. Neste contexto, esta pesquisa buscou avaliar e comparar as percepções de profissionais de saúde e da população em geral com relação à forma de obtenção dos órgãos, em especial a abordagem de mercado, e comparar a opção desinteressada com outra opção, que tem a percepção do envolvimento da necessidade pessoal ou familiar para obter órgãos com o fim de transplante, utilizando a abordagem de mercado. Para atender aos objetivos deste estudo foi elaborado um questionário para coletar a opinião dos participantes. Sua distribuição foi realizada pessoalmente, de forma aleatória, e também foi elaborada uma versão eletrônica que foi divulgada via página no facebook, criada exclusivamente para este fim. A análise das respostas obtidas foram discutidas ao nível de 5% de significância e consideradas significativas quando o valor de p foi < 0,05. Ao todo, 692 pessoas participaram da pesquisa. Foi identificado que na categoria do profissional de saúde há maior tendência do que entre aqueles que não são profissionais da saúde em discordar dos incentivos indiretos relacionados com a redução de impostos e licença remunerada de 30 dias. Estas foram as únicas associações significativas ligadas aos profissionais da saúde no estudo. A maioria dos participantes (80,1%) concordou que a doação de órgãos deve ser um ato desinteressado e estritamente solidário. Por outro lado, 52% acredita que o mercado poderia ser um sistema justo e benéfico para todos, visando ampliar a possibilidade de realização de transplantes. Em uma situação extrema, de carência absoluta de órgãos, 54,9% dos participantes indicaram que pagariam por um órgão para salvar a sua vida ou a vida de algum familiar. Nesta questão, 24,1% discordaram e 20,2% indicaram que não possuem opinião sobre o assunto. / Waiting in aqueue for obtaining organ transplant constitutes a major problem in healthcare worldwide. The numbers of voluntary donors do not grow to the same extent of the need for organs. Given this situation, there was an illicit market for organs, in which buyers and intermediaries to address the countries where there is a large percentage of low-income population, aiming to acquire organs from living individuals, through payment. In this context, this study aimed to evaluate and compare the perceptions of health professionals and the general public regarding the method of obtaining the organs, especially the market approach and compare the disinterested option with another option, which has the perception of involvement personal or family need for organs for the purpose of transplantation, using the market approach. To meet the objectives of this study, a questionnaire was developed to collect the opinions of participants. Its distribution was held personally randomly and was also prepared an electronic version of the questionnaire was disseminated via facebook page created solely for this purpose. The analysis of the responses were discussed at 5% significance and considered significant when the p value was <0.05. In all, 692 people participated in the survey. It was identified that the health professional category there are more likely than among those who are not health professionals to disagree on the indirect incentives related to the reduction of taxes and paid leave of 30 days for those who make donations. These were the only significant associations related to health professionals throughout the study. Most participants (80.1%) indicated that agree that organ donation must be a disinterested and strictly act of solidarity. On the other hand, 52% believe that the market for organs could be fair and beneficial system for all in order to extend the possibility of performing transplants. In an extreme situation, absolute shortage of organs, 54.9% of respondents indicated they would pay for an organ to save your life or the life of a family member. On the same question, 24.1% disagreed and 20.2% indicated that they have no opinion on the matter.

Submitted by Clebson Anjos (clebson.leandro54@gmail.com) on 2016-01-26T17:00:38Z No. of bitstreams: 1 arquivototal.pdf: 949590 bytes, checksum: ef2a4db0439b131164e7c6e2572420b8 (MD5) / Made available in DSpace on 2016-01-26T17:00:38Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 949590 bytes, checksum: ef2a4db0439b131164e7c6e2572420b8 (MD5) Previous issue date: 2014-08-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This dissertation begins by stating the fact that the Brazilian legislators chose to criminalize the organ trade, which includes organs, tissues and other body parts, by making illegal not only the purchase, but also the sale, with disregard for the motive and personal circumstances of the seller. As a result, the seller cannot be treated as a defendant, but only as a victim As a result, the seller cannot be treated as a defendant, but only as a victim. Said that, it was considered the hypothesis that this heavy criminalization is against the principle of equality because it also affects the people who suffered exploitation as victims of organ trafficking.Said that, it was considered the hypothesis that this heavy criminalization is against the principle of equality because it also affects the people who suffered exploitation as victims of organ trafficking. In order to verify this hypothesis, not only through a legal perspective, but also through a more holistic point of view, i.e., interdisciplinary, this article was divided into three chapters: the first one gives an understanding of the fundamentals of Human Rights, such as dignity and other principles, and puts the principle of equality as a key topic for further reflexions. The organ trafficking is debated as a transnational organized crime with a focus on the organ trade, its demand and supply, and some aspects of the UN Protocol to Prevent, Suppress and punish Trafficking in Persons, especially Women and Children (Palermo Protocol) and its application in Brazil; The second chapter provides an understanding of the victimology and one of the most important theories of criminal law, through aspects of bioethics and informed consent. It was done an analysis of the Brazilian laws connected to the criminalization of the organ trade. The third and last chapter analyzes a Court case and its sentencing. This case involved 'Operação Bisturi', an investigation initiated by the Federal Police in the state of Pernambuco in 2003, and the Criminal Case number 2003.83.00.27440-0, which has indicted several people for purchase and / or sale of organs based on the Transplant Law n. 9434/1997. This case shows some peculiarities that confirm the hypotheses in this research. The methodology was based on inductive method and is still theoretical-descriptive and exploratory, qualitative, documentary and bibliographic character. In conclusion, the article finishes by stating the need for further critical analysis of the total prohibition of organ trade and for changes in the Law number 9.434/1997, specifically the removal of overly broad elements from the statute. It was suggested that statute should carry death as a result in intentional crimes, as well as mid-term conducts and the enforcement of collateral consequences of the conviction. In addition, It was suggested further jurisprudence stating the low-degree offense in the victims conducts. / A presente dissertação parte do fato de que o legislador brasileiro optou por proibir totalmente a comercialização de órgãos, tecidos e partes do corpo humano, criminalizando não apenas a sua compra, mas também a venda, desconsiderando o motivo e a situação pessoal do vendedor. Assim, é descartada a possibilidade de tratá-lo como réu, mas, como vítima. Diante disso, foi adotada a hipótese de que tal criminalização rigorosa esteja contrariando o princípio da isonomia, porque afeta também pessoas que sofreram exploração como vítimas do tráfico de órgãos. Para verificar essa hipótese, não somente sob a perspectiva jurídica, mas por oferecer uma visão mais holística, ou seja, interdisciplinar, o trabalho foi dividido em três capítulos: o primeiro, destinado à compreensão da dignidade e seus princípios, como fundamento dos direitos humanos, trazendo o princípio da isonomia como um ponto de partida para as reflexões. Discutiu-se o tema do tráfico de órgãos, como crime organizado transnacional, com enfoque na comercialização, demanda e oferta, abordando-se aspectos relativos ao Protocolo Adicional à Convenção das Nações Unidas contra a Criminalidade Organizada Transnacional relativo à Prevenção, à Repressão e à Punição do Tráfico de Pessoas, em especial de Mulheres e Crianças (Protocolo de Palermo) e sua aplicação no Brasil; o segundo capítulo volta-se à compreensão da vitimologia e de umas das mais importantes teorias de direito penal, buscando entender aspectos da bioética e do consentimento informado. Foi realizada uma análise da legislação brasileira voltada à criminalização do comércio de órgãos. No terceiro e último capítulo, analisou-se a sentença criminal do processo que envolveu a ‘Operação Bisturi’, deflagrada em 2003, pela Polícia Federal no estado de Pernambuco, Ação Penal 2003.83.00.27440-0, que indiciou várias pessoas por compra e/ou venda de órgãos, como previsto na Lei de Transplantes n. 9.434/1997, mostrando algumas peculiaridades que confirmam as hipóteses levantadas nessa pesquisa. A metodologia baseou-se no método indutivo, sendo ainda teórico-descritiva, com caráter exploratório, qualitativa e bibliográfica. Concluiu-se pela necessidade de reflexões críticas acerca da total proibição da comercialização de órgãos, que a referida lei n. 9.434/1997 necessita de alterações, com a exclusão de tipos abertos. Sugeriram-se ainda tipos que abarquem o resultado morte, de forma dolosa, bem como a formulação de tipos intermediários e a aplicação de efeitos extrapenais da condenação. e jurisprudência que viesse a declarar a baixa ofensividade da conduta das vítimas.

O tempo de espera para obtenção de órgão para transplante constitui-se num grande problema na área da saúde em todo o mundo. O número de doadores voluntários não cresce na mesma medida da necessidade de órgãos. Diante deste quadro, surgiu um mercado ilícito de órgãos, em que os compradores e intermediadores se dirigirem aos países onde há uma porcentagem grande de população vulnerável, objetivando adquirir órgãos de indivíduos vivos, mediante pagamento. Neste contexto, esta pesquisa buscou avaliar e comparar as percepções de profissionais de saúde e da população em geral com relação à forma de obtenção dos órgãos, em especial a abordagem de mercado, e comparar a opção desinteressada com outra opção, que tem a percepção do envolvimento da necessidade pessoal ou familiar para obter órgãos com o fim de transplante, utilizando a abordagem de mercado. Para atender aos objetivos deste estudo foi elaborado um questionário para coletar a opinião dos participantes. Sua distribuição foi realizada pessoalmente, de forma aleatória, e também foi elaborada uma versão eletrônica que foi divulgada via página no facebook, criada exclusivamente para este fim. A análise das respostas obtidas foram discutidas ao nível de 5% de significância e consideradas significativas quando o valor de p foi < 0,05. Ao todo, 692 pessoas participaram da pesquisa. Foi identificado que na categoria do profissional de saúde há maior tendência do que entre aqueles que não são profissionais da saúde em discordar dos incentivos indiretos relacionados com a redução de impostos e licença remunerada de 30 dias. Estas foram as únicas associações significativas ligadas aos profissionais da saúde no estudo. A maioria dos participantes (80,1%) concordou que a doação de órgãos deve ser um ato desinteressado e estritamente solidário. Por outro lado, 52% acredita que o mercado poderia ser um sistema justo e benéfico para todos, visando ampliar a possibilidade de realização de transplantes. Em uma situação extrema, de carência absoluta de órgãos, 54,9% dos participantes indicaram que pagariam por um órgão para salvar a sua vida ou a vida de algum familiar. Nesta questão, 24,1% discordaram e 20,2% indicaram que não possuem opinião sobre o assunto. / Waiting in aqueue for obtaining organ transplant constitutes a major problem in healthcare worldwide. The numbers of voluntary donors do not grow to the same extent of the need for organs. Given this situation, there was an illicit market for organs, in which buyers and intermediaries to address the countries where there is a large percentage of low-income population, aiming to acquire organs from living individuals, through payment. In this context, this study aimed to evaluate and compare the perceptions of health professionals and the general public regarding the method of obtaining the organs, especially the market approach and compare the disinterested option with another option, which has the perception of involvement personal or family need for organs for the purpose of transplantation, using the market approach. To meet the objectives of this study, a questionnaire was developed to collect the opinions of participants. Its distribution was held personally randomly and was also prepared an electronic version of the questionnaire was disseminated via facebook page created solely for this purpose. The analysis of the responses were discussed at 5% significance and considered significant when the p value was <0.05. In all, 692 people participated in the survey. It was identified that the health professional category there are more likely than among those who are not health professionals to disagree on the indirect incentives related to the reduction of taxes and paid leave of 30 days for those who make donations. These were the only significant associations related to health professionals throughout the study. Most participants (80.1%) indicated that agree that organ donation must be a disinterested and strictly act of solidarity. On the other hand, 52% believe that the market for organs could be fair and beneficial system for all in order to extend the possibility of performing transplants. In an extreme situation, absolute shortage of organs, 54.9% of respondents indicated they would pay for an organ to save your life or the life of a family member. On the same question, 24.1% disagreed and 20.2% indicated that they have no opinion on the matter.

O tempo de espera para obtenção de órgão para transplante constitui-se num grande problema na área da saúde em todo o mundo. O número de doadores voluntários não cresce na mesma medida da necessidade de órgãos. Diante deste quadro, surgiu um mercado ilícito de órgãos, em que os compradores e intermediadores se dirigirem aos países onde há uma porcentagem grande de população vulnerável, objetivando adquirir órgãos de indivíduos vivos, mediante pagamento. Neste contexto, esta pesquisa buscou avaliar e comparar as percepções de profissionais de saúde e da população em geral com relação à forma de obtenção dos órgãos, em especial a abordagem de mercado, e comparar a opção desinteressada com outra opção, que tem a percepção do envolvimento da necessidade pessoal ou familiar para obter órgãos com o fim de transplante, utilizando a abordagem de mercado. Para atender aos objetivos deste estudo foi elaborado um questionário para coletar a opinião dos participantes. Sua distribuição foi realizada pessoalmente, de forma aleatória, e também foi elaborada uma versão eletrônica que foi divulgada via página no facebook, criada exclusivamente para este fim. A análise das respostas obtidas foram discutidas ao nível de 5% de significância e consideradas significativas quando o valor de p foi < 0,05. Ao todo, 692 pessoas participaram da pesquisa. Foi identificado que na categoria do profissional de saúde há maior tendência do que entre aqueles que não são profissionais da saúde em discordar dos incentivos indiretos relacionados com a redução de impostos e licença remunerada de 30 dias. Estas foram as únicas associações significativas ligadas aos profissionais da saúde no estudo. A maioria dos participantes (80,1%) concordou que a doação de órgãos deve ser um ato desinteressado e estritamente solidário. Por outro lado, 52% acredita que o mercado poderia ser um sistema justo e benéfico para todos, visando ampliar a possibilidade de realização de transplantes. Em uma situação extrema, de carência absoluta de órgãos, 54,9% dos participantes indicaram que pagariam por um órgão para salvar a sua vida ou a vida de algum familiar. Nesta questão, 24,1% discordaram e 20,2% indicaram que não possuem opinião sobre o assunto. / Waiting in aqueue for obtaining organ transplant constitutes a major problem in healthcare worldwide. The numbers of voluntary donors do not grow to the same extent of the need for organs. Given this situation, there was an illicit market for organs, in which buyers and intermediaries to address the countries where there is a large percentage of low-income population, aiming to acquire organs from living individuals, through payment. In this context, this study aimed to evaluate and compare the perceptions of health professionals and the general public regarding the method of obtaining the organs, especially the market approach and compare the disinterested option with another option, which has the perception of involvement personal or family need for organs for the purpose of transplantation, using the market approach. To meet the objectives of this study, a questionnaire was developed to collect the opinions of participants. Its distribution was held personally randomly and was also prepared an electronic version of the questionnaire was disseminated via facebook page created solely for this purpose. The analysis of the responses were discussed at 5% significance and considered significant when the p value was <0.05. In all, 692 people participated in the survey. It was identified that the health professional category there are more likely than among those who are not health professionals to disagree on the indirect incentives related to the reduction of taxes and paid leave of 30 days for those who make donations. These were the only significant associations related to health professionals throughout the study. Most participants (80.1%) indicated that agree that organ donation must be a disinterested and strictly act of solidarity. On the other hand, 52% believe that the market for organs could be fair and beneficial system for all in order to extend the possibility of performing transplants. In an extreme situation, absolute shortage of organs, 54.9% of respondents indicated they would pay for an organ to save your life or the life of a family member. On the same question, 24.1% disagreed and 20.2% indicated that they have no opinion on the matter.

This thesis describes the situation on the human organ black market. It is aimed at countries that are most affected by this phenomenon, despite the illegality of the entire process in these countries. The aim of this thesis is the analysis of the market, identification of groups of people affected by this phenomenon and analyze global legalization of financial compensation. The theoretical part describes the areas of the world where this market is the most developed. Thesis summarizes the situation in India, Pakistan and also analyzes the current Iranian and Australian system of financial compensation. Impacts of selling organs to poor donors are analyzed from the perspective of economic and psychological, emotional and social impacts. Organ sales paradoxically lead to a large proportion of cases the overall deterioration donors from all these perspectives. The practical part is focused on the economic situation description of the human organ market and for its amendment in the event of the introduction of financial compensation. The financial compensation provided for lost wages during surgery and undergoing medical risk is a possible way to increase the supply of donors in developed countries. In this thesis are used the individual examples and data which are collected from a small number of respondents (because of the difficulty in acquiring data due to the illegality of the process). There are used data published by the World Health Organization, The World Bank and also data from surveys directly collected from places that are affected by this issue.

This thesis highlights the issue of organ trafficking in Bangladesh and focuses on the role of the international organizations in combatting organ trafficking. The objective of this paper is to provide a deeper understanding of the role of the UN and international organizations.  This thesis draws information for sources such as the United Nations (UN) and non-governmental organizations (NGOs) to examen organ trafficking. Organ trafficking leads to human rights abuses and health consequences faced by victims. The consequences of organ trafficking impact the healthcare systems, ethics in transplantation and community trust. (WHO, 2019). It requires strengthening of legal frameworks, enhancing law enforcement, promotion of international collaboration to address organ trafficking. (UNODC 2020) This study contributes to the existing literature by combining information from reputable sources, and highlight the need efforts by local authorities, international organizations, and the civil society to combat organ trafficking and protect vulnerable people from this trade.