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AP Photo/Al Hartmann
Surgeons perform a kidney transplant.

Brooklyn Man Arrested for Selling Kidneys; Should It Be Legal?

July 27, 2009 02:00 PM
by Denis Cummings
The arrest in the New Jersey corruption case of a Brooklyn man who brokered the sale of kidneys has renewed a debate over whether the buying and selling of organs should be legalized.

Kidney “Matchmaker” Arrested by FBI

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Levy Izhak Rosenbaum was arrested by FBI agents on July 23 for allegedly serving as a broker in the sale of kidneys. According to the charges against him, Rosenbaum would bring donors from Israel to the U.S., where they would have a kidney removed and be paid $10,000. He would then sell the kidney for as much as $160,000.

“If true,” The Associated Press reported, “it would be the first documented case of organ trafficking in the U.S.”

The buying and selling of organs in the United States is banned under the 1984 National Organ Transplant Act, punishable by up to five years in prison and a $50,000 fine. Only one country, Iran, allows organs to be sold, but there is an active international black market that accounts for 5-10 percent of all kidney transplants, according to the World Health Organization.

In the U.S., hospitals perform interviews with donors and recipients to ensure that there is no payment involved, explains Time’s Claire Suddath and Alex Altman, so “it's difficult to hoodwink a doctor into believing that a fraudulent organ donor's motives are purely altruistic.” However, AP reports that Rosenbaum appeared “to have a thorough knowledge of the ins and outs” of the system and used bribes when needed.

The kidney black market is made possible by a shortage of kidneys in the U.S. and internationally. Some have called for the selling of organs to be made legal to encourage donations and fulfill demand, but medical organizations are united in their opposition to it.

Congress is also opposed to it, but Sen. Arlen Specter, D-Pa., is circulating a bill, the Organ Trafficking Prohibition Act of 2009, that would allow states to compensate donors through programs that do not involve cash payments. For example, a donor could have their funeral expenses paid.

Background: Kidney shortage in the U.S.

There are more than 80,000 people in the U.S. on the United Network for Organ Sharing/Organ Procurement and Transplantation Network kidney transplant waiting list. Little more than 13,000 kidneys are donated—either by living or deceased donors—each year, not nearly enough to provide kidneys for all those on the list.

Last year, 16,517 people received kidney transplants, while 4,530 people died, though 1,600 of them were too sick to receive a possible transplant.

Opinion & Analysis: Legalizing the sale of organs

Dr. Sally Satel, editor of “When Altruism Isn’t Enough: The Case for Compensating Kidney Donors” and herself a kidney recipient, wrote in The Wall Street Journal that the Rosenbaum case illustrates the need for a legal, regulated kidney market.

“When I needed a kidney several years ago and had no donor in sight, I would have considered doing business with someone like Mr. Rosenbaum,” she writes.

Advocates of legal organ selling say that a financial incentive would increase the number of organ donations by healthy individuals or the families of the deceased. Writing in a 2005 edition of Kidney International, Drs. Eli and Amy Friedman say that as many as 100,000 people could be saved annually by introducing a regulated kidney market.

“Introducing appropriate legalization to regulate and manage kidney sales through a national regulatory body would be a ‘natural’ extension of the present end stage renal disease network collaborating with United Network for Organ Sharing and the OPTN,” they write. “Eliminating black market brokers would divert funds to kidney sellers. Money saved by decreasing the number of dialysis patients might fund additional kidney transplants.”

However, many object to an organ market because it would exploit the poor. “Even in a regulated, government-run version of transplant tourism, ‘unethical realities’ lead to exploitation of the poor and the vulnerable,” argued Harvard Medical School professor Francis L. Delmonico at a 2008 Harvard symposium on the issue.

Virginia Postrel, who donated her kidney to Dr. Satel, wrote in The Atlantic, “A well-designed system could address the concerns about donor welfare by including educational programs, waiting periods, and follow-up care for donors, and possibly by allocating the payments over time rather than offering immediate cash.”

Harvard ethicist Nir Eyal said at the sympsosium that selling an organ has a stigmatizing effect and causes “dignitary harm” to the donor and the impoversihed communities from which the majority of donors would come. He suggests that a form of compensation more subtle than cash payments or “gifts,” such as paired exchanges or benefits like health insurance and funeral costs, would lessen the stigma.
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