Statement of the Pontifical Academy of Sciences Summit on Organ Trafficking and Transplant Tourism
In accordance with the Resolutions of the United Nations and the World Health Assembly, the 2015 Vatican Summit of Mayors from the major cities of the world, the 2014 Joint Declaration of faith leaders against modern slavery, and the Magisterium of Pope Francis, who in June 2016, at the Judges’ Summit on Human Trafficking and Organized Crime, stated that organ trafficking and human trafficking for the purpose of organ removal are “true crimes against humanity [that] need to be recognized as such by all religious, political and social leaders, and by national and international legislation,” we, the undersigned participants of the Pontifical Academy of Sciences Summit on Organ Trafficking, resolve to combat these crimes against humanity through comprehensive efforts that involve all stakeholders around the world.
Poverty, unemployment, and the lack of socioeconomic opportunities are factors that make persons vulnerable to organ trafficking and human trafficking for the purpose of organ removal. Destitute individuals are victimized in schemes of organ trafficking when induced to sell their organs in a desperate search for a better life. Similarly, desperate are the patients who are willing to pay large amounts and travel to foreign destinations as transplant tourists to obtain an organ that may keep them alive--- oblivious of the short and long-term health consequences of commercial transplantation. Unscrupulous brokers and health care professionals make organ trafficking possible, disregarding the dignity of human beings. The operative procedures are performed in unauthorized facilities that clandestinely serve transplant tourists. But organ trafficking can also occur at legitimate facilities, in situations where individuals who are willing to sell their organs present themselves to transplant centers as a relative or altruistic friend of the recipient. The media have made an important contribution to public understanding in highlighting the plight of trafficked individuals by publishing their independent investigations of transplant-related crimes and corrupt healthcare professionals and unregulated facilities.
A number of international legal instruments define, condemn, and criminalize these practices, namely the United Nations Protocol against Trafficking in Persons (Palermo Protocol), the Council of Europe Convention against Trafficking in Human Beings, and the Council of Europe Convention against Trafficking in Human Organs. We support these documents, which assert that the transplant professionals who commit or abet these crimes should be held legally accountable whether the offenses take place domestically or abroad.
The legal instruments of the recent past are an important link to emerging innovative policy to combat social inequality. Trafficking in human beings for the purpose of organ removal and organ trafficking are contrary to the United Nations General Assembly 2030 Agenda for Sustainable Development as an issue of human rights and social justice because the poor are exploited for their organs and yet not able to receive a transplant if they suffer organ failure. Jeffrey Sachs has written that “Sustainable development argues that economic policy works best when it focuses simultaneously on three big issues: first, promoting economic growth and decent jobs; second, promoting social fairness to women, the poor, and minority groups; and third, promoting environmental sustainability”. Countries in conflict and without domestic stability can become the locations of transplant-related crimes.
Progress has been made by healthcare professionals aligned with the Declaration of Istanbul to curtail organ trafficking. Nevertheless, a number of destinations for transplant tourism remain around the world where appropriate legislation to curtail these crimes and protect the poor and vulnerable do not exist or are poorly enforced. These practices also persist because some states have failed in their responsibility to meet the need of their citizens to obtain an organ transplant.
Thus, aware of the UN Sustainable Development Goals, the UN Palermo Protocol on Human Trafficking, the Resolutions of the World Health Assembly (2004 and 2010), the Council of Europe Convention against Trafficking in Human Beings, the Council of Europe Convention against Trafficking in Human Organs, the Madrid Resolution on Organ Donation and Transplantation, and the Declaration of Istanbul, and as a result of the data on organ trafficking presented at this PAS Summit on Organ Trafficking, we the undersigned pledge our commitment to combat these illicit and immoral practices as a community of stakeholders fulfilling the directive of Pope Francis to combat human trafficking and organ trafficking in all their condemnable forms.
The following recommendations from the PAS Summit on Organ Trafficking are proposed to national, regional and municipal governments, to ministries of health, to the judiciary, to religious leaders, to professional healthcare organizations, and to the general public for implementation around the world:
1. That all nations and all cultures recognize human trafficking for the purpose of organ removal and organ trafficking, which include the use of organs from executed prisoners and payments to donors or the next of kin of deceased donors, as crimes that should be condemned worldwide and legally prosecuted at the national and international level.
2. That religious leaders encourage ethical organ donation and condemn human trafficking for the purpose of organ removal and organ trafficking.
3. That nations provide the resources to achieve self-sufficiency in organ donation at a national level—with regional cooperation as appropriate—by reducing the need for transplants through preventive measures and improving access to national transplant programs in an ethical and regulated manner.
4. That governments establish a legal framework that provides an explicit basis for the prevention and prosecution of transplant-related crimes, and protects the victims, regardless of the location where the crimes may have been committed, for example by becoming a Party to the Council of Europe Convention against Organ Trafficking.
5. That healthcare professionals perform an ethical and medical review of donors and recipients that takes account of their short- and long-term outcomes.
6. That governments establish registries of all organ procurement and transplants performed within their jurisdiction as well as all transplants involving their citizens and residents performed in another jurisdiction, and share appropriate data with international databanks.
7. That governments develop a legal framework for healthcare and other professionals to communicate information about suspected cases of transplant-related crimes, while respecting their professional obligations to patients.
8. That responsible authorities, with the support of the justice system, investigate transplants that are suspected of involving a crime committed within their jurisdiction or committed by their citizens or residents in another jurisdiction.
9. That responsible authorities, insurance providers, and charities not cover the costs of transplant procedures that involve human trafficking for the purpose of organ removal or organ trafficking.
10. That healthcare professional organizations involved in transplantation promote among their members awareness of, and compliance with, legal instruments and international guidelines against organ trafficking and human trafficking for the purpose of organ removal.
11. That the World Health Organization, the Council of Europe, United Nations agencies, including the United Nations Office on Drugs and Crime, and other international bodies cooperate in enabling a comprehensive collection of information on transplant-related crimes, to yield a clearer understanding of their nature and scope and of the organization of the criminal networks involved.
1. Chancellor Marcelo Sánchez Sorondo, Chancellor of the Pontifical Academy of Sciences
2. Jeremy Chapman, Director of the Division of Medicine and Cancer Westmead Hospital, Sydney, Australia
3. Alex Capron, USC University Professor Scott H. Bice Chair in Healthcare Law, Policy and Ethics (Gould School of Law) Professor of Medicine and Law (Keck School of Medicine) Co-Director, Pacific Center for Health Policy and Ethics
4. José Nuñez, Medical Director Donation and Transplant program of the World Health Organization WHO Geneva, Switzerland
5. Beatriz Domínguez Gil, Medical Officer Organización Nacional de Trasplantes Madrid, Spain
6. Francis Delmonico, New England Organ Bank Professor of Surgery, Harvard Medical School Massachusetts General Hospital Boston, MA, USA
7. Gustavo Vera, MP City of Buenos Aires, Argentina
8. Marta López Fraga, Scientific Officer European Committee on Organ Transplantation (CD-P-TO) European Directorate for the Quality of Medicines & HealthCare (EDQM), Council of Europe
9. Mirela Busic, Head of Department for Special Health Care and Transplantation, Ministry of Health of the Republic of Croatia
10. Branko Hrvatin, President Supreme Court of Croatia Zagreb, Croatia
11. Aimee Comrie, Crime Prevention and Criminal Justice Officer UNODC, Vienna, Austria
12. Dominique Martin, Senior Lecturer in Health Ethics and Professionalism at Deakin University Geelong, Australia
13. Elmi Muller, Department of Surgery, Groote Schuur Hospital University of Cape Town, South Africa
14. Annika Tibell, Chief Physician, PMO, new Karolinska, Karolinska University Hospital Adjunct professor Medical Ethics, Karolinska Institutet Stockholm, Sweden
15. Emanuele Cozzi, Italian National Transplant Centre, Italy
16. Gilad Erlich, Senior Criminal Prosecutor District Attorney of the Central Region (Greater Tel Aviv), Israel
17. Axel Rahmel, Medical board German Organ Transplantation Foundation, Frankfurt am Main, Germany
18. Ignazio Marino, Professor of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
19. Kristoff Van Asshe, Research Professor in Health Law and Kinship Studies, University of Antwerp, Belgium
20. Mustafa Mousawi, Chairman of Organ Transplant Center, Kuwait President of Kuwait Transplant Society
21. Bassam Saaed, Consultant Pediatric Nephrologist Al Jahra Hospital, Kuwait - President of the Middle East Society for Organ Transplantation (MESOT)
22. Somchai Eiam-Omg, Professor of Medicine Division of Nephrology Chulalongkorn University Hospital, Bangkok, Thailand
23. Ali Bagheri, Assistant Professor of Medicine and Medical Ethics, Tehran University of Medical Sciences, Iran. Member of UNESCO International Bioethics Committee
24. Alexis García López, Department of Nephrology-Urology and Kidney Transplantation, Manuel de Jesús Rivera Children’s Hospital, Managua, Nicaragua
25. Marti Manyalich, President of Donation & Transplantation Institute, DTI Barcelona, Spain
26. Marina Minina, Head Coordinating Center of Organ Donation Moscow, Russia
27. Shashank Bengali, South Asia Bureau Chief at Los Angeles Times
28. Naziha Syed Ali, Assistant Editor at Dawn Newspaper, Pakistan
29. Jay Lavee, President, Israel Transplantation Society Professor of Surgery Director, Heart Transplantation Unit Leviev Heart Institute, Sheba Medical Center Tel Aviv University Faculty of Medicine, Tel Aviv, Israel
30. Mario Abbud Filho, Associate Professor of Medicine Head Nephrology Discipline, Medical School FAMERP, Director Organ Transplantation Center Foundation FUNFARME São José do Rio Preto, SP, Brazil
31. Gabriel Gondolesi, Jefe de Cirugía General. Jefe de Trasplante Hepatico, Reno-Pancreático y de Unidad de Soporte Nutricional, Rehabilitación y Trasplante Intestinal. Hospital Universitario, Fundación Favaloro. Investigador en Salud del Conicet, miembro del IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
32. Benita Padilla, Head, Human Organ Preservation Effort (HOPE) Manila, Philippines
33. Gabriel Danovitch, Medicine, Nephrology Ronald Reagan UCLA Medical Center Connie Frank Kidney Transplant Center Los Angeles, California, USA
34. Igor Codreanu, Transplant Agency of Moldova
35. Alejandro Niño Murcia, President of Latin American and Caribbean Society of Transplantation, Bogotá, Colombia
36. Mehmet Haberal, Founder and President of the Turkish Transplantation Society President of the Executive Supreme Board of Baskent University Turkey
37. Jiefu Huang, Chairman National Organ Donation and Transplantation Committee Beijing, P.R. China
38. Nancy Ascher, Professor of Surgery Division of Transplant Surgery Isis Distinguished Professor in Transplantation Leon Goldman, MD Distinguished Professor in Surgery
39. Adeera Levin, President, International Society of Nephrology Vancouver, Canada
40. Phil O'Connell, Immediate Past President The Transplantation Society Sydney, Australia
41. Haibo Wang, Councilor, Declaration of Istanbul Custodian Group Director, China Organ Transplant Response System Member of National Organ Donation and Transplantation Committee, P. R. China
42. Ali Malek Hosseini, Chief of Organ Transplantation Shiraz University of Medical Sciences Shiraz, Iran
43. Terence Kee, Senior Consultant Department of Renal Medicine Singapore General Hospital
44. Phan Hai An, Director of International Cooperation Department Hanoi Medical University Head of Kidney Diseases and Dialysis Department Viet Duc University Hospital, Vietnam
45. Maryana Doitchinova Simeonova, Executive director of the Bulgarian Agency of transplantation Sofia, Bulgaria
46. Milbert Shin, Human Rights Attorney
47. Debra Budiani-Saberi, Director of NGO Coalition for Organ Failure Solutions Washington DC, USA
48. José Medina Pestana, Professor of Nephrology and Head of the Kidney and Pancreas Transplant Program Hospital do Rim São Paulo, Brazil
49. Maria Matamoros, Director, Liver Transplant Centre / Caja Costarricense de Seguro Social (CCSS), Costa Rica
50. Riadh Fadhil, Professor of Urology & Transplant Surgery at Hamad Medical Corporation Director of Qatar Organ Donation Center (HIBA)
51. Rudolf Garcia Gallont, Presidente Directiva Hospital Herrera Llerandi
52. Maria Antonio Soledad, Department of Health Philippines
53. Tim Pruett, President American Society of Transplant Surgeons Professor of Surgery and Internal Medicine, John S Najarian Chair of Transplantation University of Minnesota Minneapolis, MN, USA
54. Greg Obrador, Universidad Panamericana, Campus México Dean, Faculty of Health Sciences & School of Medicine Mexico City, Mexico
55. Karina Jazmín Durán Martínez, Fiscal de la Unidad Epecializada en Investigación de Tráfico de Menores, Personas y Órganos, Subprocuradoría Especializada en Investigación de Delincuencia Organizada, México
56. John Gill, Professor of Medicine Division of Nephrology St. Paul’s Hospital Vancouver, Canada
57. Sandeep Guleria, National Kidney and Transplant Institute Delhi, India
58. Faissal Shaheen, Director General Saudi Center for Organ Transplantation (SCOT) Senior Consultant Physician and Nephrologist
59. Hirato Egawa, Tokyo Women’s Medical University Department of Surgery, Institute of Gastroenterology
60. Campbell Fraser, Department of International Business and Asian Studies Griffith Business School Nathan campus, Griffith University, Australia
61. Monir Moniruzzaman, Assistant Professor Department of Anthropology and Center for Ethics and Humanities in the Life Sciences Michigan State University
62. Sunil Shroff, Mohan Foundation Chennai, India
63. Sally Johnson, Director of Organ Donation and Transplantation NHS Blood and Transplant, UK
64. James McDaid, Belfast City Hospital Queen’s University Belfast, Ireland
65. Aonghus Kelly, European Union Integrated Border Assistance Mission in Libya
66. Curie Ahn, Department of Translational Medicine Seoul National University, South Korea
67. Fahim Zaman, MD, FACP
68. Ademola Aderibigbe, Former Head Renal Care Center University of Florin Teaching Hospital & Director Maayoit HealthCare Ltd Ilorin, Nigeria
69. Andreas Karampinis, President Hellenic Transplant Organization Athens, Greece
70. Roman Danielewicz, Polish Transplant Society Warsaw, Poland
71. Alessandro Nanni Costa, Director-General Italian National Transplant Centre, Italy
72. Jose Marie Simon, Honorary President FIAMC (Fédération Internationale des Associations de Médecins Catholiques)
73. María del Carmen Bacqué, Presidenta del INCUCAI (Instituto Nacional Unico Coordinador de Ablación e Implante)
74. Salvador Aburto, Director General Centro Nacional de Trasplantes de la Secretaria de Salud Ciudad de México, México
75. Nelufar Hedayat, Journalist and presenter for Fusion Media Network London, UK
76. Rosi Orozco, United vs. Trafficking Foundation
77. John McCaffrey, Galileo Foundation