A major problem facing the underdeveloped countries of the world today, and one that is often ignored, is the trade in illegal organs. Traded organs become illegally traded organs once they are either obtained or sold illegally in order to turn a profit for those involved in the trade (a group which may or may not include the person from whom the organ was sourced). Of course, for any good to be traded, there must first be a market for it, and, moreover, for an illegal market to emerge it must be a good that is hard to come by legally and also highly valuable for those who are obtaining or selling it. Traded organs fit into both the two latter categories: in many developed countries they are very difficult to obtain by legal means, and for a number of wealthy and desperate people in these countries they may well represent the difference between life and death.
(For a broad general overview of the illegal organ trade and its consequences, visit http://smartsgroupd.blogspot.com/p/joshua.html. See http://smartsgroupd.blogspot.com/p/phoebe.html for further discussion of the shortcomings inherent in the organ donation systems of most developed countries which contribute to the perpetuation of the illegal organ trade.)
As already noted, for any trade in organs to exist, there must first be a market. Typically, in western countries, the demand market is provided by those dying of some form of organ failure, and the organs are supplied either out of the kindness of a relative’s or stranger's heart (pardon the pun), or because a registered organ donor died, and their organs could be harvested and used to keep eligible recipients alive. However, because legally obtained organs are in such short supply in these same western countries, some people prefer to take a different option, either travelling overseas for an operation in a country where organs are in greater supply (Pang, A 2006), or more directly, by engaging the services of a criminal organisation. In such situations, the likelihood is that the organs were obtained and possibly transplanted illegally; if they could be obtained legally, there would be no need for the person to look for them using a method outside the boundaries of generally accepted medical practice. Therefore, the first factor determining the creation and continuation of an illegal market for organs is the extreme shortage of organs that exists in most developed countries as a result of demand exceeding supply. Once a market is established, there must then be some method to determine the price at which organs are sold.
Price is an important factor in the trade of any good, regardless of the legal status of the good. In the case of organs, an illegally traded organ can cost a lot, especially when considered relative to the price of most legally obtained organs (which are generally available free of charge to those fortunate enough to survive the waiting list). The going price for a legal kidney in a place like the Philippines (where it is legal to buy and sell organs) is around $6316, whereas the same organ, if obtained through an ‘Organ Hunter’, can fetch a price upwards of $85000 (Carney, C 2007). One noteworthy point is that it is possible for a person in need of an organ to pay for it legitimately by travelling to a country in which the trade is legal, which is referred to as Organ Transplantation, or Medical Tourism (Pang, A 2006); however, despite the high price tag, an illegal trade outside of such channels still exists. The value of any good is determined by a number of factors, including: supply (organs are constantly in very short supply which drives prices up); difficulty in obtaining/shipping the good (organs are also hard to obtain, and there are difficulties involved in safely storing and transporting them, which adds to their price); the clientele (when a producer knows that the good is regularly bought by wealthy people, he or she will tend to employ price discrimination, and charge the customer more without fear of losing demand because he or she is confident any price can be paid); and, finally, by the elasticity of demand of the good (a producer is likely to increase the price he or she is selling the good for when he or she knows that the consumers need it and will pay the price set) (Parry, G and Kemp, S 2010). Price therefore becomes another determining factor for trade in any market; it is important to understand how effective the price of the good or service is in controlling the trade. In the case of the illegal organ trade, the relative scarcity of organs in western countries, combined with the desperation and relative wealth of the clientele, results in the creation of the illegal market for organs and contributes to the determination of the price of these organs. Price, in turn, leads us to the next two important factors relating to a market for any good or service, buyers and sellers. In this case, it would also be appropriate to include producers (a.k.a. those from whom the organs were ‘sourced’), as the trade evidently affects them too at a very profound level.
Sellers of any good are constantly looking to maximize their profit. Normally, this can be done by raising the price of the good, decreasing costs involved in moving/storing and other forms of handling, attempting to obtain the good cheaply, etc. In the trade of most legal goods, the seller attempts to do all these things, but is generally limited by laws preventing them from overcharging consumers or underpaying producers. In the case of an illegally traded good, the seller is free to raise their prices as much as they want, as long as (1) the buyer is not completely cut out of the market, or (2) the supply is not cut off because of unreasonably low sale prices (Moffat, M 2011). In the illegal organ trade, the seller completely controls the supply of organs, while consumers who need the organs will be forced to pay whatever price the seller sets. The “producers” of the organs, or the original owners, can be willing donors, but ‘organ theft’ is also common, as was recently demonstrated in India where the police arrested a gang on suspicion of kidnapping and kidney extraction (Ramesh, R 2008). Regardless of the individual circumstances of each case, these ‘producers’ are getting a raw deal (again, no pun intended), either having the organs stolen from their body or receiving negligible income/compensation through an illegal trader (Havocscope 2011). These people are being subjected to significant extortion, assuming they survive the operation at all. The main, if not only, reason many of these people might wish to co-operate with an organ dealer would be because of the differing access different people have to forms of material wealth and power; in the illegal organ trade, differential economic power seems to be the dominant force behind such transactions, where those who become ‘producers’ or illegal organs have been left vulnerable to the lure of the organ traders. Often, for these producers, participation in the organ trade is almost as important as it is for the wealthy consumers: without the additional (albeit very temporary and costly) revenue, some would be unable to survive.
In the majority of markets, according to the economic concept of consumer sovereignty, the consumer of any good is said to be “king” in that overall they determine what goods in what quantities are produced, and have some degree of influence over the price. However, in the trade of illegal necessities, such as organs, the seller becomes king, as they are the integral part of the transaction, and of the market; they are therefore in a position to fully exploit both producers and consumers.
(Further discussion of the motivations behind impoverished people's involvement in the organ trade can be found at http://smartsgroupd.blogspot.com/p/jakov.html.)
The Ultimate Question: Why do we have this trade?
The immediate question that most people seem to ask in regard to illegally traded organs is “Why”? In this case, the biggest driving factor in economic terms is, of course, consumer demand. Without some original demand existing for a product, there can be no market. In the case of the illegal organ trade, the original demand for the market arises from the shortage of legally obtained organs in most countries. Humans, like any species, are willing to do almost anything to survive, and when their life is on the line, monetary and other barriers can become secondary considerations to the apparent necessity of survival. As such, when a person realises that in order to continue to survive they need a new organ, and that the likelihood of their obtaining one by legal means is low to nonexistent (as it is in most western countries), they will turn to illegal means, despite exorbitant costs.
People will also often ask how somebody in need of an organ can knowingly ruin the life of another person when they obtain that organ by illegal means. This can most easily rationalised when it is perceived in light of the fact that most illegally obtained organs are destined for rich people in western markets, and originate from developing countries, where crime rates are high and standards of living pitifully low. Even for most (normally) reasonably moral people, the fact is that the actual crimes taking place are out of sight, and unlikely to directly affect them. As the saying goes, out of sight, out of mind, and so a person buying one of these organs can often simply forget about where it came from, and put away any feelings of guilt.