Dr. Robert Hickey is a retired clinical psychologist who specialized in addiction medicine. He directed substance abuse treatment programs at two medical schools and served as the president and CEO of a behavioral health management firm before retiring due being diagnosed with kidney cancer. He received a controversial kidney transplant in October 2004. Given his background, education, and experience, he realized the human organ transplant industry was unfair, broken, and unethical. Since his transplant he has devoted himself to making it easier for others to get the life-saving surgeries. He has facilitated 137 organ transplants over the past 10 years. He lectures around the world on the topic, “Ethics in Transplant Medicine?”, and recently served as the senior consultant for the HBO documentary, “Tales from the Organ Trade.”
SBB: Bob, we’re interested in learning more about the international trade in human organs for transplant. Much research has been done to reveal it as a major international industry, you have been involved in it personally and as a activist.
RH: Yes Shelley, this a human disaster that has been industrialized and nationalized. There is a very active black market for human organs across the world. For years many health authorities in various countries have tried to suppress it, but desperate people facing death will do whatever they can to continue living. So there are always illegal organ brokers willing to step in.
SBB: Where are the most active markets?
RH: The most active black markets operate in China and some of the Baltic states. All of them are very shady and dangerous. Facing certain death, patients are willing to take their chances. I recently finished as a senior consultant on an HBO documentary, “Tales from the Organ Trade,” which was taped in the U.S., Canada, Israel, Turkey, and Moldova. We met many people from across the world attempting to get transplants. Due to the fact that such activities in China are not only sanctioned by the government but also protected, it is not difficult to get an organ there and be transplanted.
Unfortunately, the organ will come from an executed prisoner. Many of these folks are prisoners of conscience imprisoned because of their beliefs or opposition to the government. Those high up in the government and the government itself profit from this organ trade and transplant tourism. Thousands of these people are in prison, which allows the gruesome practice of custom ordering your organ. An egregious violation of international law and a few treaties.
SBB: Bob, you had a kidney transplant, can you tell us about that?
RH: Thanks for asking! I was diagnosed with renal cell carcinoma in December 1997. I was flying my airplane on a business trip from Colorado to Kansas City. En route I began to feel ill. I completed the flight and went to bed. The next morning I was very ill so I went to the hospital. After three days of testing, I was told I had kidney cancer. My left kidney was removed. Following surgery I was told I would be on dialysis within a year. In March 1999 I started dialysis, which continued until October 2004, when I received a very controversial kidney transplant.
SBB: What made it controversial?
RH: Well, after being on dialysis and on the national transplant waiting list for that long, I had no idea how close I was to getting a kidney. I decided I had to advocate for myself. I went on the Internet through a nonprofit organization, www.matchingdonors.com, and found an altruistic, non-related, living donor. He at that time was a 32-year-old, photographer/truck driver from Tennessee. His name is Rob Smitty. I continue to have regular contact with him.
Shelley, since my kidney transplant I have traveled the world assisting people needing organ transplants and speaking out on what I consider the dark and troubled organ transplant industry. In December 1997 I was diagnosed with kidney cancer. My left kidney was removed but following the surgery I was told I would be in total kidney failure within a year. In March 1999 I began dialysis to save my life. The goal was to keep me alive until I could get a kidney transplant. By November 2003 my quality of life had deteriorated to the point where I decided to stop treatment and end my life by discontinuing dialysis.
Shortly after announcing my decision to my family I became aware of an nonprofit organization in the Boston area, www.matchingdonors.com, started by a physician to improve chances for people needing some organ transplants to be matched up with an altruistic, living donor. I signed up and found such a donor in February 2004. After going through an arduous and convoluted, long-delayed testing process I did receive a kidney transplant in October 2004. That transplant was very controversial and received worldwide media attention.
As a result of the media coverage I was contacted by thousands of people from around the world who were desperately seeking organ transplants themselves. Although I had gone through the process of getting a transplant, I felt I was ill equipped to know how to help. I threw myself into the learning process. I began to engage in research of the issues related to human organ transplants. I read medical journals. I spoke with a long time friend [Victor Chan, M.D.] who was a nephrologist [kidney specialist] in Vancouver, British Columbia. I quickly learned the transplant system was unfair, and corrupt.
Many of the people who contacted me seeking help in finding organ donors were considering going overseas to the Philippines, China, Moldova, or India to pay for an organ donor. In discussions with my friend Victor, I had learned of the horrors of people going to these places. Organ brokers would seek out prospective donors who were, for the most part very poor and offer them money if they would give up a kidney or part of a liver for a wealthy foreigner. The poor donors seldom received the promised amount of money. They were subjected to surgeries in filthy clinics by poorly trained doctors without consideration of their own health status.
SBB: The reports we, as an international journal, receive are that the Chinese regime is controlling and profiteering from this program. How does the program function?
RH: China is even worse to this day. The organs the Chinese authorities sell are essentially and ‘organs on demand.’ Someone needs an organ, a prisoner is executed, the paying foreigner gets a transplant. Those high up in the Chinese government and the country itself profit significantly from this international black market. What is even more egregious is the fact that most of the executed prisoners are prisoners of conscience. They are imprisoned because they have beliefs different from those promulgated by the Chinese government. Thousands of these people are being imprisoned and executed.
So as you might guess, I always discouraged people needing transplants from going overseas for their own wellbeing but also for the wellbeing of those from whom their transplanted organs might come. Their chances of survival are greatly reduced. They would have difficulty finding a physician in North America to provide post-transplant care and follow-up.
SBB: Is there no outrage from the international community?
RH: There is a poorly structured international agreement referred to as The Declaration of Istanbul on Organ Trafficking and Transplant Tourism, which 47 nations have signed. Although China is not a signatory to the agreement, they have promised the international community several times that harvesting organs from executed political prisoners would stop. The grotesque practice continues to this day. It is unconscionable that this government-sponsored initiative continues.
There are many reasons why an international treaty/agreement is necessary but the Declaration of Istanbul is both ineffective and dangerous. Ineffective because it does nothing to curtail the abuses in countries such as China. Dangerous because it prohibits people from engaging in legitimate medical tourism for the purpose of getting a legally sanctioned organ transplant from a country with a surplus of cadaver organs as a result of presumed consent laws. We should have a treaty with countries such as Mexico, Spain, and Iran where cadaver donor organs are available. Such an agreement would obliterate China as a destination for black market organ sales.
In the Western world, the organ transplant industry is driven by money, not altruism. The rules, regulations, and restrictions established in these countries contribute to the expansion of illegal, black market functioning. In Canada the wait for a kidney can be 10 to 12 years. A person on dialysis that long will develop significant cardiac deterioration. Even if a cadaver organ for transplant becomes available after such a long wait, that person would not qualify medically for the surgery. Yet, Canadian authorities and the various regional and provincial transplant authorities refuse to innovate to shorten the waiting times.
Due to the Declaration of Istanbul, the United Kingdom does not allow its citizens to seek organ transplants outside the country. However, if you are wealthy and own homes internationally you can get an organ transplant wherever your other homes may be. So internationally, the wealthy have an advantage to which the poor and working classes have little or no access.
SBB: Bob, the mainstream media, for the most part is not covering this story. But you recently did a cable show on the subject, how did that turn out?
RH: I recently served a consultant for an HBO documentary, “Tales from the Organ Trade.” The documentary examines the desperation of people in Canada and the United States looking for kidney transplants. Walter Rassbach, a resident of Denver, had found an altruistic, nonrelated, living kidney donor through the Internet in 2012. However, he could not find a transplant center willing to even test his prospective donor. I had met a transplant surgeon from Mexico who is board certified here in the U.S. He is practicing at Angeles Health International Hospitals in Tijuana and Mexico City. He agreed to do the surgery. Total cost would be $45,000.00 as opposed to $200,000.00 in the U.S. His transplant was stopped when members of the U.S. Transplant Society contacted Mexican health officials and told them they were violating the Declaration of Istanbul. The same thing happened in the case of a San Diego man, Lon Rosado.
Both men had discussed going to Moldova to get organs. Although they do that, the documentary follows to trail to that country to discuss the process with organ brokers, prospective organ donors, transplant surgeons who are from Israel and Turkey, as well as visiting the shady clinics where the transplants take place. It is a story of international exploitation, deceit, and desperation. It further demonstrates why people from around the world will immerse themselves in the murky organ trade in countries like Moldova or China.
SBB: In 1984 the United States passed the National Organ Transplant Act, has this helped to show any improvement in this calamity?
RH: Yes, the United States’ National Organ Transplant Act (NOTA) was passed in 1984. The law required that the transplant system be run by a nonprofit entity, which led to the formation of the United Network for Organ Sharing, commonly referred to as UNOS. NOTA includes a phrase, “Organs cannot be obtained for any valuable consideration.” Of course, this was meant to prohibit the sale of organs. Nevertheless, there is a multibillion-dollar market for cadaver organs in the country. The 58 nonprofit Organ Procurement Organizations (OPO) don’t sell organs. They charge what is euphemistically referred to as ‘organ procurement fees.’ The organ donation business in the U.S. is a multi-billion-dollar-a-year business. As one transplant surgeon said to me while I was lecturing at Harvard, “Everyone in the transplant and organ donation business in this country makes money except the donors!”
SBB: How do we change this tragic and disastrous situation for the better?
RH: I have given much thought to the matter of where we go from here with regard to the organ transplant business, Shelley. Here is the answer: Humanity must get the huge amounts of money out of the organ replacement business, and we must stop the profiteering off human body parts. Once we put a price on any part of the body, we make the life within it totally worthless. Thank you, Shelley.
SBB: Thank you, Bob.
There is an unheralded and unmerciful war being waged on the human body. The war criminals are, in some cases, both governmental, supported by the police and military, and commercial, with corporate and industrial groups worldwide turning the healing processes into an unregulated medical used car lot, with proof of prior ownership and the acquisition process questionable.
This is a war waged only on civilians, prisoners of conscience, and the desperately poor or ill who are burdened with overwhelming need and forced to bargain with money for their right to survive. It is a war of commerce upon conscience.
“Show me who makes a profit from war, and I'll show you how to stop the war.”
—Henry Ford, US industrialist and war profiteer (1863–1947)
Shelley B. Blank has worked with major national and international newspapers as a journalist as well as a corporate executive. He has produced programs for Public Radio and lectured on modern multimedia communications and technology.
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