The arrest of Levy Izhak Rosenbaum, the Brooklyn resident charged last month with acting as a “matchmaker” for buyers and sellers of human organs, has shone a spotlight on the issue of live donor organ trafficking in the United States. How could Rosenbaum have been able to ply his trade for as long as a decade, according to statements in the criminal complaint filed against him, without being caught?
The 1984 National Organ Transplantation Act makes it clear that the buying and selling of organs is illegal, with violators facing up to five years in prison and a $50,000 fine. This prohibition is intended to prevent the exploitation of those who may be desperate enough to sell an organ.
However, when it comes to enforcing the law, transplant centers are essentially left to police themselves, with the law failing to provide any guidance on how to proceed if a live donor has been paid. Nancy Scheper-Hughes, an anthropologist from the University of California, Berkeley, who has been documenting the international organ trafficking business for over a decade, has said that “other countries have mobilized the justice system around the traffic, and the U.S. has in my estimation turned a blind eye”. The Daily News in New York reported that Scheper-Hughes had informed the FBI about Rosenbaum’s business seven years before he was finally arrested.
Reports of potentially illegal organ transactions are rare within the medical community, according to Alex Capron, a professor of health care law, policy and ethics at the University of Southern California. Mr. Capron believes that this is due to doctors feeling bound by a confidential relationship with their patients, and that any evidence of wrongdoing would likely be avoided by the patient simply disappearing.
The United Network for Organ Sharing (UNOS) is a nonprofit organization under contract with the Department of Health and Human Services. To be a member of the Organ Procurement and Transplantation Network, which is necessary to receive Medicare payments, transplant centers must demonstrate that they are not facilitating the purchase of organs. They must also have an independent donor advocate on staff and conduct psychosocial assessments prior to surgery. UNOS conducts occasional audits to ensure compliance with its guidelines.
However, the burden of proof can vary from center to center, and the guidelines do not specify how rigorous an investigation must be. They only state that the center should get “confirmation of the voluntary nature of proceeding with the evaluation and the donation.” A UNOS spokesman has confirmed that tips about suspicious activity have been passed on to federal authorities in the past.
Dr. Gabriel Danovitch, the medical director of the kidney transplant program at University of California, Los Angeles, has highlighted the delicate trust-based process of live organ donation, and warned that increased regulation could deter legitimate donors. Danovitch noted that doctors and hospitals would suffer immense reputational damage if they were to break the law. He recalled a case where he refused a suspicious donation of a kidney from a gardener to his multimillionaire employer, citing that “it didn’t smell right.”
The recent charges against Rosenbaum have revealed a long-standing scheme of organ brokering. According to the criminal complaint, Rosenbaum charged the kidney recipient $150,000 for medical examinations in Israel, visa fees and the donor’s care in recovery. The only other person mentioned in the complaint was a lab worker whom Rosenbaum paid in cash to verify recipients’ blood types.
Danovitch suggested three possible explanations for how such a scheme could have existed: hospitals and doctors were deceived by the emotional relationship between the donors and recipients; they ignored signs of impropriety; or they were complicit.
Dr. Gabriel Danovitch, medical director of the Kidney and Pancreas Transplant Program at UCLA, has stated that there is no evidence to suggest that doctors and hospitals have been complicit in any organ-trafficking schemes. If any investigations were to uncover systemic wrongdoing, he would support the implementation of stricter regulations and increased oversight.
The criminal complaint against Levy Izhak Rosenbaum, recently charged with running an illegal organ-trafficking operation, alleges that he aided a donor and recipient in deceiving medical professionals and creating a false relationship. According to the complaint, Rosenbaum referred to this as “the easy part.”
Dr. Nancy Scheper-Hughes, a professor of medical anthropology at UC Berkeley, has conducted her own investigations into the sale of live organs and has found that, while it does occur in the United States, it is not as widespread as in other countries. She has also noted that, despite the fact that this practice has been known for some time, the transplant community has worked to keep oversight within their own ranks. “That’s just not the way justice works in the world,” she said.
Emily Witt has achieved remarkable success in her career. After graduating from Brown University with a bachelor’s in Portuguese and Brazilian Studies and Art Semiotics, she was awarded a Fulbright fellowship to spend a year researching Mozambican cinema and reporting for U.N. news agencies IRIN and PlusNews in Mozambique. She then went on to become a staff writer at the Miami New Times, where she was a finalist for a Livingston Award. Most recently, she graduated with honors from the Stabile Center for Investigative Reporting at Columbia University Graduate School of Journalism. Her work has been featured in The New York Times, Oxford American, n+1, Men’s Journal and other publications. Witt’s impressive career is a testament to her hard work and dedication.
Reprinted with permission of ProPublica.org
