Violence Against Women and Sex Selection Abortion


Wesley Smith at NRO has an interesting article about the vicious gang-rape in India and the possibility that sex-selection abortion might have played a role in it. Sex selection abortions have been the norm in China and India for a few decades. Because of the social pressure to make sons, daughters are often killed before they are born. This in and of itself constitutes are crime against women in the first place, but it has other ramifications and consequences. In societies where men greatly outnumber women, unmarried men commit the majority of the crimes.

From Smith’s post: “Growing evidence suggests that in countries like India and China, where the ratio of men to women is unnaturally high due to the selective abortion of female fetuses and neglect of girl children, the rates of violence towards women increase. “The sex ratio imbalance directly leads to more sex trafficking and bride buying,” says Mara Hvistendahl, author of Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men. A scarce resource is generally considered precious, but the lack of women also leaves many young men without marriage partners. In 2011, the number of cases of women raped rose by 9.2 percent; kidnapping and abductions of women were up 19.4 percent..” This is a quote from a Time essay by Erika Christakis.

This will hopefully wake us up to unintended consequences of snuffing out human lives before they are born.

John Gurdon Embraces Human Cloning


Wesley Smith has reported that Nobel Laureate John Gurdon, who shared the Nobel Prize in Medicine this year with Japanese induced pluripotent stem cell discoverer Shinya Yamanaka, has come out in favor of human cloning.

From the story in the Daily Mail:
‘I take the view that anything you can do to relieve suffering or improve human health will usually be widely accepted by the public – that is to say if cloning actually turned out to be solving some problems and was useful to people, I think it would be accepted,’ he said. During his public lectures – which include speeches at Oxford and Cambridge Universities – he often asks his audience if they would be in favour of allowing parents of deceased children, who are no longer fertile, to create another using the mother’s eggs and skin cells from the first child, assuming the technique was safe and effective.

‘The average vote on that is 60 per cent in favour,’ he said. ‘The reasons for “no” are usually that the new child would feel they were some sort of a replacement for something and not valid in their own right. ‘But if the mother and father, if relevant, want to follow that route, why should you or I stop them?’

 

Smith then quotes from his magnificent book “Consumers Guide to a Brave New World,” which all my readers to RUN out to buy and read over and over again:

Scientists would have to clone thousands of embryos and grow them to the blastocyst stage [one week] to ensure that part of the process leading up to transfer into a uterus could be “safe,” monitoring and analyzing each embryo, destroying each one in the process. Next, cloned embryos would have to be transferred into the uteruses of women volunteers [or implanted in an artificial womb]. The initial purpose would be analysis of development, not bringing the pregnancy to a live birth. Each of these clonal pregnancies would be terminated at various points of development, each fetus destroyed for scientific analysis. The surrogate mothers would also have to be closely monitored and tested, not only during the pregnancies but also for a substantial length of time after the abortions.

Finally, if these experiments demonstrated that it was probably safe to proceed, a few clonal pregnancies would be allowed to go to full term. Yet even then, the born cloned babies would have to be constantly monitored to determine whether any health problems develop. Each would have to be followed (and undergo a battery of tests both physical and psychological) for their entire lives, since there is no way to predict if problems [associated with gene expression] might arise later in childhood, adolescence, adulthood, or even into the senior years.

 

Smith, in my view, is spot on. Therapeutic cloning will not stop at using cloned blastocysts to make patient-specific embryonic stem cell lines. The reason for this is that even though cells made from differentiated embryonic stem cells can have therapeutic value, such cells can also be rejected by the immune system of the host animal. A much more fail-safe way to do this experiment is to gestate the embryos to the fetal stage and use the fetal tissues.

Once we go down the road of cloning and destroying embryos just to make embryonic stem cell lines from them, what’s to keep us from aborting fetuses just to get their cells? This slippery slope is real and speaks volumes, none of it good, about a society that sacrifices its youngest and more vulnerable members to serve the needs of others. It cheapens human life to the nth degree and at its lowest point, it simple murder.

Gurdon, however, speaks of reproductive cloning to replace children lost through tragedy. While I can appreciate the sentiment, sentiment is an extremely poor reason basis for ethics. Folks, biology is not destiny. Cloning experiments in animals have shown us that even cloned embryos made from material taken from the same mother, that are genetically identical are neither identical to their mothers nor are they identical to each other. Random events that occur during development and the way each individual responds to their environment shapes them in a unique manner. The cloned sheep Dolly was completely unlike her cloned siblings in personality, behavior, or overall appearance. The same can be said for CC (for “Carbon Copy”), the first cloned cat, which looked unlike her mother and had a very different personality.

Yet these cloned children are asked from the second they are born to replace another child who is unlike them. The cloned child is a human person and while the right for each person to be authentically who there are in an inherent right of all human beings, this very right is denied these cloned kids – they are born for the very reason that they can be someone else. This is a violation of everything it means to be human, and it is the very reason no good thing can come from human cloning.

Gurdon is a brilliant scientist, but as we have seen before, great scientists sometimes make terrible ethicists.

Our Dangerous Obsession With Health


Wesley Smith has written a fine column at the First Things “On the Square” site. He draws from another terrific article by Yuval Levine at the New Atlantis. Both of these articles tackle a similar issue and is our society’s unhealthy preoccupation with avoiding any kind of suffering and supply our every whim whether it is good for us or not. We used to be a society that was concerned with cultivating virtue or even justice and equality. Today, if is about our desires and the avoidance of discomfort or suffering of any type.

There is nothing wrong with promoting health, but when health becomes the primary purpose of society, it becomes an excuse for immediate gratification and hedonism. In the words of Levin: “Unbalanced and unmoored from other goods, [health] can become a vessel for self-absorption and for decadence. It can cause us to abandon our commitment to our highest principles, and to mortgage the future to avert the present pain.”

Levin and nailed it in my view. We murder our unborn children mostly because they are a terrible inconvenience to us, and then we murder other children in order for many to give birth to the one kind of child we want at the right time. This is not about justice, it is about hedonism.

If you want two very insightful articles on what ails our bioethical sensibilities, read Smith here and Levin here.

Gardasil: Does it Work and Is it Safe?


Gardasil is a vaccine made by Merck and it stimulates the immune system to recognize and attack various strains of the human papilloma virus.  Human papilloma virus causes warts, but particular strains of it also cause a sexually transmitted disease called genital warts, which are the beginnings of cervical carcinoma.  One-quarter-of-a-million women die each year, globally, from cervical cancer.

This vaccine has been the center of several political and policy debates.  The Gardasil debate has definitely caught the attention of the country. During the Republican presidential candidate debates, on September 12, 2011, candidates Congressman Ron Paul (TX) and Congresswoman Michele Bachmann (MN) attacked fellow candidate Texas Governor Rick Perry for his executive order to mandate the vaccination of Texas school children.  The next day, Congresswoman Bachmann said, on NBC’s Today Show, “I will tell you that I had a mother last night come up to me here in Tampa, Fla., after the debate and tell me that her little daughter took that vaccine, that injection, and she suffered from mental retardation thereafter.”  As much as I like Michelle Bachmann, that was a pretty astounding statement about this vaccine.

As the father of three girls, two of whom are in high school, believe me, I understand the issue. Parents want to make such significant choices for their families on their own without Big Brother doing it for them. Nevertheless, health care professionals and epidemiologists, who see the 250,000 deaths each year from cervical cancer want to see the herd immunity against human papilloma virus (HPV) to go up so that the carrier rates of this virus will fall. Mandating the vaccination is one way to do that. “Not so fast,” say many parents who have worked very hard to teach their children sexual ethics that are at odds with those of the culture. “We have taught our girls to save sex for marriage and prevented them from being exposed to the oversexed pop culture of modern youth and now you want us to vaccinate them against the rotten fruits of that culture?” It is a fair question.

What gets lost in all this is that the vaccine, Gardasil, made by the pharmaceutical giant Merck, based in Whitehouse Station, New Jersey, does exactly what the company says it does. There have been some movements on the web to discredit Gardasil. For example, The Truth About Gardasil is raising money to make a full-length film about the dangers of Gardasil. Other such campaigns are also found on the web.

On the other hand, journal Nature has summarized the results of the Gardasil trials, Future I and Future II. These trials enrolled 17,600 women across the Americas, Europe, and Asia-Pacific who received the vaccine between December 2001 and May 2003.

The results from these studies are pretty clear and positive. Gardasil, in these women, was 100% effective in preventing genital warts, the precursor to CIN or cervical intraepithelial neoplasia. While there were women diagnosed with CIN or AIS (adenocarcinoma in situ), the numbers were too low to draw any firm conclusions. Gardasil was not able to get rid of HPV in women with established infections at the time of injection, which is no surprise, since it is a vaccine and not a treatment.

Gardasil contains a mixture of peptides (polymers of amino acids) from four different strains of HPV: strains #6, #11, #16 and #18. Strains #16 & #18 are responsible for 70% of all cervical cancer cases globally. Strains #6 and #11 cause 90 percent of all genital warts. Therefore, Gardasil contains a mixture of the most troublesome strains of HPV. There are other strains of HPV that cause cervical cancer. For example, long-term infections with HPV strains #31 and #45 can also cause cervical cancer. Therefore, Gardasil does not prevent all types of cervical cancer. However, in those women who were vaccinated with it, it seems to prevent cervical cancer, at least over the course of 9-12 years.

If lots of women die each year from cervical carcinoma, then surely we should rejoice that many of these women who have been vaccinated will not contract cervical cancer. Men can also contract penile cancer from HPV. Therefore, this vaccination is also being marketed and given to men as well. Mind you, unchecked promiscuity has plenty of other risks and these risks should not be minimized. However, if some women will not die from HPV as a result of Gardasil, it seems to me that this is a good thing.

What about the side effects of Gardasil that are touted on sites like The Truth About Gardasil? In the Future I and Future II studies, there were no serious side effects reported. This is from a global population of young women. Therefore, the side effects mentioned on The Truth About Gardasil website might be 1) particular to those women, which certainly deserves much more research; 2) unrelated to the vaccine; or 3) related to the vaccine but only tangentially.

Should these side effects be ignored? Not at all. The CDC runs a web site where reactions to Gardasil and all other vaccines are monitored known as the Vaccine Adverse Event Reporting System (VAERS). According to this site, there were 12,424 reported adverse events after about 23 million doses of vaccine between June 2006 and December 2008. That’s an adverse reaction rate of 0.054% per dose. Folks, that’s pretty low. Also, if you consider that the vast majority of adverse reactions are really minor (fainting, headaches, sores at the site of the injection that resolve over time), this constitutes a pretty small number of adverse reactions.  The problem is the 32 deaths, but even here, the deaths are the result of embolisms (clots in the bloodstream) and these are caused by other things that are probably not related to the vaccine. The 32 deaths means that Gardasil has a 1 / 1,000,000 deaths per dose rate. This is rate that is so low that is seems very unlikely that the vaccine is causing the deaths, and the proximity of the death to the vaccine is coincidental at best.

Where does this leave us?  The vaccine does what it says it does – prevent cervical cancer from the two major strains of HPV. It is not a cure for it. It is, as far as we can tell to date, safe. The rate of deaths after a Gardasil injection are not higher than immediate deaths in general and that seems to indicate that the deaths are not related to the vaccine. Also, the severe adverse reaction rates are well within the safety levels expected for a good vaccine.

Regardless of your views on whether or not Gardasil should be mandated, you must say that it works and that it is safe. The data support such a conclusion. Therefore, other statements about Gardasil should be about policy and not about the safety or efficacy of the vaccine. Gardasil works and is safe.

For studies on Gardasil, see the following:
1. Future II Study Group N. Engl. J. Med. 356, 1915–1927 (2007).
2. Garland, S. M. et al. N. Engl. J. Med. 356, 1928–1943 (2007).
3. Paavonen, J. et al. Lancet. 374, 301–314 (2009).
4. Future I/II Study Group BMJ 341, c3493 (2010).
5. Munoz, N. et al. J. Natl Cancer Inst. 102, 325–339 (2010).
6. Lehtinen, M. et al. Lancet Oncol. 13, 89–99 (2012).
7. Kreimer, A. R. et al. Lancet Oncol. 12, 862–870 (2011).
8. Donovan, B. et al. Lancet Infect. Dis. 11, 39–44 (2011).
9. Brotherton, J. M. L. Lancet Infect. Dis. (in press).
10. Brotherton, J. M. L. et al. Lancet 377, 2085–2092 (2011).
11. Australia Dept. Health and Aging. National HPV vaccination data for girls aged 15 in 2009. National HPV Vaccination Program (2011).
12. Shearer, B. D. HPV Vaccination: Understanding the impact on HPV disease. http://www.nccid.ca/files/Purple_Paper_Note_mauve/PP_34_EN.pdf (2011).
13. Widgren, K. et al. Vaccine 29, 9663–9667 (2011).
14. Department of Health, UK. Annual HPV Vaccine Coverage in England in 2010/2011.
15. Centers for Disease Control and Prevention Morbid. Mortal. Weekly Rep. 60, 1117–1123 (2010).

Disclosure: I own no stock in Merck, and was neither paid by Merck for this article, nor contacted by them at any time in the writing of this article. These conclusions are mine, and therefore, if you disagree with me, please do not call me a paid shrill for Merck because I am not. Instead, please simply address where in the published data you think I have misunderstood, and I will do my best to respond.

Todd Akins and Pregnancy as a Result of Rape


Republican candidate for U.S. Senator from the state of Missouri, Todd Akin, really stuck his foot in his mouth during an interview on the Jaco Report on Fox. After he stated that abortion should be legal to save the life of the mother, the host asked if it should also be legal in the case of rape.

Akin responded: “People always want to try and make that as one of those things, well, how do you slice this particularly tough sort of ethical question. It seems to me, first of all, that from what I understand from doctors, that’s really rare. If it is a legitimate rape, the female body has ways to try and shut that whole thing down. But let’s assume maybe that didn’t work or something. I think there should be some punishment, but the punishment should be of the rapist and not attacking the child.”

Akin issued an apology but the damage is already done. His statement was poorly worded and garbled. He probably meant to refer to a forcible rape, which is also known as an assault rape as opposed to a date rape. He was probably trying to make this distinction since there have been cases whereby women who become pregnant from consensual intercourse have later claimed rape. His wording failed to properly clarify what he meant.

Even worse was his statement that ” the female body has ways to try and shut that whole thing down.” Again I think he was trying to refer to the physical trauma experienced by a woman when she is raped. Stress and emotional factors can alter a woman’s menstrual cycle. In order to get pregnant, and stay pregnant the body of the woman must produce a complex mix of hormones. This hormone production is under the control of the brain and the part of the brain that controls reproductive hormones (the limbic system) is easily influenced by emotions. An assault rape certainly qualifies as great emotional trauma. Such trauma can radically upset ovulation, fertilization, implantation and even the nurturing of a pregnancy.

Having said all that, women do get pregnant from assault rapes. Approximately 1 in 15 women who are raped will get pregnant from it (see Statistics on Sexual Violence Against Women: A Criminological Study, 1990). Another article by Holmes, Resnick, Kilpatrick, and Best (Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women) from the American Journal of Obstetrics and Gynecology (1996 Aug;175(2):320-4; discussion 324-5), finds that the national rate of rape pregnancies is 5.0% per rape among victims of reproductive age (aged 12 to 45). This rate is higher because some women who are raped are too old or too young to become pregnant from the rape. Nationally, there were an estimated 32,101 rape pregnancies each year. Only 11.7% of rape victims received immediate medical attention after the assault, and 47.1% received no medical attention related to the rape. 32.2% kept the infant, 50% underwent abortion and 5.9% placed the infant for adoption. 11.8% had a spontaneous abortion.

Thus the statistics show that pregnancy as a result of an assault or forcible rape does occur frequently enough so that pro-life politicians, thinkers and workers must take it seriously. The simple fact is that the baby should not pay the price of his or her life for the crimes of the father. That is the crux of the pro-life position. Abortion as a that ends the life of a baby who is the product of a rape still ends the life of a baby who had nothing to do with the crime still kills a baby. Had Akin put it this way, then he would not have stuck his foot in his mouth the way he did.

There are complications with forcing the woman to be a life-support system for a baby she did not wish to conceive, but the fact still remains that a baby’s life hangs in the balance. In the scheme of things, it seems to me that having the woman bear the brunt of the pregnancy is the lesser of two evils and saving the life of the baby is a greater good.  Trying to be cute about it will only get you in trouble and mark you as ignorant and insensitive to women.

ObamaCare and the Coming Two-Tiered Medical System


John C. Goodman has a fabulous article in the Wall Street Journal about the coming hell that awaits the US when ObamaCare kicks in completely.

Most of the provisions of ObamaCare come online on Jan. 1, 2014. Within a decade of this date, approximately 30 million people more people are expected to acquire health plans. Now research has indicate if people get health insurance and if they are under the mistaken illusion that it is free, they begin to go to the doctor for hang nails and other ridiculous things. Therefore, economic studies show that these 30 million extra people will essentially double their use of the health-care system.

The Obama administration is constantly reminding senior citizens that they are entitled to a free annual checkup. Also, in its new woman-centered campaign, women are being told, they will have access to free breast and pelvic exams and even free contraceptives. Yes, once Shangri-La arrives when ObamaCare fully takes effect, we will all be entitled to a long list of preventive services, with no deductible or copayment. If it sounds too good to be true, that’s because it is.

The problem? Where to start. First, our health-care system simply cannot meet this huge increase in demand for primary-care services. While the original ObamaCare bill contained a line item for increased doctor training, this provision was zeroed out before passage to keep down the cost of health reform. This the entire primary care services entitlement will result in nothing less than gridlock of the worse kind.

Since, according to ObamaCare, health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force, doctors will be forced to offer these services. Here’s the catch: According to a study in the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician’s time each year, or 7.4 hours per working day. Given the massive amounts of paperwork ObamaCare is going to generate for physicians, there is no way on this green earth that any doctor, nurse or physician’s assistant in going to be able to perform these services for patients.

Health care professionals will spend time searching for problems and talking about the search, and if screenings turn up a real problem, there will have to be more testing and more counseling. Here’s the bottom line: in order to meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.

Now if we apply some very basic economics to this situation, if demand exceeds supply in a normal market, prices rises until they price many people out of the market. However, in this case, as in other developed nations, Americans do not primarily pay for care with their own money for health care. Therefore they pay with something else even more precious and that is time.

According to a 2009 survey by medical consultancy Merritt Hawkins, the average wait to see a new family doctor in this country is just under three weeks. However, in Boston, Massachusetts, which enacted near-universal coverage under Gov Mitt Romney, the wait is about two months.

How long it takes you to see a doctor is a non-price barrier to medical care, and there is substantial evidence that it is even more important in deterring care than the fee the doctor charges, even for low-income patients.

If people cannot find a primary-care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. However, a 2007 study of California in the Annals of Emergency Medicine showed that up to 20% of the patients who entered an emergency room left without ever seeing a doctor, because they got tired of waiting. Under ObamaCare, this situation will certainly worsen dreadfully.

Economics again: if demand exceeds supply, doctors much more flexibility to see whomever, whenever. Therefore, they tend to see those patients first who pay the highest fees. For example, a 2008 New York Times survey of dermatologists uncovered an extensive two-tiered system. Patients in need of services covered by Medicare waited 2-3 weeks to see a doctor, and the appointments were made by answering machine. For Botox and other treatments not covered by Medicare for which patients pay the market price out-of-pocket, appointments to see those same doctors were often available on the same day, and made by live receptionists.

Physicians will increasingly need to jealously protect their time in order to make a proper living. Therefore, patients in plans that pay below-market prices, which include the elderly, disabled on Medicare, low-income families on Medicaid and people with subsidized insurance acquired through the ObamaCare exchanges, will wait the longest. However, the wait time will only get longer and longer as more and more Americans turn to “concierge medicine” for their care.

Concierge medicine differs from region to region and doctor to doctor, but it generally refers to patients who pay doctors to be their agents, rather than the agents of third-party-payers (e.g. insurance companies or government bureaucracies).

As an example, a Medicare patient can pay $1,500 to $2,000 to form a new relationship with a doctor, and this relationship includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health-care system.

This spells trouble for ObamaCare, since a typical primary-care physician has about 2,500 patients, according to a 2009 study by the Centers for Disease Control and Prevention. When that same physician opens a concierge practice, he’ll typically take about 500 patients with him, according to the MDVIP, which is the largest organization of concierge doctors. That’s about all the doctor can handle, given the extra time and attention those patients are going to expect. What about the 2,000 patients left behind? They must find another physician. Therefore, as concierge care grows, the strain on the rest of the system increases.

It is not difficult to predict what happens next. As concierge medicine rapidly grows, every senior and non-senior who can afford one will have a concierge doctor. The rest who cannot afford the cost will not. This we will quickly switch to a two-tiered health-care system, in which the rich get fast, high-quality care, and the poor wait forever for low-quality care.

This will leave us with a vulnerable population that will have less access to care than they had before ObamaCare became law. All because the president and the dunderheads in Congress do not understand that incentives matter or even the first rule of economics.

Illegal Kidney Trade Booms as New Organ is ‘Sold Every Hour’


Illegal kidney trade has risen to an estimated 10,000 black market operations annually. Most of these operations involve the use of purchased human organs, and at this rate, more than one operation occurs an hour, according to the World Health Organization.

The evidence for this come from data collected by a worldwide network of physicians, and these data show organ traffickers are defying those laws intended to curtail their activities. Instead these traffickers are cashing in on the increasing international demand for replacement kidneys, which is driven by the increase in diabetes and other diseases.

Wealthy patients will go to China, India, or Pakistan for surgery and will pay up to $200,000 (~£128,000 for you across the pond) for a kidney. Unfortunately, these payments often go to gangs who harvest organs from vulnerable, desperate people, sometimes for as little as $5,000. This makes organ trafficking a very lucrative business. Traffickers and surgeons will take great risks to make such large sums of money. This is well illustrated by the arrest of 10 people, including a doctor, suspected of belonging to an international organ trafficking ring. According to the Israeli police, there is evidence that these suspects are also guilty of extortion, tax fraud and grievous bodily harm. Similar illicit organ trafficking rings have been uncovered in India and Pakistan.

A British newspaper known as The Guardian contacted an organ broker in China who advertised his services under the slogan, “Donate a kidney, buy the new iPad!” This particular broker offered £2,500 for a kidney and said the operation could be performed within 10 days.

The resurgence of trafficking has prompted the World Heath Organization to suggest that humanity itself is being undermined by the vast profits involved and the division between poor people who undergo “amputation” for cash and the wealthy sick who sustain the body parts trade. Luc Noel, a doctor and WHO official who runs a unit that monitors trends in legitimate and underground donations and transplants of human organs, said, “The illegal trade worldwide was falling back in about 2006-07 – there was a decrease in ‘transplant tourism.’” But he added: “The trade may well be increasing again. There have been recent signs that that may well be the case. There is a growing need for transplants and big profits to be made. It’s ever growing, it’s a constant struggle. The stakes are so big, the profit that can be made so huge, that the temptation is out there.”

A complete lack of adequate law enforcement in some countries, and the absence of sufficient laws to protect the vulnerable in other countries, mean that those offering financial incentives to poor people to part with a kidney have it too easy, Noel said.

Kidneys make up 75% of the global illicit trade in organs, Noel estimates. Rising rates of diabetes, high blood pressure and heart problems are causing demand for kidneys to far outstrip supply. WHO data shows that of the 106,879 solid organs known to have been transplanted in 95 member states in 2010 (legally and illegally), approximately 73,179 (68.5%) were kidneys. WHO also noted, however, that those 106,879 operations satisfied just 10% of the global need. WHO does not know how many cases involved the organ being obtained legitimately from a deceased donor or living donor such as a friend or relative of the recipient, but Noel believes that one in 10 of those 106,879 organs was probably procured by black marketeers. If so, that would mean that organ gangs profited almost 11,000 times in 2010.

Proof of illegal trafficking is being collected by networks of doctors in various countries known as “custodian groups”. These groups are working to support the Declaration of Istanbul, the 2008 statement against global organ exploitation that was agreed by almost 100 nations. Made up of hospital specialists who treat patients with end-stage kidney failure who survive on dialysis, and surgeons who operate on those lucky enough to get a new kidney, the groups monitor reports of black market activity in their own country or involving compatriots abroad.

A medical source with knowledge of the situation said: “While commercial transplantation is now forbidden by law in China, that’s difficult to enforce; there’s been a resurgence there in the last two or three years. Foreigners from the Middle East, Asia and sometimes Europe come and are paying $100,000 to $200,000 for a transplant. Often they are Chinese expats or patients of Chinese descent.” Some of China’s army hospitals were believed to be carrying out the transplants, the source added.

The persistence of the trade is potentially embarrassing for China. The health ministry in Beijing has outlawed organ trafficking and has also promised to stop harvesting organs from executed prisoners by 2017, a practice that has brought international condemnation.

John Feehally, a professor of renal medicine at University Hospitals of Leicester NHS trust, said: “Since the Declaration of Istanbul the law on trafficking has been changed in the Philippines – which was one of the centers of transplant tourism – and the Chinese government realizes that things have to change.” Feehally is also president of the International Society of Nephrology, which represents 10,000 specialist kidney doctors worldwide. “Trafficking is still continuing – it’s likely that it is increasing,” he said. “We know of countries in Asia, and also in eastern Europe, which provide a market so that people who need a kidney can go there and buy one.”

The key issue, Feehally said, was exploitation. “You are exploiting a donor if they are very poor and you are giving them a very small amount of money and no doctor is caring for them afterwards, which is what happens.  The people who gain are the rich transplant patients who can afford to buy a kidney, the doctors and hospital administrators, and the middlemen, the traffickers. It’s absolutely wrong, morally wrong.”
Noel wants countries to defeat the traffickers by maximizing the supply of organs from deceased and living donors, and encouraging healthy lifestyles to delay or prevent people getting those conditions such as diabetes in the first place.