U.S. APPROACHES TO
TRAFFICKING FOR THE PURPOSE
OF ORGAN REMOVAL
Human Rights and Special Prosecutions Section
U.S. Department of Justice
Organ trafficking: the problem and responses
U.S. regulatory approach
U.S. federal law – NOTA
U.S. criminal prosecutions
U.S. case studies
Overview of the most common U.S. scenarios
U.S. citizens and Non U.S.-donor
residents travel travels to U.S. for
Ban foreign Restrict to
Criminalize Open or
coercion of quasi-open
the “helpless” market
U.S. Regulatory Approach
U.S. Health and Human Services
United Network for Organ Sharing
Oversees organ Manages organ Oversight/guidance
procurement, waiting list for transplant facilities
Requirements of Donor
The patient’s diagnosis, if known
The nature and purpose of a proposed treatment or procedure
The risks and benefits of a proposed treatment or procedure
Alternatives (regardless of their cost or the extent to which the
treatment options are covered by health insurance)
The risks and benefits of the alternative treatment or
The risks and benefits of not receiving or undergoing a
treatment or procedure
* Donor can back out at any time and the reasons for
that decision remain confidential.
Other Relevant Entities
(CDC, DEA) (AMA)
NGOs States (state
National Organ Transplantation Act (NOTA) of 1984
42 U.S.C. § 273-74
It is “… unlawful for any person to knowingly
acquire, receive, or otherwise transfer any human
organ for valuable consideration for use in human
Amended in 2007 to permit paired donation
Establishes regulatory framework
Creates criminal offense
Criminal Offense Issues
Scienter requirement: “knowingly”
Focus on organs as opposed to people?
Valuable consideration – does not include
Criminal Offense Issues cont.
No criminal liability for attempt
Does NOT create civil private right of action
Federal via U.S. Constitution
Challenges in Investigations/Prosecutions
Choice of defendant
Payment = valuable consideration?
Problems proving mens rea
U.S. Litigation: NOTA
Immigration law Criminal law Criminal law
• NOTA • Conspiracy to • Conspiracy to
conviction is a harvest coordinate
“serious non- corneas from donation
political” executed between
crime Chinese buyer and
• Bar to asylum prisoners seller
eligibility • Thrown out for • Currently
evidentiary pending in
problems New Jersey
U.S. Litigation: Other theories?
United States v. Levy Izhak Rosenbaum
broker a sale
of a kidney
by an Israeli
donor to a
the U.S. for
Context of ongoing investigation of other crimes
and other targets
Use of undercover agent
Use of cooperating witness
Setting up the sale
Evidence of other brokered agreements
For UC operation, conspiracy charge
Substantive NOTA violation for completed sales
Possible wire fraud charges
Hypothetical fact pattern
In 2009, S.,
$25,000 for a
team they met
in bible class.
They do not
and do not
Who is the defendant?
Was the payment valuable consideration?
If it happened overseas, jurisdiction?
Immigration crime of donor?
Sentencing/punishment – seize assets?
Human Rights and Special
U.S. Department of Justice
1301 New York Avenue N.W.
Washington, D.C. 20350