On Monday I was at the Frontline Club in London for a screening of the documentary Tales From The Organ Trade by the Canadian director Ric Esther Bienstock. The film is a revealing insight into the international world of black market organ trading. It presents a number of key players from live kidney donors to the recipients and explores the ethics, morality and legality of providing organs for cash.

At the heart of both the film and the organ trade is desperation. There is a play between those in abject poverty who make the decision to sell their organs for cash and those desperate for a lifesaving transplant weighing up the pros and cons of paying for an illegal transplant that could save their life.

As Ric Esther Bienstock stated in a Q&A following Monday night’s screening, her film does not set out to answer the ethical rights or wrongs of organ trade, rather to raise questions and spark conversations about the subject of organ transplants. Such as; is it unethical for a doctor to carry out a lifesaving operation with consenting parties even though it is illegal? The film also leaves the viewer questioning the ethics of paying for organs, as it often seems that selling an organ can be of benefit to those wanting to get out of poverty (though it is a large cost) as well as for those whose lives are saved by a transplant.

The black market for human organs exists due to the high demand. Transplant lists grow ever longer throughout the world and there is a sizeable lack of donors. After death organ donations cannot at present provide an organ for everyone in need, primarily due to the lack of registered donors. Hence the tireless drives to sign more people up to the organ donor list. Increasingly when concerning kidney transplants the medical profession will turn to a patient’s family and friends for live donation. All that comes between a paying recipient and a willing donor is an ethics committee. The committee is designed to stop the buying and selling of organs, yet paid-for organs are certainly transplanted if all it takes is a good lie.

The film focused on the more palatable – though by no means easy to digest – organ trade, a neatly framed analogy of the trade with rich patients (mostly westerners) opting to pay for illegal but lifesaving transplants with organs provided by poorer donors. Donors interviewed appeared to have made the decision to donate consciously, though not to say they would necessarily be doing so if they didn’t have the need for the money. There was no mention of the sickening black market trade seen around the world where the donor has no choice if they donate or not. And this ghastly trade is not something happening on far off shores either. For instance as reported by The Telegraph last year a girl from Somalia was trafficked to the UK with the intent of removing her organs to sell on to those desperately waiting for lifesaving operations. Taking advantage of people in need of money can happen anywhere.

The most surprising aspect of the film is the fact that there are donors willing to sell their kidneys. It is understandable for people wishing to donate altruistically, but the thought that some people choose to sell a part of their body to help lift them out of poverty is quite startling.

Echoing Ric Esther Bienstock, Tales From The Organ Trade doesn’t provide answers as to whether buying and selling organs is either right or wrong. Is there much of a moral difference between taking peoples organs against their will or taking advantage of people in a vulnerable situation and paying them for their organs? Or if someone is willing to sell their kidney is it wrong to disallow them from doing so? The subject is so tied up with ethics, emotions, life and death. It is important to talk about organ donation and this film is certainly a tool to aid with conversations. The demand for transplant organs is only set to increase with a progressively richer and sometimes more unhealthy growing world population. It seems obvious that changing our views on after-death donation and signing up to organ donor registers is one way we can help to ease the demand for organ trading.