US trade in body parts signals concern over ethical misconduct and collusion

While international standards are in place for the US organ transplant industry, ethical appropriation of the human body and body parts is not well regulated. Selling hearts, kidneys or tendons for transplant is illegal, yet there are no federal laws governing the sale or lease of cadavers or body parts for use in research or education. Few state laws provide any oversight and almost any person, regardless of training, can dissect and sell human body parts.

As a result, a covert industry of “body brokers,” also known as “non-transplant tissue banks,” has grown throughout the country. Last October, Reuters completed a yearlong investigation that resulted in an eight-part series on America’s body trade, a little-known and virtually unregulated industry.

Through interviews and public records, Reuters identified 34 body brokers doing business across the US within the past five years. These brokers acquire dead bodies and may sell the parts for profit to medical researchers, training organizations and other buyers. Twenty-five of these body brokers were for-profit corporations, the rest were nonprofits.

Reuters highlighted the activities of Science Care, a for-profit company that earned $27 million in revenues during 2017 by recruiting body donors through hospices, funeral homes and online ads as well as by hosting medical training seminars where doctors are able to practice new skills on donated bodies. According to Internal Revenue Service audits and court documents, Science Care owners received at least $12.5 million in earnings from donated bodies between 2012 and 2014.

In 2016, the owners sold Science Care to a billion-dollar private equity firm. Terms were not disclosed, but the sale included an unusual component: written agreements from more than 100,000 people to donate their bodies to Science Care upon death.

Each year, thousands of Americans donate their bodies in the belief they are contributing to science. In actuality, many are also unknowingly contributing to commerce as their bodies are traded as raw material in a largely unregulated national market.

On August 2, 2016 in Tennessee, a young man named Cody died after a heart attack on his way home from dialysis. Unable to afford the burial or cremation costs, Cody’s parents donated their son’s body to an organization called Restore Life USA. The facility sells donated bodies in whole or by part to researchers, universities, medical training facilities and others. Restore Life sold Cody’s cervical spine the month after he died. The transaction required just a few email exchanges and $300, plus shipping.

Body brokers have also been closely aligned with the American funeral industry. Reuters identified 62 funeral operators who have struck mutually beneficial business arrangements with brokers. The funeral homes give brokers access to potential donors. The brokers then pay morticians referral fees, ranging from $300 to $1,430, according to broker ledgers and court records. Most brokers deny that they “sell” body parts but rather only charge “fees” for services.  Investigators for this expose found that this is simply untrue. In many states it is legal for funeral homes to sell items recovered from dead bodies, such as gold dental work. It is also not against the law to operate a so-called body broker firm from the same facility that houses a funeral home and crematory.

Medical training on cadavers in the US usually occurs in designated facilities equipped for such work. However, Reuters identified at least 90 so-called “cadaver labs” that have taken place with little regulation since 2012 in dozens of cities from New York to San Diego, hosted by large global hotel chains such as Hilton, Hyatt, Sheraton and Radisson, that raise biosafety risk concerns.

Nearly 15 years ago, a federal health advisory panel meeting on the regulation of body brokers asked the US government to apply the same strict oversight to the body parts trade that already governs organ transplantation. Nothing came of the panel’s recommendation.

The World Health Organization and Europe have enacted criteria to help protect ethical and legal standards for the management of human tissue, organs and bodily remains. The Council of Europe recently published a new manual on implementing the principle of prohibition of financial gain, as set out in the Oviedo Convention and its additional Protocol. The principle states that the human body and body parts should not be used for financial gain. Human trafficking for the purposes of organ and tissue extraction for financial gain or other comparable benefits for the donor which then benefit a third party, or for those participating in the transplantation process, is prohibited. The manual stipulates that the stated principle “contributes to the promotion of altruistic donations and to ensuring the safety and quality of donated human body parts for a reliable system of donation.”

The absence of any legal standards for the selling of human remains fails to protect and uphold internationally accepted ethical standards that ensure transparency and respect for the human body in life and after death. Without legal implications or consequences, pathways towards collusion with ethical violators and criminal acts remain open, such as those seen in China’s transplant industry. In China, however, it is not just a few dozen companies selling remains of deceased persons but a national government-run program generating huge profits by selling body parts of living human beings, causing their death in the process.