Transplant Surgery abroad is not the same in every country

[mitchorganbroker]

I know what you guys need to get in order to clinch the deal . A free tea shirt,  a seasons pass to all Philippine baseball games and a trip to a white sand beach on the Island of Mindoro. Its a good site for snorkeling and scuba diving. I have been there.   

[Panda_9]

I wouldnt go to the Phillapines if you paid me!

[sandman]

Sandman, are you saying that I am in N.America ? Angie can see that I post from the Philippines. Do you think N.American laws apply to the Philippines ?.
 Sandman the quote that follows you placed an Angies board  "Now, the services that you seem to be offering may apear to the rest of the world that the US deals with in this matter as a black market for organs and transplants. And contrary to popular belief" That may appear phrase is what you have leaned upon , so kindly show specific proof or back off the name calling.

The following , I though you understood but obviously not..
 I look to find patients, while remaining physically in Asia to screen patients by speaking to them and looking at the records ,then we refer them  to a Surgeon who is also in the Philippines, who then contacts a donor. The Donor goes before a Hospital ethics committee, still in the Philippines for approval of his compensated donation. In the Philippine, their own law applies in the Philippines ,so why do you keep bringing up N.America law  ? Is it superior ?
   What part of this work which is legal in the Philippines are you calling black market. ?
You know, in N. America if a donor is approved after the ethics committee , even if it took 6 months. It is legal.
So if you follow the laws of where this takes place(Philippines), its legal. Can't you understand this and not forget it in a week ?

Hey, did you even read my last message completely or did you just read the first sentance and start posting from there?

Stop twisting my words around.  I never said you were in North America.  But doesn't matter anyway because my basic means to trace route your IP fails.  How Angie would be able to run a trace route on you and I can't, is beyond me.  But that's besides the point.  North American laws do not apply in the Philippines and visa versa BUT, North American laws DO apply to North Americans.  North America would be Canada, USA and Mexico.  In North America, it IS illlegal to transport many items to and from this country without the proper documentation or without paying some sort of duty fee.  And there are other items that are simply prohibited to North Americans.  Now, I'm not exactly up to date on US customs laws so please forgive me if my data is out of date but last I checked, it is illegal for citizens of the US to acquire human organs out side of North America unless acquired through emergency surgery.  Now, I'm not sure how this pertains to the services you are offering but I can assure it, it is severely frond upon.  Prove me wrong and I will retract my previous statement.

[mitchorganbroker]

Yes I read your post completely, but I only want you to answer(the verb and Adverb) part of it, that why I asked about that part.
 Did you read the Post from BigSky ?  It stated     " First off I do not agree with the buying and selling of organs for obvious reasons. However if you think it is black market you are wrong.  To be black market it would have to be illegal in the Philippines in the first place or the transaction would have to occur in the US.
The only way it will be black market is if the transaction occurs in the US.  Since the "donor" (term used very loosely) is not in the US it is doubtful that will ever be the case.  Also to my knowledge there is no US law that prohibits US citizens from traveling to such countries for such things.  US law nor does Customs have any authority in what is going on unless it occurs in the US and even then the organ transfer has to affects interstate commerce.  No I am not siding with the guy either.  "

As to your last sentence " it is illegal for citizens of the US to acquire human organs out side of North America unless acquired through emergency surgery.  Now, I'm not sure how this pertains to the services you are offering but I can assure it, it is severely frond upon.   Prove me wrong and I will retract my previous statement. "
   You said " it is severely frond upon". Sandman, do you think a Philippine hospital is under N.American jurisdiction ??
Who cares what they Frond upon. I frond upon that they don't help save Darfur.
    Between your frond statement and the words of BigSky, what do you think . Did that prove you are wrong.. I don't care if you withdraw past wrong stuff. I want you to stop calling me names which infer dishonesty, pure and simple. Nothing about what someone frowns upon. You proved yourself wrong and nobody jumped up to imply Asia is under US jurisdiction.
  Time for you to be fair.

[angieskidney]

He is in the Philippines.

23   324 ms   417 ms   321 ms  cable-*-*-*-*.mydestiny.net [*.*.*.*(blocked out for privacy reasons)]

Trace complete

Solid Broadband Corp. is a broadband service company, is envisioned to be the largest provider of multimedia services in the Philippines.

Also Bigsky has a very important point regarding Mitch here.

The argument isn't about how we feel it is wrong and how in North America it is wrong .. because it is legal in the Philippines.  It is comparable to when I worked for "Canadian Satellite" (which actually took money from customers and gave them American Signals) when it was seen by Americans as illegal for Canadians to have American Satellite accounts. But in Canada it was "Grey Market" until the R.C.M.P. declared it "Black Market" a few years ago causing the business to go under.

The problem I have with Mitch is that he is insulting but there have been insults thrown at him too since most of us are defensive about this issue. Why? Well, we feel Mitch is pushing it on us and calling us trapped prisoners by our own will if we don't jump on the next flight out and put up the neighbours house so we have the money to throw into something that might not even be as safely regulated as we are used to.

Let's just stick to facts and stop the fighting. We can agree to disagree but let's stop the insults as they are non-preductive!

[stauffenberg]

While the British Parliament claims to have the capacity to legislate for the entire world, and in a famous quip among English lawyers, could "make it illegal to smoke on the streets of Paris," the American Constitution, being designed for a federal state, has to demarcate very carefully the geographical range of the legal authority of each level of government.  Each state controls matters within its own boundaries, and the federal government is limited to interstate matters, matters of strictlly national concern, and certain specific topics which may extend into state jurisdiction, such as control over foreign ambassadors.  But American law does not purport to control what you can do outside the country.  It is also pure science fiction to imagine that customs has any control over integral or surgically integrated parts of the human body, and no one has ever had to pay an import duty for bringing in a cardiac pacemaker he had installed in his chest while he was on vacation in Germany!  Generally, internationally the principle of 'comity among nations' applies, and each country respects the laws of every other country within the foreign country's jurisdiction.  Just because you got married in, say, England where the marriage laws do not require a blood test for venereal disease before a marriage license is issued, does not mean that on arriving in a U.S. state that did insist on such a blood test for a marriage license your English marriage would suddenly be regarded as invalid.  Similarly, how you got your new kidney abroad would also not be an issue.

For those who are still convinced that buying organs is universally wrong, despite the dozens of medical ethicists who now agree that payment for kidney donation is morally legitimate, just consider the variety of different nations' attitudes to payment.  Iran instituted in 1997 a system under which the government pays live kidney donors for their donation through charitable organizations, and now the waiting list for kidney transplants has fallen to zero, so patients are transplanted as soon as they get sick, and dialysis is needed only for those medically ineligible for transplants.  In British Columbia, Canada, the government now pays families which donate the organs of a deceased family member $5,500 for the funeral expenses.  Pennsylvania also has a less generous system of compensating donor families for funeral expenses.  In a variety of Asian and Middle Eastern countries payment of live donors is the normal procedure, even for the locals.  But at the other extreme, in Japan for decades it was considered immoral to take an organ from a brain-dead person, and even today no organ can 'morally' be taken from anyone 15 and under according to Japanese law, thus producing enormous tragedies for pediatric patients in need of a small-sized organ transplant, who in the U.S., in contrast, would be given top priority for a new kidney!  So you can see how arbitrary these supposedly 'God given,' 'universally necessary,' 'absolute' moral principles really are.  I would say that amidst such a relativity of value judgments from one culture to another, you have a right to base your decision on your own needs, not on the prejudices of some society of mainly healthy people who don't know what you're going through.

[Zach]

Welcome back stauffenberg, I thought we lost you.

[sandman]

Okay mitch, I have one last question for you before I just give up on you completely.  ( now this is just hypothetically speaking, mind you ) IF someone here was to go and get a transplant from you, and for some odd reason, the medical professionals that they deal with found out where the procedure took place.  Now what if their insurance providers would refuse to pay for follow up care, how are those patients suppose to pay for continuing health care?

[mitchorganbroker]

Sandman,
You said this was your last question.   OK   
----------------------------------------------------------
Geoff,
 I owe you an apology for commenting about your meds. Now , I understand your point about the depression we get at times. Hang in there.

[stauffenberg]

Sandman: most nephrologists, by training, by experience, and by the Hippocratic oath, are on the patient's side, and many of them I have spoken to regard the laws against paid organ donation as cruel and groundless, based on a knee-jerk reaction of the general public to a problem they don't understand.  As a result, they will usually turn a blind eye to any evidence that you got a transplant under unusual circumstances, or they will even positively congratulate you for your initiative.  They are healers, not policemen.

How a private or a public insurance program will respond to the fact that you got a transplant abroad by unusual means depends on the particular program and its rules, so no general answer can be given.  There are many lawyers in the U.S. who specialize in getting Medicare/Medicaid claims approved, so you might want to consult one of them with your hypothetical first if you are using the public system in the U.S.  In Canada and Britain, the only rule of the public healthcare system is that they treat patients for free as and when they need it, regardless of what brought them in the door of the doctor's office or the hospital.  In Canada it wasn't even the law until last year that a doctor is obligated to report to the police all gunshot wounds treated, and even that has sparked protests from the medical profession.  If you have private insurance, it is good to keep in mind that some private insurers will pay for a Philippine transplant, because they look at the matter purely in financial terms, and it is much cheaper to pay $80,000 once plus $10,000 a year for anti-rejection drugs than it is to pay $60,000 a year for however long the patient lives.  In any case, however, you should look at the fine print of the policy first to see what is covered and what is not.

[mallory]

This is a link to a press release from the Department of Health in the Philippines:

http://www.doh.gov.ph/press/09031999.pdf

It states:

Health Secretary Alberto Romualdez Jr., today ended the moratorium on all transplant operations of living non-related donors even as he ordered the creation of an ethics committee in all institutions with transplant facilities to ensure that all transplantation conforms to legal and moral requirements.

The said moratorium did not cover transplant operations of Filipinos with foreign citizenship and all foreigners married to a Filipino national and residing in the Philippines.

According to Romualdez, the practice of acquiring an organ from a living related donor is acceptable. He added that donation from a living non-related donor is also acceptable but emphasized that there should be no form of profiteering among donor and alleged agent.  Although the sale of an organ does not violate any law, the health chief said that the organized practice of organ donation for profit is against ethical standards and is not within the commerce of man. Romualdez also revealed that should a doctor be found guilty, this may result to revocation of his license.

“If we allow the practice of living non-related donors in the country, this will open doors for foreigners to buy kidney and other body parts here in our country since many of our countrymen are poor,” Romualdez said. “This will be discriminating against poor Filipinos,” he added.

The health chief disclosed that people who accepts payment for organ donation are not properly informed of the consequences. The operation on a healthy donor may be a possible source of infection and may cause excessive bleeding.

Meanwhile, the DOH reported that a kidney is sold for about P100,000 with the agent getting P 10,000 to P12,000 per deal. The sale of kidney has already happened in the past but these were done before the transplantation ethics was discussed and put into order. In the country, the first kidney transplant was done some 20 years ago.

It also states:

Commercial or for “profit” kidney donation shall not be allowed; Compensation in Living Non Related Organ Donation shall be carried out in the spirit of altruism between donor and donee; and shall not in anyway, be transacted through brokers;

And it also states:

LNRD* donation for foreigners shall temporarily be disallowed pending further deliberation.
*Living Non-Related Donor

In the U.S., The National Organ Transplant Act makes it illegal for "any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation."  While this does not prevent a U.S. citizen from obtaining a transplant outside the country, I believe it could make it more difficult to obtain care following a transplant outside the United States.  

In a June 2002 article in the New England Journal of Medicine (co-authored by three MDs and three PhDs), it stated:

The fundamental truths of our society, of life and liberty, are values that should not have a monetary price. These values are degraded when a poor person feels compelled to risk death for the sole purpose of obtaining monetary payment for a body part. Physicians, whose primary responsibility is to provide care, should not support this practice. Furthermore, our society places limits on individual autonomy when it comes to protection from harm. We do not endorse as public policy the sale of the human body through prostitution of any sort, despite the purported benefits of such a sale for both the buyer and the seller.

Here is a link to the article, but you may have to subscribe:

http://content.nejm.org/cgi/content/full/346/25/2002?hits=20&where=fulltext&andorexactfulltext=and&searchterm=organ+donation&sortspec=Score%2Bdesc%2BPUBDATE_SORTDATE%2Bdesc&excludeflag=TWEEK_element&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

In all my searching, and I have done a lot, I have yet to find any articles documenting the statistics specifically for organ donors in the Philippines, indicating the impact (either positive or negative) socially, physically and economically.  Mitch and Stauffenberg, do you have any statistics you can share with us?

Based on everything I have seen, and based a great deal on reading Mitch's posts, I would not consider going to the Philippines for a transplant as a viable option for me.  However, I agree with Stauffenberg that everyone should get to make that decision based on their own needs, and I would not fault anyone who felt it was the right decision for them.  

[mitchorganbroker]

Mallory , how have you been ? Nice to hear from you again. That was some nice articles but to put them into the present context in 2006, the (http://www.doh.gov.ph/press/09031999.pdf)  Health Secretary Alberto Romualdez Jr., did use the word today back in 1999 . The articles from the New England Journal was also out of date (2002) and out of country ( in the US).
    If you had a live unrelated donor transplant would the long term outcome of the donor have any bearing on the long term outcome of Mallory.? The donor's long term well being depends on the country he lives in. It's fair to say that with health care  much better in the US than in the Philippines,  your live donor's outcome would be better if YOU take him back with you to the US.
   While this would be unusual , it could be your chance help improve the donor's outcome.

[Sara]

Is anyone else getting tired of seeing Mitch post things in other areas of the board?  Why is this being encouraged?     He is not our friend, he's trying to make money off of us (you)! 

[sandman]

Dear Members,

I made a deal with him that if I allow him one thread to state his case and have his say, he promised not to spam the site anymore. I set the ground rules to him, that he is ONLY allowed to post in this thread ONLY and he must not engage in a "Flame" war with another member. He must remain calm and act professionally. One of the rules was that he must create a new account with the member "mitchorganbroker" so the members would now that this is indeed the same person who was previously spamming the site.

He was given this chance on D&T (Dialysis & Transplant City) now he will have his chance here. If the members want me to just delete this thread and ban him yet again just let me know, the majority rules.

- Epoman
Owner/Admin

Okay, so if these are in fact the ground rules that have been set to mitch then why is mitch posting in other threads here?  Epoman, was there a change of heart in this which I have quoted above?  Is mitch now allowed to post in other threads, other then this one?

[waitlisted]

Is anyone else getting tired of seeing Mitch post things in other areas of the board?  Why is this being encouraged?     He is not our friend, he's trying to make money off of us (you)! 

Dear Members,

I made a deal with him that if I allow him one thread to state his case and have his say, he promised not to spam the site anymore. I set the ground rules to him, that he is ONLY allowed to post in this thread ONLY and he must not engage in a "Flame" war with another member. He must remain calm and act professionally. One of the rules was that he must create a new account with the member "mitchorganbroker" so the members would now that this is indeed the same person who was previously spamming the site.

He was given this chance on D&T (Dialysis & Transplant City) now he will have his chance here. If the members want me to just delete this thread and ban him yet again just let me know, the majority rules.

- Epoman
Owner/Admin

Okay, so if these are in fact the ground rules that have been set to mitch then why is mitch posting in other threads here?  Epoman, was there a change of heart in this which I have quoted above?  Is mitch now allowed to post in other threads, other then this one?

Without taking any sides here these quotes sound quite intolerant. Where is the freedom of speech? In my opinion it is good to discuss about issues including this from differnet viewpoints, even all sides seem to be sometimes very stubborn with their own opinions...

Like mentioned already earlier by some members, finally it is everybody's own decision how he or she gets his or her transplant if he or she wants one and is capable for getting one.

[sandman]

I could care less where he posts, as long as he stays with-in reason to the forums policy rules, keeps with-in topic and doesn't contine to peddle his services out side of this thread other then a signature link.  You don't have to like someone to have a conversation with them.  If we let him stay, he may actually learn something.    Just my 

I simply wanted to know if he was breaking the ground rules set to him by Epoman or if he is allowed to post outside of this thread now.

[Sara]

If we let him stay, he may actually learn something. 

Maybe a new angle on how to rip people off. 

He was SPAMMING the board, even after Epoman banned him several times.  That in itself is enough for permanent ban, IMO.  Then Epoman was nice enough to give him one thread to state his business or whatever, and he insults and disrespects the forum members (I know there have been some not-so-nice comments toward him but I don't think it matters).  Then he goes and posts about his motorcycle and shares pics of himself with his "friends".  Come on people, he is not going to have a change of heart because of us.  He is out there to make money.  We are potential customers (possible victims is more like it, but that's just my opinion) and all he's seeing is $$$.  He's not our friend, he's probably just doing this because he thinks some people may see his posts and think "maybe he's a nice guy, maybe I'll go give him thousands of dollars now."  He is not using this board or its members to help people!  He probably is learning how to scam us better, and we are playing into it. 

[mitchorganbroker]

Sara, I have stated before that I haven't charged Philippine people for my help, nor will i change that in the future.
I believe you have told us that your Husband is from the Philippines. Is he the patient.? I am not speaking for the Doctor/ Hospital, when I give charity. The Philippine Surgeon gives a discount for his own people, that are 100% Filipino. The Hospital is color blind and charges everybody the same, if the service is the same.
  So in that case your Philippine husband is not my potential customer.

[Sara]

Oh, wow, he gets a discount?  Oh that changes things.  Nevermind, I now think you are a great person, and what you are doing is so worthwhile!

(your computer screen should be dripping with sarcasm by now    )

[vandie]

If we let him stay, he may actually learn something. 

Maybe a new angle on how to rip people off. 

He was SPAMMING the board, even after Epoman banned him several times.  That in itself is enough for permanent ban, IMO.  Then Epoman was nice enough to give him one thread to state his business or whatever, and he insults and disrespects the forum members (I know there have been some not-so-nice comments toward him but I don't think it matters).  Then he goes and posts about his motorcycle and shares pics of himself with his "friends".  Come on people, he is not going to have a change of heart because of us.  He is out there to make money.  We are potential customers (possible victims is more like it, but that's just my opinion) and all he's seeing is $$$.  He's not our friend, he's probably just doing this because he thinks some people may see his posts and think "maybe he's a nice guy, maybe I'll go give him thousands of dollars now."  He is not using this board or its members to help people!  He probably is learning how to scam us better, and we are playing into it. 

The comments made from him matter, but not the ones towards him?    

I found it interesting to see the pics.  That does not mean that I, or anyone else, will be giving him thousands of dollars.  I doubt we have anyone here naive enough to throw him money because he's being nice.  If he's following Epoman's rules, I don't see why he shouldn't be able to post.  If he's not, Epoman will give him the deserved boot.
We all get passionate about certain topics, but sometimes we need to take a breath and realize what may be a good decision for one person may not be a good one for everyone else.  If someone here had exhausted all of their options, and made the informed decision to go to a person like Mitch, I hope they will feel comfortable enough to come to this wonderful group for support.

[Sara]

He started this, vandie.  He was the one spamming the board, spamming people's emails.  If he cared about patients and wanted to learn, he would have come to this board like a normal person, introduced himself, NOT tried to sell people on his service, definitely would not have spammed the board or its members, and would be asking appropriate questions about how to better help his clients.  None of this has happened.  If a person decides to buy a kidney, that's their own personal choice.  I don't happen to agree with it, but then again I am not the one with kidney failure.  I would also hope they came here to find kidney failure-related support.  I just don't think we need to or should put up with Mitch and his crap.

[vandie]

I do agree that he seems to on the "sale." However, I do feel with his intial posts that I have gained a lot of knowledge on this subject from a lot of posts; both prons and cons. 
That's why I love this board.....

[stauffenberg]

Mitch actually is a nice person.  From the two transplant patients of his I have gotten to know and spoken to on the telephone, I learned that a) there were periods when he was holding large amounts of money they had sent him and, even though he could have run off with it and not been caught, he followed through on the deal and kept his promises scrupulously; b) he takes a personal interest in his clients, calls them every day while they are in the hospital, and even helps them out with advice on renal or non-medical problems that arise. The two kidney donors I met personally also had no complaints about the way they had been treated in the process.  If you actually go to the Philippines you will see that paid organ donation in that country is the NORMAL way people get kidney transplants and the whole process is quite friendly, relaxed, and casual -- there are no men in trenchcoats whispering about deals in dark alleys. The only unpleasant part is the actual haggling with the doctors over their price, but as long as you let Mitch take care of that part of the matter for you -- and that is what you hire him to do -- then your experience of the transplant is smooth and simple.

[mallory]

Mallory , how have you been ? Nice to hear from you again. That was some nice articles but to put them into the present context in 2006, the (http://www.doh.gov.ph/press/09031999.pdf)  Health Secretary Alberto Romualdez Jr., did use the word today back in 1999 . The articles from the New England Journal was also out of date (2002) and out of country ( in the US).
   

Yes, Mitch, I am well aware of the dates of the articles I posted.  Where are the articles supporting your statements?  Oh, that's right, you haven't provided any!  You haven't provided any support for your views, you have just continued to belittle and demean everything we say and to tried to intimidate us into listening to you.  Do you have any update to Romualdez's statement to indicate that he has changed his opinion?  You do not.  Do you have any articles from the New England Journal of Medicine stating that selling organs is ethically acceptable?  You do not.  Do you have any statistics on the social, physical and/or economic impacts of kidney donation in the Philippines?  You do not.  You have provided no documented facts at all to support your position.

I'm sick of you, I'm sick of your opinions, and I'm sick of listening to you.  I'm not going to try to discuss things with you reasonably, or provide information, because you are not willing to do the same.  

Put up or shut up, Mitch.  Provide documented facts that support buying a kidney in the Philippines.  That's all I ask, provide the facts.

[stauffenberg]

I don't believe that statistics are even collected regarding the number of people who have had transplants in the Philippines through paid organ donation, nor do I think the data even exist on the outcomes of paid organ donors there.  The Philippines is a Third World country, where people are still struggling to get the potholes in the streets fixed: data collection of the sort you are looking for is not high on the priority list of the local epidemiologists, who have other concerns.

What i can tell you is that all the data from Western countries show that altruistic organ donors suffer no shortening of life expectancy and no greater rates of disease or incapacity than the general population.  Just because selling or giving away an organ is a serious issue ETHICALLY for many people does not mean that nature cooperates and also makes it a serious issue MEDICALLY, since it does not.  In Sweden the practice is to have only ONE SINGLE follow-up medical appointment for an organ donor within two months after donation, since the procedure is so harmless.  Some now recommend a check-up of donors every two or three years by a general practitioner, as I posted earlier.  What this amounts to is that a Philippine donor would not be in a dangerous position because of the need for elaborate, high-tech, and highly-sophisticated, intensive medical check-ups after donation.  Also, since the donor is paid US $7000 and a check-up by a general practitioner in the Philippines costs anywhere from $6 to $10, the paid donor should be quite able to take care of his follow-up care if he wishes.

As for the statement you quoted, it is of no significance, because the police in the Philippines are so corrupt they obey only bribes and not the law, and the judicial system is so inefficient and chaotic that the average fender-bender case takes more than a decade to make its way through the courts.  Every person of any means has a huge fence around his house and his own team of private security guards, as do all the hotels for tourists from First-World countries, since that is that is the only operative law.  When I was in the Philippines looking into the option of Mitch's service a few years ago -- that is, AFTER the passage you quoted -- the first thing every dialysis nurse and nephrologist said on meeting me was, "Oh, you must be here for a transplant," as though it were the most ordinary thing in the world.  There was no whispering, no winking, no nodding, but it was all above-board and no one was concerned about any legal problems.  I understand how you might worry about the whole adventure when looking at it from the outside and trying to imagine what it would be like, but once you actually go there, if you ever do, you would feel foolish for having made such a big deal of it, since foreigners getting transplants there by paid organ donation is regarded as the most natural thing in the world, and everything functions naturally, smoothly, and automatically.  You go in on dialysis and you come out two weeks later with a new kidney and you wonder why it ever seemed so impossible and why you waited so long.