233.3: Organ Trafficking: The Portuguese Experience in Developing A Legal Framework and a Protocol of Conduct for Health Professionals for the Management of Patients Who Receive an Organ Transplant Abroad and Return Home for Follow-up Care and for Reporting Suspected Cases to Law Enforcement Authorities for Criminal Investigation

Abstract

The existence of a world-wide illicit trade in human organs for the purposes of transplantation is a well-established fact, and various means have been adopted to combat this criminal activity, in particular the Council of Europe Convention against Trafficking in Human Organs. This Convention is the first international legal instrument that criminalizes all illicit transplant practices. Healthcare professionals who treat patients in pre transplant and post-transplant play a crucial role in prevention, detection and reporting organ trafficking. However, healthcare professionals face with medical, legal, and ethical challenges when confronted with suspected or confirmed cases of organ trafficking due to their duty to preserve medical confidentiality. We present the recently developed Portuguese Model for the implementation of the Convention against Trafficking in Human Organs. Firstly, we present the changes introduced in Portuguese criminal law for the criminalisation of organ trafficking, including the options made with respect to donors and recipients regarding their criminalisation or not, and the solutions adopted to ensure that acts committed outside the country by nationals or residents can also be punished. Secondly, we present a protocol/code of conduct to provide an appropriate framework to prevent and address transplant-related crimes for healthcare professionals. Such protocol provide guidelines for the management of patients, including on how to ensure traceability and biovigilance for patients who travel for transplantation, and indicators for the identification of signs of organ trafficking and/or human trafficking for the purpose of organ removal. Third, we introduce the Portuguese reporting mechanism for the communication of information about such cases to law enforcement authorities for the purposes of criminal investigation. Finally, we present the amendments made to the Medical Code of Ethics to address doctors’ concerns regarding medical confidentiality. The new regulation provide an exception to the duty of medical secrecy in relation organ trafficking and human trafficking for the purpose of organ removal.