The Power of Soft Law: A Case Study on the Issue of Organ Transplantation and the Declaration of Istanbul

The presenter elaborated on the following points:

1. Why organ transplantation is an important international issue; the effects of commercializing organ exchanges and the connection with transplant tourism.
2. How the discussion of this issue evolved at the WHO -- It began in 1987 with World Health Assembly resolutions condemning commercialization and calling for a study by the Director General. Unlike the case of cloning, there was a strong consensus on this issue. In 1991, the WHO adopted guiding principles, which led to 50 counties legally banning organ sales.
3. The evolution of the science (eg, creating cells and tissues, not organs, for transport) and the market (eg, doctors in SE Asia begin performing transplant operations for foreigners, some because their countries had no laws on the subject). Discussion of how the ethical thinking evolved in response to these developments to allow and promote buying and selling organs so that the supply would meet the increased demand.
4. The movement to convince the Director General to take another look at this issue -- With the help of professional groups, the World Health Assembly adopted the Declaration of Istanbul. In 2010 the WHA adopted a new set of guiding principles that remain soft law.
5. Effectiveness of soft law when followed by WHO guiding principles and resolutions. Example: The Transplantation Society and Declaration of Istanbul Custodian Group have brought forward violations of standards and are rallying people against organ tourism and trafficking to increase government enforcement.