The Question No One Asked: Organ Removal in Labor Migration and a Bioethics of Conversion

Allegations that organs are removed from migrant workers inside otherwise lawful labor-migration channels have been reported from more than one African state, in differing forms, and none has been resolved on the public record. This article asks why, taking as its point of departure the contested Ugandan case of a domestic worker who returned from Saudi Arabia in 2021 without her right kidney. The obstacle is not permissive law: the Palermo Protocol has counted organ removal as exploitation since 2000, the 2018 Declaration of Istanbul reaches removal without valid consent, and Uganda’s Prevention of Trafficking in Persons Act makes organ removal an aggravating circumstance. On the documentary record reviewed, the instruments through which such wrongdoing is detected are built around the clinical transplant relationship, which the configuration proposed here would not enter. That configuration, decoupled exploitation, is an analytic proposal and not an established empirical category: the migrant is separated from every transaction conducted over her own body. Analyzing United States trafficking assessments for 2019 through 2023, and separately the developments of 2024 and 2025, it argues that four kinds of obstacles to enforcement are present on the Ugandan record, and that Bernard Lonergan’s account of conversion yields two predictions about them that determinate observations would falsify.