In America, in direct response to indefinite delays on the national transplantation waitlists and an inadequate supply of organs, a growing number of terminally ill Americans are turning to international underground markets and coordinators or brokers for organs. Chinese inmates on death-row and the economically disadvantaged in India and Brazil are the often compromised co-participants in the private negotiation process, which occurs outside the legal process - or in the shadows of law. These individuals supply kidneys and other organs for Americans and other Westerners willing to shop and pay in the private process. This 2006 book contends that exclusive reliance on the present altruistic tissue and organ procurement processes in the United States is not only rife with problems, but also improvident. The author explores how the altruistic approach leads to a 'black market' of organs being harvested from Third World individuals as well as compelled donations from children and incompetent persons.