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Background.Transplant tourism is a phenomenon where patients travel abroad to purchase organs for transplants. This paper presents the results of a fieldwork study by describing the experiences of Dutch transplant professionals confronted by patients who allegedly purchased kidney transplants abroad. Second, it addresses the legal definition and prohibition of transplant tourism under national and international law. The final part addresses the legal implications of transplant tourism for patients and physicians.Methods.The study involved seventeen interviews among transplant physicians, transplant coordinators and policy-experts and a review of national and international legislation that prohibit transplant tourism.Results.All Dutch transplant centers are confronted with patients who undergo transplants abroad. The estimated total number is four per year. Transplant tourism is not explicitly defined under national and international law. While the purchase of organs is almost universally prohibited, transplant tourism is hardly punishable because national laws generally do not apply to crimes committed abroad. Moreover, the purchase of organs (abroad) is almost impossible to prove.Conclusions.Transplant tourism is a legally complex phenomenon that warrants closer research and dialogue. The legal rights and obligations of patients and physicians confronted with transplant tourism should be clarified.

This article provides an introduction to the articles submitted to the special issue of Trends in Organised Crime on ‘Organised Crime in Latin America’. The aim of the special issue is to draw together novel empirical research findings and theoretical accounts on various aspects of organised crime in the particular geographic context.

This research explores the understudied phenomenon of performance and image enhancing drug (PIED) markets by examining the structure and formation of the market for PIEDs in the Netherlands and Belgium. Furthermore, this study aims to understand and analyse the actors that operate in the PIED dealing environment. In particular bodybuilding is adopted as a case study. Finally, this thesis examines how the PIED control system and its application influence these respective markets. Chapter one introduces the global PIED problem, the policy options currently available to deal with it, and its connection to anti-doping and sport. Chapter two begins by reviewing the literature on PIED use and its supply, and reflects on the anti-doping and PIED policies that seek to regulate this market. In chapter three the theoretical contours of this dissertation are developed. Chapter four describes the research methods which form the empirical bases of the findings chapters. Chapter five focuses on the general characteristics of PIED suppliers, and the ways in which the actions of PIED dealers are influenced by the market cultures in which they operate. Chapter six examines the importance of socio-cultural factors in the formation and development of PIED dealing networks within bodybuilding subcultures. Chapter seven analyses and describes the characteristics of the Belgian and Dutch PIED markets, and unravels the complex relationship between the two. Chapter eight explores the illegal production of steroids in the Netherlands and the flourishing Internet trade in Belgium. Chapter nine assesses the harms related to the production and distribution of PIEDs, and accounts for the effects that Belgian and Dutch PIED policies may have on this illicit market. Finally, in chapter ten, the main findings of this dissertation are summarized, future research endeavours are considered and policy implications are drawn from the analysis. This thesis illustrates that social systems of rules and values, and in particular the embeddedness of culture, are important factors in our efforts to comprehend illicit PIED markets. Specifically, ‘the beliefs, norms, ‘tools’, rules and behaviours appropriate to a cultural setting are key factors for understanding the structure of PIED markets and greater attention must be given to the role played by socio-cultural factors in influencing the market behaviour of criminal groups and individuals. Nevertheless, this thesis also demonstrates that it is imperative to examine the production, distribution and use of PIEDs, as embedded within a diverse combination of social, economic and cultural processes. Indeed, the structure and formation of illicit PIED markets are shaped by a variety of factors including the types of PIEDs dealt within them, the characteristics of the users, the social structures which sustain them, the cultural and economic context in which the markets exist, and market forces (e.g. technical innovations, drug policies).

This research explores the understudied phenomenon of performance and image enhancing drug (PIED) markets by examining the structure and formation of the market for PIEDs in the Netherlands and Belgium. Furthermore, this study aims to understand and analyse the actors that operate in the PIED dealing environment. In particular bodybuilding is adopted as a case study. Finally, this thesis examines how the PIED control system and its application influence these respective markets. \ud \ud Chapter one introduces the global PIED problem, the policy options currently available to deal with it, and its connection to anti-doping and sport. Chapter two begins by reviewing the literature on PIED use and its supply, and reflects on the anti-doping and PIED policies that seek to regulate this market. In chapter three the theoretical contours of this dissertation are developed. Chapter four describes the research methods which form the empirical bases of the findings chapters. Chapter five focuses on the general characteristics of PIED suppliers, and the ways in which the actions of PIED dealers are influenced by the market cultures in which they operate. Chapter six examines the importance of socio-cultural factors in the formation and development of PIED dealing networks within bodybuilding subcultures. Chapter seven analyses and describes the characteristics of the Belgian and Dutch PIED markets, and unravels the complex relationship between the two. Chapter eight explores the illegal production of steroids in the Netherlands and the flourishing Internet trade in Belgium. Chapter nine assesses the harms related to the production and distribution of PIEDs, and accounts for the effects that Belgian and Dutch PIED policies may have on this illicit market. Finally, in chapter ten, the main findings of this dissertation are summarized, future research endeavours are considered and policy implications are drawn from the analysis. \ud \ud This thesis illustrates that social systems of rules and values, and in particular the embeddedness of culture, are important factors in our efforts to comprehend illicit PIED markets. Specifically, ‘the beliefs, norms, ‘tools’, rules and behaviours appropriate to a cultural setting are key factors for understanding the structure of PIED markets and greater attention must be given to the role played by socio-cultural factors in influencing the market behaviour of criminal groups and individuals. Nevertheless, this thesis also demonstrates that it is imperative to examine the production, distribution and use of PIEDs, as embedded within a diverse combination of social, economic and cultural processes. Indeed, the structure and formation of illicit PIED markets are shaped by a variety of factors including the types of PIEDs dealt within them, the characteristics of the users, the social structures which sustain them, the cultural and economic context in which the markets exist, and market forces (e.g. technical innovations, drug policies).