While the trade in human organs remains largely in the darkness as it is hardly reported, detected or scientifically researched, a range of key institutional stakeholders, professionals, policymakers and scholars involved in this field show remarkable high levels of moral condemnation and share a rather unanimous prohibitionist line. Some have equated this phenomenon to genocide or talk about 'neo-cannibalism', others present it as dominated by mafias and rogue traders. However, organ trafficking takes very different shapes, each one with their own ethical dilemmas. Simplistic formulaic responses purely based in more criminalization should be critically evaluated. Based on a qualitative study conducted on the demand for kidneys (transplant tourism) in and from the Netherlands, the authors present in this article some of the main empirical results and discuss their implications. But before doing that, this contribution briefly describes the global patterns of contemporary organ trade and the way the problem has been framed and constructed by international policy bodies, professional (transplant) organizations and some scholars. Abstract published by arrangement with Taylor and Francis.