9 May, 16 | by BMJ
Guest Post by Wendy Rogers
Earlier this year, a Malaysian politician, Datuk Bung Moktar Radin, travelled to China to receive a kidney transplant. The details are scanty. There is no mention of the source of the kidney that the Malaysian MP received. Reports of foreigners travelling to China for transplants rarely make the media, yet they may be an important link in trying to untangle the secrets of China’s secretive transplant system.
Back in the early to mid-2000s, Chinese hospitals brazenly advertised on the internet for foreign customers, offering kidney, liver and heart transplants with astonishingly short waiting times of 2-4 weeks. In contrast, patients in countries like Australia, the UK, and the US typically wait years, with many dying before an organ becomes available. Despite initial denials, Chinese officials eventually admitted that virtually all their organs were sourced from executed prisoners. Using executed prisoners as organ donors is uniformly considered unethical because of concerns that prisoners may be manipulated or coerced rather than being genuine volunteers. Voluntary donation is at the heart of most transplant programs world-wide, although there are exceptions.
Violating this ethical principle by selling organs from executed prisoners to foreign (and Chinese) patients might seem enough to make China a pariah in the international transplant community. But this is only one part of China’s terrible transplant secret. Reputable international investigators have gathered evidence that Chinese prisoners of conscience, mainly Falun Gong practitioners, Uyghurs, house Christians and Tibetans, are murdered for their organs. Falun Gong practitioners, who make up the bulk of the millions of Chinese citizens in “re-education through labour (laojiao)” camps, are subject to medical tests to examine the health of their transplantable organs. This process creates a living organ bank where foreign patients and wealthy Chinese citizens can be matched to potential donors, who are then killed on demand so that their organs can be transplanted. This reverse matching process guarantees a suitable organ within a very short waiting period.
Many people struggle to believe this claim, that Chinese prisoners of conscience are systematically murdered for their organs, as a matter of state policy. Such actions breach China’s international legal obligations under treaties they have signed and ratified, and may well amount to crimes against humanity. Yet the evidence is impossible to dismiss. The award-winning documentary Hard to Believe presents a compelling case, as do the carefully researched books of Matas and Kilgour, Trey, and Gutmann. Of course, it is difficult to investigate a secret like this. China is unlikely to open its prison camps and hospitals to rigorous international inspection, despite the absolute requirement of transparency in transplantation (WHO Principle 11). But if China had nothing to hide, an ethical and legal source of organs would be easy to prove. Most countries have transparent systems of organ procurement, starting with voluntary donors whose organs are then matched to those on transplant waiting lists. The numbers of donors and transplants, as well as the circumstances of donors’ deaths, are made public and can be independently audited. In China, information about donors and transplants is vague and unreliable, with constantly changing, conflicting and incompatible numbers published in media pronouncements that appear closer to propaganda than verifiable fact.
Despite efforts, including a petition to the United Nations initiated by Doctors Against Forced Organ Harvesting (DAFOH), some members of the international community seem reluctant to engage with the mounting evidence compiled by human rights lawyers, doctors and investigative journalists, and even less inclined to challenge China on this matter. In a surprising move, the 2016 conference of The Transplant Society (the premier international body of transplant surgeons) will be held in Hong Kong. Holding this high profile conference in Hong Kong sends a strong message that China’s transplant programme now meets acceptable standards. Actions like this, as well as academic acclaim and honorary professorships in Australia, the USA, the UK and elsewhere for Chinese surgeons such as Huang Jeifu, serve to welcome China into the international transplant community. Indeed, many seem to believe that the claimed reforms of 2015 have ended unethical practice. While there is now the semblance of a voluntary donation system, this has not put an end to the continuing use of prisoners’ organs. Rather than rolling out the red carpet, we should be demanding an answer to the simple question: Exactly where do China’s transplanted organs come from? Until we know the answer to that question, we must be wary of the smoke and mirrors obscuring the truth about organ procurement in China.
Read the full paper here.