“This is no time … to take the tranquilizing drug of gradualism.”
Rev. Martin L. King Jr.
(“I Have a Dream” Speech, 1963)
September 16, 2013
Recently, China has announced its intention of phasing out the harvesting of organs from executed prisoners by 2015 and the introduction of the China Organ Transplant Response System (COTRS), a computerized organ-allocation system.
Unfortunately, COTRS lacks transparency: the matching process and information about the organ donors are not open to the public or to an independent third party. With regard to the announced 2015 time frame, Chinese officials speak vaguely of ending the reliance on executed prisoners, not of the complete cessation.
Doctors Against Forced Organ Harvesting (DAFOH) holds that the announcement and the introduced systems are misleading and insufficient.
DAFOH states:
1. The international community considers the harvesting of organs from executed prisoners and from prisoners of conscience unethical. If killing for organs—under the guise of executing prisoners—is unethical, it remains so every day it continues. Seeking an end of this unethical practice conforms to ethical standards defined by medical organizations, such as WMA, TTS, WHO, and others.
Once it is recognized as unethical and as a crime against humanity, the harvesting of organs from prisoners needs to end immediately. It is ethically indefensible to gradually end a crime against humanity. The Chinese government announcement of “phasing out” this crime against humanity is a deceptive statement in itself. When people’s lives are at stake, then “This is no time … to take the tranquilizing drug of gradualism.”
2. In 1984, the Chinese regime issued a law to legalize organ extraction from executed prisoners. Chinese officials still called it a lie when Dr. Wang Guoqi testified about this practice before Congress in 2001. China denied the practice until 2005, when international pressure forced Chinese officials to admit the practice. Then they stated that up to 90 percent of organs originated from this source, which contributed to more than 10,000 transplants per year. Since the Chinese regime has a history of lacking in candor, it is mandatory to implement steps for scrutiny and monitoring.
In 2007, one year before the 2008 Olympic Games in Beijing, the Chinese Medical Association (CMA) pledged to the World Medical Association (WMA) to end the harvesting of organs from executed prisoners, except for relatives. Despite the pledge, China continued to perform more than 10,000 transplantations every year without an effective public organ-donation system.
Now, six years after CMA’s pledge, China does not even speak of ENDING the practice as it did in 2007, but only announces—with an indefinite time frame—to PHASE OUT the practice. We hold that the recent 2013 announcement from China is actually a step back from the pledge in 2007. Based on the above, it is incomprehensible why the international community applauds the recent announcements.
3. The official Chinese terminology is vague and ambiguous as it only announces the beginning of the phaseout without establishing a deadline when the harvesting of organs from executed prisoners will eventually come to a complete end. According to statements from Chinese officials, the time frame could be 2015, but also “indefinite.” When asked when the practice of harvesting organs from executed prisoners will end, Chinese officials describe the time frame as “indefinite.” In other announcements, Chinese officials speak of “phasing out the dependency on organs from executed prisoners,” which does not address the end of this unethical practice but only a shift in the percentage, keeping the option open to continue the practice if needed.
The official statements from China are insufficient and vague. Without international scrutiny and monitoring, the phaseout can last “indefinitely” and euphoric commendation is premature and misplaced. Instead of applauding China for its phase-out announcement, one should rather consider the innocent victims who will lose their lives every day this abusive practice continues.
4. The recent announcements state that China will introduce a computerized organ-allocation system. Yet, the computerized organ-allocation system does not guarantee that the organs entered into the computer system are ethically procured. Instead, without openness to verification, the computerized organ allocation system poses the risk of enabling a more efficient allocation of unethically procured organs. It has to be ensured beyond any doubt that the new computerized organ allocation is not a sophisticated form of “organ laundering,” using prisoners’ organs and erasing all traces of their unethical procurement.
Resolving the unethical organ harvesting from prisoners in China does not require a computerized organ-allocation system. Instead, what is required is an immediate cessation of the unethical organ harvesting and a system that provides traceable documentation of subsequent procurements.
As long as China does not officially acknowledge organ harvesting from prisoners as unethical, it remains uncertain whether this organ source will ever be abolished even after establishing a computerized organ-allocation system and a voluntary organ-donation program.
The mixing of the two pools of organs, one from executions and another from organ donations, through the announced computerized organ-allocation system will only serve to whitewash the unethical practices. It gives them a coat of legitimacy and acceptance. It is simply a way to pretend the initial crime did not occur. The mere establishing of a computerized organ-allocation system without immediate cessation of the organ harvesting from prisoners is ethically meaningless.
5. In a May 20, 2013 ABC TV interview with Huang Jiefu, former vice minister of health in China, when asked about the harvesting of organs from prisoners, he replied, “Why do you object?” This suggests that Chinese officials still do not acknowledge that organ harvesting from executed prisoners is unethical. Ethical organ donation requires free, voluntary, and informed consent, yet China evades this requirement by trivializing it as “written” consent from prisoners.
The announcements from China speak of a phaseout of organ harvesting from executed prisoners, but it is not mentioned whether military hospitals, known to be heavily involved in the unethical organ-harvesting practices, will be included. The announced developments also do not address the from China never-acknowledged organ harvesting from prisoners of conscience, in particular from detained Falun Gong practitioners as the largest target group.
In 2012, David Matas said at the annual conference of the International Association of Genocide Scholars in San Francisco:
“On Nov. 30, 1999, the ‘610 Office’ [in China] called more than 3,000 officials to the Great Hall of the People in the capital to discuss the campaign against Falun Gong, which was then not going well. Demonstrations were continuing to occur at Tiananmen Square. The head of the ‘610 Office,’ Li Lanqing, announced the government’s new policy on the movement: ‘Defame their reputations, bankrupt them financially, and destroy them physically.’
A call to destroy Falun Gong physically is a call to genocide. It is not admittedly a call to genocide through sourcing their organs. Nonetheless, when that sourcing occurs, in the context of a call for physical destruction, the two should be linked. Organ sourcing is the means. Physical destruction is the intent.”
There is virtually no dividing line between destroying physically and harvesting organs from Falun Gong practitioners—the latter is even profitable. Thus, without publicly admitting the use of prisoners of conscience as an organ source, there is no guarantee that this path of organ sourcing will end. A gradual phaseout of this abusive practice with an indefinite end is ethically indefensible. It might be desirable from the side of the perpetrator but it is gruesome and unacceptable from the side of the victim. It is a tragedy for both the victims and the medical profession. The following quote by Rev. Martin L. King Jr. appears as timely as it was in the 1960s:
“ … the fierce urgency of now. This is no time to engage in the luxury of cooling off, or to take the tranquilizing drug of gradualism … Now is the time to make justice a reality for all of God’s children.”
6. The announced phaseout of the organ harvesting from executed prisoners was accompanied by an official announcement of a public organ-donation system. Yet, there is a traditional reluctance in the Chinese populace to donate organs, which is also acknowledged by Chinese officials. Furthermore, there is no brain-death legislation in place, which would regulate the organ procurement from the brain-dead. Thus the public organ donation system would be based on cardiac-death donations, which would reduce the effectiveness of some of the donated organs.
In September 2013, the Chinese Guang Ming Daily published an article stating that from 100 potential organ donors in China, only 5 percent of the donors’ organs can eventually be used for transplantation. Overall, the conditions in China are likely to result in a continuation of the use of organs from prisoners beyond the pledged time frame of two years.
It has to be assured beyond any doubt that prisoners of conscience, primarily detained Falun Gong practitioners, are not forcibly enrolled into such public organ-donation program under a fake identity. It has been observed that fake identity documents with a Chinese nationality were issued to foreign transplant tourists in order to bypass the transplant-tourism-prohibition law. Transparency and monitoring is required to prevent an entering of fake identities into the computerized organ-allocation system.
7. In October 2011, The Lancet published the letter “Time for a boycott of Chinese science and medicine pertaining to organ transplantation.” The letter called for a “boycott on accepting papers at meetings, publishing papers in journals, and cooperating on research related to transplantation unless it can be verified that the organ source is not an executed prisoner.”
While we appreciate the strict call for ethical standards in publications from China, we are missing the same strict call when it comes to defending our own ethical standards. As much as the co-authors were courageous to publish the aforementioned letter in The Lancet due to ethical concerns, we should be even more motivated to call openly for an immediate end of the unethical organ harvesting itself.
Refusing to publish papers, which include data from executed prisoners, is a necessary but insufficient response to the abuses in China. We have an absolute imperative to also object vociferously to the harvesting itself. Living in a society that allows freedom of expression, we are not prohibited from openly calling for an immediate end of the unethical organ harvesting in China. In fact, as medical doctors and medical organizations, it is our ethical responsibility and obligation to call for an immediate end of this unethical practice.
In 2006, China Daily reported the number of transplants in China as high as 20,000, with 90 percent of the organs coming from executed prisoners. Attention and pressure by the international community in the past few years have contributed to the recent developments and indicate that we need to continue our efforts to call for an immediate end of the organ-harvesting abuse.
Once the practice is recognized as unethical, there is no excuse to continue it. The unethical organ harvesting from prisoners could be resolved at once if the international community combines its efforts and opposes the practice with one voice. There is no law that prohibits us from calling upon China to refrain from unethical organ harvesting immediately—it only requires the willingness to do so.
Otherwise, we might need to ask ourselves if China were successful in using a computerized organ-allocation system and the announcement of a phaseout like a Trojan horse to undermine and dilute our ethical standards.
We call upon the international community to join us in calling upon China to immediately and unconditionally end the unethical harvesting of organs from executed prisoners and all prisoners of conscience.