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Promoting Ethics in Medicine

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Letter from the Editor, Ann F. Corson, MD

Each voice makes a difference.

One Israeli doctor, after hearing that his patient’s heart transplant had been scheduled in advance, moved a nation to enact legislation over a decade ago that banned its citizens from going to China for transplants.

One Australian ethicist moved the conscience of academic journal editors to retract Chinese transplant papers that reported data where organs were obtained from executed prisoners.

A small cadre of attorneys, human rights activists, and investigators have traveled the globe, presenting overwhelming evidence of China’s transplant abuse that has been amassed over the last thirteen years.

An international NGO sponsored an independent People’s Tribunal which verified that China is indeed commodifying the bodies of its own citizens into a hugely profitable transplant industry.

Voices of Falun Gong practitioners around the world have moved governments to pass resolutions and some to enact legislation with criminal penalties for organ trafficking.

Still, as international human rights lawyer David Matas said in Hong Kong on July 20, 2019, “it is not enough.”

Without pressure from the rest of the world, why would the Chinese Communist Party (CCP) dismantle a transplant industry that generates an annual profit of over $1 billion dollars?

The most powerful media have, in large part, avoided the issue and remained silent as a result of influence from the CCP.

The newest president of The Transplantation Society has received honors from a country that has flagrantly violated internationally accepted transplant ethics for 30 years.

The UNHRC was recently presented with the China Tribunal’s findings that China is killing religious and ethnic minorities to harvest their organs for sale and that all U.N. member states have a legal and moral obligation to act. Will the U.N. finally act now?

China is now the second-largest contributor to the U.N. budget, accounting for 12 percent of the organization's funding. Pictures of China’s President Xi and Mao Zedong grace the U.N.’s main corridor.

Investigative reporter, Ethan Gutmann accused the World Health Organization and The Transplantation Society of complicity in China’s crimes. Even the British Foreign Office has “made apologies for the Chinese.”

It is time for each one of us to make a choice.

We can choose to do what is ethical by condemning China’s abuses or we can choose to condone the commodification of innocents to enrich their government, thereby becoming accomplices to crimes against humanity.

United Nations Headquarters with waving flags in New York, USA
UNHRC “Legally Obligated” to Stop Organ Harvesting in China

Global religious freedom was at the top of U.S. President Donald Trump’s agenda at the September United Nations General Assembly (UNGA). Trump opened a discussion on religious freedom in his keynote address saying, “Today, with one clear voice, the United States of America calls upon the nations of the world to end religious persecution.”

During three weeks of hearings, the United Nations Human Rights Council (UNHRC) heard advocates present evidence of China’s ongoing religious persecution and human rights abuses, including the live forced organ harvesting from prisoners of conscience, primarily from faith-based groups such as Falun Gong, Uighurs, Tibetans and House Christians.

Doctors Against Forced Organ Harvesting (DAFOH) hosted a panel discussion event during the UNGA to highlight the crimes of human forced organ harvesting and genocide in China. Panelists included the Hon. David Kilgour, former Canadian Secretary of State for Asia-Pacific and Dr. Torsten Trey, DAFOH Executive Director, who reminded the audience that the U.N. Convention on the Prevention and Punishment of the Crime of Genocide is a mandate and U.N. member states must not shirk their responsibility to act.

Trey declared that the killing of imprisoned Falun Gong practitioners for their organs amounts to genocide under international law. “The victims are specifically targeted as an organ source, not just to provide organs,” he said, adding, “There is a specific intent to eradicate this group of people. Definitive actions from the international community are needed.”

Last June, the China Tribunal concluded, “The Tribunal’s members are certain – unanimously, and sure beyond reasonable doubt – that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims.” This independent People’s Tribunal charged that “thousands of innocents have been killed to order having the physical integrity of their beings — their bodies — cut open while still alive for their kidneys, livers, hearts, lungs, cornea and skin to be removed and turned into commodities for sale.”

In a statement to the UNHRC, the China Tribunal’s senior attorney, Hamid Sabi, shared the Tribunal’s findings, declaring that China is killing religious and ethnic minorities to harvest their organs for sale and that all U.N. member states have a legal and moral obligation to act. The findings revealed that China has been extracting organs as a mean of genocide against the Falun Gong spiritual group for at least 20 years, and that the slaughter is ongoing today.

Over the last two weeks, Sabi’s testimony before the UNHRC has been widely reported by mainstream media from Britain (Independent, The Telegraph) the United States (Reuters, The Washington Examiner, National Review, The Epoch Times, Fox News, The New American, Nation of Change, Europe (Health Europa), India (Khabarhub), and Australia (The Sidney Morning Herald), as well as by business (Business Insider, Quartz, Daily Investor Hub, Safehaven) and religious (Catholic News Agency) media.

At a separate U.N. event, Geoffrey Nice, the China Tribunal’s chairman and lead prosecutor in the trial of former Yugoslavian president Slobodan Milosevic, said, “Governments, U.N. bodies and ruling bodies of medical associations dealing with transplant surgery can no longer avoid what it is inconvenient for them to admit. Crimes revealed in the China Tribunal judgment require immediate action. The time of convenient ‘uncertainty’, when all these entities could say the case against (China) was not proved, is past.”

Stethoscope on book
Concerns Over Unethical Transplant Practices Result in Retraction of over 20 Chinese Academic Papers

Last February, ethicist Wendy Rogers of Macquarie University in Sydney, Australia published serious concerns that over 90% of the peer-review published articles from mainland Chinese transplant professionals used data from over 80,000 transplants surgeries where organs were most likely sourced from executed prisoners. In addition, Rogers and her team found that ethical standards had not been met in approving the publication of these studies.

Since then, several medical journals have retracted about 5% of the previously published Chinese transplant research papers. These retraction events have been reported by media around the world, including The Daily Mail, New Scientist, National Review, Evolution News, Multibriefs and Medscape Medical News.

In June, the Clinical Journal of the American Society of Nephrology published their concerns about three kidney transplant studies conducted in China. Kidney International followed suit.

A few months later, the journals Transplantation and PLOS One retracted fifteen papers on organ transplantation by mainland Chinese researchers due to concerns over unethical organ sourcing and procurement practices.

Transplantation, which retracted seven papers, noted the manuscripts were withdrawn after it became “clear, with the benefit of hindsight, and through the Chinese Government’s subsequent clarifications of their practices, that most deceased donors were from executed people, before the Government implementation of Donation after Circulatory Death in 2010 in selected hospitals and widely from 2015. This was not transparent to reviewers and editors at the time of original acceptance for publication of these articles.”

The Plus One editors retracted eight papers, stating, “Details as to the donor sources and methods of obtaining informed consent from donors were not reported in this article, and when following up on these concerns the authors did not clarify these issues or the cause(s) of donor death in response to journal inquiries. International ethical standards call for transparency in organ donor and transplantation programs and clear informed consent procedures including considerations to ensure that donors are not subject to coercion.”

Earlier this month, Medscape Medical News reported that the retracted article count has climbed to over twenty with more journals expected to join the tide of ethical concerns.

In explaining their decisions, the British Medical Journal reported that all the journals retracting papers referenced  Rogers’ article that examined the ethical standards of 445 transplantation articles from China.

“We are pleased to see that at least some editors of the journals that we identified as publishing unethical research have started the process of investigating and retracting papers,” Rogers stated. “We reiterate our call for a systemic response by the academic transplant community – to issue a moratorium on publication of all transplant research from the PRC until guidelines are developed and implemented regarding compliance with international ethical norms.”

Wesley J. Smith from the National Review wrote, “Retracting papers should just be the beginning. Chinese organ-transplant doctors should be barred from international symposia and such events in China should be boycotted, as well as refusing or retracting other honors until the country proves that it no longer countenances kill-and-harvest, whether for sale, research, or otherwise.

Although the editorial boards of several peer-reviewed medical journals are beginning to grasp the truth about China’s transplant industry, Rogers feels "the lack of engagement and leadership from the transplant community is disappointing."

Mehmethaberal

Incoming TTS President Honored in Iran as New Law Allows Sale of Prisoner Organs

A recent publication of The Transplantation Society (TTS) celebrated Iran’s honoring of its incoming president, Dr. Mehmet Haberal (photo courtesy of Wikipedia). “As a token of their appreciation to Prof. Haberal, the Iranian Ministers of Health and Medical Education unveiled Prof. Haberal’s name and portrait at the entrance of a 300-seat auditorium in the new hospital given his name” and “praised him for his continuing support of transplant activities throughout the region.”

Iran has long ignored internationally accepted ethics and violated WHO guiding principles prohibiting monetary payment or reward for donated organs. Since 1988, it has been legal to sell organs in Iran.

Several of the WHO Guiding Principles address ethical issues surrounding compensation for donated organs. For example, the WHO Guiding Principle 5 states, "Cells, tissues and organs should only be donated freely, without any monetary payment or other reward of monetary value. Purchasing, or offering to purchase, cells, tissues or organs for transplantation, or their sale by living persons or by the next of kin for deceased persons, should be banned. "

In his incoming message to TTS, Dr. Haberal said, “Among our primary concerns will be the ethical means of meeting the growing demand for organs through ethical organ donation and procurement, promoting scientific understanding and equality in standards of clinical practice and patient care, transparency in transplantation activities, and of course educational programs to meet the needs of our members.”

The international transplant community has ignored and/or tolerated the Iranian model of compensated kidney donor system for over 30 years.

Additionally, a new Iranian law that entered into force on June 16, 2019 allows the pre-sale of organs from convicts on death row. The law states, "If a convict voluntarily offers his or her organ before or after execution and no medical obstacle is offered, then the judge can approve this in coordination with the ministry of justice and the coroners’ office."

There was strong opposition from Iran’s Association of Surgeons who have condemned the law as “extremely worrying, damaging to our profession and the prestige of Iran in the eyes of the civilised world.”  In contrast, Judge Rasul Kohbayehzadeh welcomed the law and considered it a "great transformation… According to the needs and requirements of society, others will benefit from the death of another human being."

As a result of Iran’s organ procurement policies, thousands of transplant tourists from other Arab countries travel to Iran specifically to obtain organs.  Also, a 2017 Korean TV documentary investigation found that Middle Eastern patients flock to at least one large transplant center in China to buy transplantable organs.

Dr. Haberal declared in his Incoming President’s Message, “we will continue to support the activities of the Declaration of Istanbul, which is celebrating its 10th Anniversary in 2018. The important changes in legislation and practice that have taken effect in various countries – and most notably in China – are a testament to how fundamentally it has addressed the needs and concerns of the international transplant community.” 

Meanwhile, the recent China Tribunal confirmed that unethical organ procurement and transplant practices, specifically the forced live organ harvesting of innocent prisoners of conscience, have been the China mode of transplantation for over twenty years.

Dr. Haberal and all TTS members need to examine the evidence as well as their own consciences and then condemn, rather than condone, those countries that fail to abide by internationally accepted ethical guidelines for human organ transplantation.

United States Capitol Building From the Senate
U.S. Senator Calls on China to End “Brutalization” and Forced Organ Harvesting of Falun Gong

U.S. Senator Patrick Leahy of Vermont issued a formal statement on September 12th calling on the Chinese government to end its persecution of Falun Gong, including the practice of forced organ harvesting, saying, “Falun Gong practitioners recently marked the 20th anniversary of the beginning of China’s campaign of brutality against their community. In the years since that initial crackdown, the Chinese government has relentlessly continued its repression of Falun Gong.”

Leahy further stated that “Falun Gong practitioners have been arrested, interred at reeducation camps, beaten, sleep-deprived, starved, sexually assaulted, electrocuted, force-fed, shackled, and had their limbs slowly broken, until they have renounced their beliefs and practices. They have had their organs harvested against their will. They have been murdered.”

He pointed out that we have no way of knowing how many Falun Gong practitioners have been subjected to the government’s crimes as China “denies to the outside world that it is happening while justifying it to their own citizens.”

“The plight of these people in China, the horrors of torture and murder by the government, can seem very far away from Washington, D.C., and very far away from my state of Vermont. And yet Vermonters travel to Washington to meet with me and my staff, urging Congress to act on behalf of Falun Gong.”

Leahy wrote, “The Chinese government should immediately cease its arbitrary detention and brutalization of Falun Gong practitioners and other religious and ethnic minorities. It should release political prisoners from reeducation centers, decriminalize religious and spiritual practices, and allow international human rights groups and journalists to interview survivors. It should commit to ending the use of torture, organ harvesting of prisoners, and propaganda against minorities.”

Senator Leahy, a former chairman of the Senate Judiciary Committee and President Pro Tempore, is the most senior Democratic Senator in the United States with 44 years in office. He said that the stories told by survivors and victim’s family members of the horrific religious persecution perpetrated by the Chinese regime “continue to shock me.”

He concluded, “The Falun Gong deserve to be remembered, and they deserve the international community’s collective action.”

Patriotic elephant
RNC Passes Resolution Against Organ Harvesting in China

Republican National Committee (RNC) member Shawn Steel (CA) led an effort to formally recognize and condemn the state-sanctioned forced organ harvesting of Falun Gong adherents and other prisoners of conscience in China, which has been taking place for the last 20 years.

On August 2nd, the RNC unanimously passed a resolution condemning the “vile practice.” The resolution came just several weeks after the independent China Tribunal announced its final judgement that forced, on-demand organ extraction for profit was indeed taking place under the direction of the Chinese Communist Party and described the acts as “unmatched wickedness, even compared—on a death-for-death basis—with the killings by mass crimes committed in the last century.”

Steel told the Epoch Times that for years he and other committee members viewed the issue of forced organ harvesting as something just too hard to comprehend or believe.  But after the China Tribunal’s conclusion was released to the world in June, he came to understand that these horrific acts were actually taking place.

The resolution recognizes that China has experienced a large increase in “transplant tourism,” that the number of transplants performed each year far exceeds the number of voluntary donors, and that organs in China are promised within two weeks, something unheard of in countries like the U.S. where people wait years for organs. The resolution concludes that “the Republican National Committee strongly condemns the practice of China’s involuntary organ harvesting.”

Steel said the resolution is just the first step in bringing these horrors to light, and called on all American institutions and foundations to be held accountable for working with Chinese medical entities in the areas of organ transplantation and research.  Steel says that the United States should also pass legislation to prevent its citizens from traveling to China for organs, as several other countries have done.

Palais de l'Europe in Strasbourg
Matas Views Ratification of COE Convention Against Trafficking in Human Organs as Critical Step

Last July, Canadian human rights attorney David Matas, while delivering a moving speech in Hong Kong entitled “The 20th anniversary of the repression of Falun Gong, ” outlined the progress of the 2015 Council of Europe Convention against Trafficking in Human Organs, the world's first treaty of its kind.

Matas described how, “after the mass killing of Falun Gong for their organs, because of the mass killing of Falun Gong for their organs, an international network of laws, ethical standards and remedies have developed to stand against the abuse.”

The COE Convention, approved in March 2015, has now been ratified by fifteen signatory countries. Fourteen European nations are enacting stricter controls concerning procurement of organs for transplant and legislation to criminalize the buying and selling of illegally removed human organs from living or deceased donors.

Matas noted, “Compared to what needs to be done, these changes are small. Yet, they are a harbinger. There is a developing momentum for comprehensive reform in face of the unrelenting and spreading persecution of prisoners of conscience in China through organ transplant abuse.”

He added, “When we remember the tragedy of the repression of Falun Gong we should also remember that long after Communist control of China has ended, has gone, the legacy of organ transplant abuse prevention and remedy will survive. We are here to say also to the perpetrators and all those complicit with them, ‘this must stop’ and ‘we will not forget what you have done.’”

Binnenhof - Dutch Parliament, Holland
Dutch Parliamentarians Speak Out Against Government’s ‘China Strategy

The Dutch government’s new 'China strategy' admits that collaboration and trade between China and the Netherlands is important but that China must play fairly and abide by internationally agreed rules. Foreign Affairs Minister Stef Blok said, “we have been too good-natured and gullible in the past” regarding issues such as "cyber espionage and influencing of our values and norms."

But, members of both coalition and opposition parties in the Netherlands expressed disappointment and surprise that their government's China Strategy does not include a discussion of China’s abominable  human rights abuses, including the live forced organ extraction of innocent prisoners of conscience, and will debate the government’s published strategy in the lower house of the Dutch Parliament.

Parliamentarian Martijn van Helvert said, “we do not accept the human rights situation in China.” Parliamentarian Sjoerd Sjoerdsma said the strategy “only contains analyzes, but is not even the beginning of an answer to the gross violations in China." All agreed that trade interests should not go before human rights.

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An Unprecedented Evil Persecution: A Genocide Against Goodness in Humankind

The Epoch Times is republishing An Unprecedented Evil Persecution: A Genocide Against Goodness in Humankind. The book, edited by DAFOH’s Executive Director Dr. Torsten Trey and Taiwanese Lawyer Theresa Chu, explores the many aspects of unethical organ transplant practices in China through the research of nineteen respected authors from around the world. The publication includes an overview of methodology and cultural context that set the stage for the largest instance of organ transplant abuse.

Chapter 14 of An Unprecedented Evil Persecution written by Huang Shiwei illustrates how transplant abuse spun out of control in the early 2000s after the mass detention of Falun Gong practitioners began.  The chapter exposes the sheer waste involved, with organs being mismatched or thrown away because they were not delivered in a timely manner. In one instance, a patient who had traveled from Taiwan to China for a kidney ended up receiving several kidneys sequentially due to organ rejection.  Each of the kidneys that had to be thrown away represented one executed prisoner.

The full text of An Unprecedented Evil Persecution: A Genocide Against Goodness in Humankind is available on The Epoch Times website.

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News in Review

Economic support of China fuels human rights abuses and organ harvesting

“China keeps 3 million in concentration camps, harvests prisoners’ organs, threatens Hong Kong and Taiwan daily and is arming North Korea. So why are we trading with them?” Outlining China’s human rights abuses including its organ harvesting crimes, this article calls for economic sanctions and tariffs, asserting that economic support of China funds a “dictatorial regime.”


Major international organizations silent and even complicit in China’s organ harvesting crimes

Comments by Ethan Gutmann, co-founder of the International Coalition to End Transplant Abuse, are quoted, “some groups in the West have been complicit with organ harvesting…the World Health Organization, the Transplantation Society, and to some extent, the Foreign Office. The British Foreign Office did nothing in this, and in fact, made apologies for the Chinese.”

  

Study finds that Australians are going overseas for organ transplants

Experts have found that more people than expected are traveling overseas for transplants and warn that transplant tourism could encourage and perpetuate the illegal trade in human body parts. Of the 200 transplant doctors surveyed, more than 50% had at least one patient who had travelled abroad for transplant surgery.


Wait times for kidney transplant as low as two weeks in China

In an interview with DAFOH member, Dr. Huige Li, the authors establish that a typical wait time for a kidney in the US is over 3 years but show that “despite international condemnation, organ harvesting from prisoners of conscience in China has never stopped. One can get a kidney of choice [in China] in just two weeks.”


DNA cataloging of Uyghurs suggests preparation for large scale organ harvesting

Although international pressure may have led the Chinese government to claim it has released large numbers of Uyghur prisoners, human rights groups report there is no evidence to support such statements. Rather, there is concerning evidence that Uyghurs are a target for forced organ harvesting. “Since 2016 DNA sequencing has been conducted for the entire population of Uyghurs, Kazakhs and other Muslims in Xinjiang, a prerequisite for organ matching.”


Woman who survived a Chinese prison camp speaks out on organ harvesting

Explaining that an “international tribunal has found that prisoners…are being used to supply the $1billion organ trade in China,” the author points out that “international reaction has been strangely silent.” She explores possible reasons for such silence in an interview with a former prisoner who escaped organ harvesting and calls on British citizens to demand their MPs take action.


Husband fears missing wife last seen in police custody was killed for organs

In an article about a missing woman, whose family believes was killed for her organs in Chinese prison, The Epoch Times explains that “according to the China Organ Harvest Research Center, China began conducting research and clinical experiments in human organ transplantation in the 1960s, but it wasn’t until 2000 that the industry entered a period of exponential growth—which coincided with the start of the CCP’s campaign against Falun Gong.”


Op-ed by David Kilgour: Canada/China Relations Today

Attorney David Kilgour, a member of Canada’s House of Commons for nearly three decades, wrote, Over two decades, the [Chinese] regime has been directing a vast network organ-harvesting from prisoners of conscience—primarily Falun Gong since 2001, but also Tibetans, Christians and Muslim Uyghurs.” He added, “Canada has already listed a number of officials alleged to be involved in gross human rights violations or corruption from Russia, Venezuela, and other nations, but no-one from China. If Canadians and others showed more commitment to our values, the inhuman commerce of forced organ harvesting might be stopped sooner rather than later.”

 

Call for Australia to deny visas to human rights violators

On September 30th, over 100 people gathered in Sydney, Australia to call on the government to deny visas to human rights violators who are responsible for religious and political persecution in China. A few weeks before the rally, a list of known perpetrators, compiled by the World Organization to Investigate the Persecution of Falun Gong (WOIPFG) and the Falun Dafa Information Center (FDI), was submitted to the Australian government. The U.S. Statement Department and officials in other countries have already received the list.


Idaho legislator op-ed exposing China’s organ harvesting of religious prisoners

Idaho State Rep. Julianne Young writes “international investigations have uncovered undeniable evidence that tens of thousands of Falun Gong practitioners have become a lucrative source of transplant organs and plastinated cadavers, with hospitals boasting transfer times on organ transplants which indicate that organs, including hearts, lungs, and livers, were lifted from one living individual and transplanted to another for tens of thousands of dollars per transplant.”


The Epoch Times interviews Canadian MP on organ trafficking bill

After a roundtable discussion on Canada’s diplomatic and trade relationship with China, MP Garnett Genuis was interviewed by The Epoch Times on organ trafficking legislation he sponsored which stalled in the last legislative session. Genuis said he was disappointed but would keep working to pass the bill because “there’s a real urgency to address this issue.”


Heart patient is given exact date when a transplant heart will be available

Former president of the Israeli Society of Transplantation, Dr. Jacob Lavee, tells the story of his patient who was given two weeks’ notice that a matching heart would be available in China. “If a patient was promised to undergo a heart transplant on a specific date, this could only mean that the—those who promised that they knew ahead of time when his potential donor would be dead.”


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Doctors Against Forced Organ Harvesting (DAFOH) aims to provide the medical community and society with objective findings of unethical and illegal organ harvesting. Organ harvesting, the removal of organs from a donor, without free and voluntary consent, is considered a crime against humanity, as well as a threat to the integrity of medical science in general. This edition of our newsletter offers up-to-date information on international efforts to stop unethical organ harvesting.

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