On August 20th 1947, the Doctors’ Trial, officially termed the United States versus Karl Brandt et al.
, passed judgment on 23 Nazi defendants (of whom 20 were doctors) at Nuremberg who were indicted on charges which included war crimes, crimes against humanity and/or membership of a criminal organization (1). Sitting before a US military tribunal, the trials collectively were known as the Subsequent Nuremberg Trials
and were heard at the Nuremberg Palace of Justice. While the Nuremberg Trials examined war crimes, they also defined crimes against humanity not limited to wartime including; murder, extermination, enslavement, deportation, imprisonment, torture, rape and other inhumane acts committed against any civilians or persecutions on political, racial or religious grounds (whether or not in violation of the domestic laws of the country where perpetrated).
The Doctors’ Trials demonstrated the medical profession was not immune from perversion of their knowledge and skills for political or ideological ends. The upcoming 70th anniversary of the Nuremberg judgment should remind medical professionals of their Hippocratic Oath to do no harm or use their medical knowledge for harmful practices including medical experiments. So seventy years on we ask the difficult question: did the Nuremberg Trials fail?
There is indisputable and mounting evidence of active involvement from Chinese doctors in the harvesting of organs from convicted death row prisoners and prisoners of conscience such as Falun Gong practitioners (2-4). This heinous practice of killing the most vulnerable for their profitable body parts has persisted for decades and, despite Chinese claims of reform and modernization (5), lacks evidence of cessation (6, 7). Seventy years on from Nuremberg, doctors are complicit again in a systematic crime against humanity.
The assertion that domestic laws cannot give absolution when it comes to crimes against humanity cannot be taken for granted. For example, it is not a view shared by Chinese transplant experts who maintain; ” …cooperation within international academic circles can only carry on through scrupulously abiding by mutual respect for each other’s sovereignty and non-interference with each other’s internal affairs (8).” This errantly implies respect for sovereignty trumps international ethical standards but this assertion is false. The Nuremberg trials established the precedent that crimes against humanity do not require prior domestic law; some acts can be regarded as criminal per se. Killing prisoners to harvest their organs is such an act.
The Nuremberg Trials against Nazi physicians made it clear: regardless of a legally binding framework or not, there is an irrevocable line in ethics and human rights, with accountability for medical professionals who cross it. Individual doctors cannot hide behind national regulations for acts defined internationally as crimes against humanity. Disturbingly, the doctors who supported the Chinese organ donation/transplantation system during these decades of criminal activity, and even participated in unethical transplants personally, are now among those leading the new alleged, but unverifiable, ethical system. It appears we are at a similar stage to 1943 when the Polish World War II resistance fighter Jan Karski found himself testifying before Supreme Court Justice Felix Frankfurter in 1943: there was a disbelief of crimes simply because they were beyond what one could imagine (9).
The Doctor’s Trials against the Nazi physicians considered the testimonies of only 85 witnesses. Yet no international body has heard the testimonies of thousands of Falun Gong practitioners and other prisoners of conscience who have been detained in China and have experienced medical abuses, many who reported their experiences in writing or verbally after escaping China. Ignorance or denial cannot excuse crimes against humanity. China’s recent announcements of an end to organ harvesting from executed prisoners and the foundation of a dubious ‘voluntary’ donor system miss the point. Firstly, there is ample evidence that this heinous practice continues despite repeated claims to the contrary. Secondly, the focus of concern should be on the victims and their allegations (which are supported by a decade of independent investigation). In promising reform, China has neither addressed these concerns by offering redress or reconciliation to the families of those killed, nor allowed independent investigation in the absence of full disclosure.
Seventy years after the Nuremberg Trials against Nazi doctors, it is time to hear testimonies of those recently persecuted, physically tortured, medically examined and threatened with organ harvesting in detention camps by Chinese doctors. They are the final echoes of those killed for organs taken by doctors whose oath should be to protect, not take, life. The commemoration of this 70th anniversary of the Doctors Trials provides lessons yet to be fully learned. It has never been more crucial for the medical profession to confront crimes against humanity. In this, as in all violations of human rights, silence is complicity. The judgment passed seventy years ago on doctors engaged in crimes against humanity is as relevant now to China as it was in 1947 for Germany.
1. Trials of War Criminals before the Nuremberg Military Tribunal under Control Council Law No. 10. Vol. I-II. October 1946-April 1949. Washington: USGPO. Vols. I-II.
2. Sharif A, Fiatarone Singh M, Trey T, Lavee J. Organ procurement from executed prisoners in China. Am J Transplant 2014; 14: 2246-52
3. Trey T, Sharif A, Schwarz A, Singh MF, Lavee J. Transplant Medicine in China: Need for Transparency and International Scrutiny Remain. Am J Transplant 2016; 16: 3115-3120
4. Rogers WA, Robertson MP, Lavee J. Engaging with China on organ transplantation. BMJ 2017; 356: j665
5. Huang JF, Zheng SS, Liu YF, et al. China organ donation and transplantation update: the Hangzhou Resolution. Hepatobiliary Pancreat Dis Int 2014; 13: 122-4
6. Trey T, Sharif A, Singh Fiatarone M, Khalpey Z, Lavee J. Organ transplantation in China: concern remains. Lancet 2015; 385: 854
7. Lavee J, Jha V. Organ transplantation in China: concerns remain. Lancet 2015; 385: 855
8. The transplant experts of the National Organ Donation and Transplantation Committee, Huang JF, Wang HB, et al. Advances in China’s Organ Transplantation Achieved with the Guidance of Law. Chinese Medical Journal 2015; 128: 143-146