“Execution by organ procurement: Breaching the dead donor rule in China” AJT article by Matthew P. Robertson and Dr. Jacob Lavee

Another seminal piece of research and analysis was published in the American Transplant Journal (AJT) on April 4, 2002 by Matthew Robertson and Dr. Jacob Lavee who have both, over many years, contributed vital information, research, and evidence on the Chinese Communist Party’s unethical and illegal forced organ harvesting of ‘undesirables’ on an industrial scale nationwide.

The authors state that the two most cherished tenets in transplant medicine are the dead donor rule which “is fundamental to transplant ethics” and the injunction that doctors do not kill or use their skills to destroy life.

Robertson, a PhD Doctoral researcher at Australian National University and Data scientist for the Victims of Communism Memorial Foundation, and Prof. Jacob Lavee of the Heart Transplantation Unit, and Deputy Director of the Department of Cardiac Surgery, at the Sheba Medical Center, Tel Hashomer, Israel, conducted a computational text analysis using highly targeted keyword searches to find text consistent with what they termed “problematic Brain Death Declaration (BDD)” in thousands of Chinese language medical journals published between 1980 and 2020. They found 71 papers from hospitals all across China that met their strict requirements for problematic BDD.

The authors developed two criteria for determining which text was consistent with problematic BDD and therefore inconsistent with the international transplant community’s latest consensus statement for assessing brain death before the extraction of donors’ vital organs. The criteria were fulfilled when the text described clinical procedures where either patients were not on mechanical ventilation and only intubated after being declared brain dead, or where intubation took place right before the surgical procedure to explant organs.

Their analysis strongly implies that transplant surgeons in mainland China are participating in a nationwide murder for money practice. Prisoners, especially prisoners of conscience, constitute a captive living organ pool supplying organs not only to Chinese patients but also to those who flock to China from other nations to pay for readily available organs that can be ordered fresh on-demand.

On April 7, 2022 two human rights NGOs, the Victims of Communism Memorial Foundation (VOC) and the International Coalition to End Transplant Abuse in China (ETAC) hosted a webinar entitled Execution by Organ Harvesting: A discussion on China’s crimes against humanity” where Robertson and Lavee define, in precise and clear detail, their definitions, research methods, and evidences used in the paper.

After publication, the Robertson and Lavee analysis was widely covered by media in the United States, United Kingdom, Australia, Israel, India, Asia, and online.

United States

USA Today provided a concise summary of China’s organ harvesting of prisoners, and referenced Robertson and Lavee’s paper, “New evidence suggests that execution by organ donation is a continuing part of the systematic campaign against Uyghurs, Falun Gong, Tibetans, Christians and other people Beijing classifies as politically problematic.”

WebMD quoted Robertson, “What we found were improper, illegitimate, non-existent or false declarations of brain death,” and Lavee, “We have shown for the first time that the transplant surgeons are the executioners — that the mode of execution is organ procurement. These are self-admissions of executing the patient.” Robertson concluded, “In the past, I don’t think the question of China’s medical professional involvement in the execution of donors has been taken as seriously as it should have. I certainly hope that with the publication of this paper in the leading journal in the field, this will change.”

Breitbart wrote, “The researchers concluded that China had likely breached a medical ethics standard known as the ‘dead donor rule,’ which asserts that doctors should not kill people to transplant their organs into another person. The report follows years of mounting evidence – organized similarly by medical researchers, human rights activists, journalists, and attorneys – suggesting that China has systematically killed political dissidents and members of religious and spiritual communities it disapproves of to sell their organs to wealthy buyers.” Falun Gong practitioners, Uyghurs, dissident Christians, and Tibetan Buddhists are all “at particularly high risk for illicit government organ harvesting.”

The Wall Street Journal reported that evidence from the AJT article proved China is not abiding by the dead donor rule. The analysis of text in 71 Chinese medical articles described organ procurement in ways that would be impossible unless the donor was still alive. “For the declaration of brain death to be legitimate, the organ donor must have lost the ability to breathe spontaneously and have already been intubated.”

The National Review pointed out why disengaging from Chinese medical institutions is important for Western universities and industry. “These findings show a uniquely close and long-running collaboration between the PRC’s medical establishment and its public security system,” [Robertson] said. “This would make PRC surgeons, many of whom were trained in the West, involved in medicalized extrajudicial killing.”

Another National Review article discussed the scale of organ harvesting in China. Robertson and Lavee, who found descriptions of murder on operating tables in China, said “Thousands of papers have been published in China about heart and lung transplantation, but most say nothing about how the donor was handled.” They also believe the international outrage over organ harvesting is restrained by China’s involvement with the World Health Organization.

The BL explained that Dr. Lavee was initially incredulous that Chinese surgeons would describe such unethical procedures in medical articles. “Somehow both the authors and their editors in the respective medical journals have forgotten to take out these incriminating details, which we have found,” adding, “If this has been a practice for 20 or 30 years in China, I guess nobody at that time was aware they were doing something wrong, although how to declare brain death is something that is known in China. They’ve published a lot about it.” Lavee also noted that “no editor of any decent journal would have published a paper that incriminates the authors in such deeds.”

A second article in The BL went into detail over the methods used in the Robertson and Lavee paper and pointed out that “Procuring vital organs from prisoners requires close cooperation between executioners and transplant teams. The state’s role is to administer death, while the physician’s role is to procure a viable organ.” According to human rights researchers, China now surpasses the United States in number of annual transplants performed, with wait times of weeks rather than months or years as in the U.S.

United Kingdom

GBN reported that the researchers said the “principle way to determine death” is by assessing if a “patient can breathe without a ventilator” and this was not done by the Chinese doctors in these studies before declaring brain death.

The New Arab raised concerns about the fate of thousands of Muslim Uyghurs, who, along with the Falun Gong, are victims of live forced organ harvesting.

The Daily Mail pointed out the analysis of Chinese medical records found prisoners’ hearts were removed before they were brain dead, the official cause of death did not align with medical procedures performed, and over 300 medical workers across China are involved in the state-sponsored killings.

The Byline Times wrote “The 71 reports span a period of 35 years and include 35 hospitals, spread across 33 cities and 15 provinces, which is indicative of a practice that is systematic and widespread. Both Robertson and Lavee pointed to public health officials within the Chinese Government who have admitted that 95% of the organs used for transplantation come from prisoners, along with documentation that shows China had no voluntary organ donor system during the time when the 71 papers were published.”

United Kingdom/Canada

Iflscience described how evidence of hearts being extracted from living, not brain dead, people was “reported from 56 hospitals in 15 provinces [across China]. The earliest paper [was] from 1980, and the most recent from 2015.”


In an interview with Australia’s 9news, Robertson said the evidence they uncovered “showed the surgeon had become an executioner” and that “the study could not confirm exactly how the prisoners ended up on the operating table, but he warned there were ‘multiple troubling scenarios’ as to how this could have as to how it could have happened. While extremely unethical, removing the heart from a living person [is] an optimal way to conduct a transplant.”

The Australian edition of the International Business Times and Sky News reported on the new research indicating prisoners were operated on while still alive and not brain dead.

Mercatornet reported “Although this atrocity is impossible to prove definitively because of the secrecy surrounding most government statistics in China, activists have accumulated mountains of indirect evidence.”


The online English edition of Haaretz in Israel reported on the article’s findings that doctors in China are executing prisoners by removing organs while they are still alive while Israel’s Chinese embassy officials claimed the analysis was all lies and distortions.


OpIndia’s byline read “Chinese surgeons are reportedly recruited by the state to kill prisoners through organ transplant surgery” and quoted Robertson saying, “We found that the physicians became the executioners on behalf of the state and that the method of execution was heart removal. These surgeries are highly profitable for the doctors and hospitals that engage in them.”

The Wire reported that the AJT study provides evidence that “Chinese state and military affiliated hospitals have killed prisoners using organ transplant surgery because organ harvesting is extremely profitable.”

The Wire Science pointed out “While there have long been credible allegations about China harvesting organs from death-row inmates and persecuted groups, the study is the first to offer scientific evidence.”

Firstpost wrote “According to the study, China has developed one of the largest transplantation systems in the world, from the 1980s to the present, based primarily on organs from prisoners, supplied by the state’s security and judicial system.”


Aljazeera quoted Robertson as saying, “We found that the physicians became the executioners on behalf of the state, and that the method of execution was heart removal.”

Online media

The ASEAN Post  reiterated that “International guidelines on the ethics surrounding organ transplants state that organ removal must not cause the death of the donor, but the new research… suggests Chinese surgeons might have done just that.” The reporter explained problematic Brain Death Declaration as when “doctors did not check whether a patient could survive on a ventilator, or patients were only partially ventilated with a mask and did not have a tube inserted into the throat.”

Robertson told Medscape Medical News that in the Chinese language scientific journals, “surgeons wrote that the donor was brain dead, but according to everything we know about medical science, they could not possibly have been brain dead because there was no apnea test performed.”

The Insider reported the study found that 348 surgeons, nurses, anesthesiologists, and other medical workers or researchers who participated in the executions of inmates between 1980 and 2015 had removed … organs prior to legitimate determination of brain death. “If the reports we examine are accurate, they indicate that heart and lung procurement by the surgeon was the proximate cause of the prisoner’s death, thus directly implicating the surgeon in the execution.”

Tweaktown quoted Robertson describing their evidence. “What we found were improper, illegitimate, non-existent or false declarations of brain death. The surgeons wrote that the donor was brain dead, but according to everything we know about medical science they could not possibly have been brain dead because there was no apnea test performed.”

BioEdge published Dr. Lavee’s reason for exposing China’s unethical and criminal transplant practices, “As the son of a Holocaust survivor who was in a Nazi concentration camp, I cannot stand aside and remain silent when my professional colleagues, Chinese transplant surgeons, have for years been partners to a crime against humanity by cooperating with the authorities and serving as the operational arm for mass executions.”

Yahoo! News pointed out “The primary reason for the increase in transplants allegedly comes down to profit. The price tag on a new heart goes for over $160,000. Other organ prices include $62,000 for a kidney, $30,000 for a cornea and a whopping $170,000 for a pancreas.”

The Vision Times explains that researchers have found that “the Chinese transplant industry had taken off only following the mass arrests and detention of Falun Gong adherents, a pool of people numbering in the tens of millions,” and “[m]uch of the existing research into organ harvesting implicates high-ranking officials in the CCP (Chinese Communist Party).”

Ruetir writes, “The identity of all the captive donors is also unknown, and it has long been debated whether non-convicted political prisoners, such as Falun Gong practitioners and Uyghur Muslims, were used as organ sources.”