China’s ambivalent Organ Donation and Transplantation
Conference in Guangzhou, August 2015
China is inviting leading doctors and medical organizations to participate in the country’s Organ Donation and Transplantation Conference in Guangzhou on August 21-23, 2015. While medical conferences are usually organized to provide opportunities for the exchange of scientific knowledge, the Guangzhou conference is instead designed to stage a celebration of China’s latest announcements.
With the majority of attendees being doctors from China, it is anticipated that the presentations may revolve around transplant findings and innovations grounded in unethically procured data gathered over the past 10 years. During this time period China saw remarkable and rapid growth of both its detention population and its transplant business, including times with up to 90% of transplant organs unethically procured from executed prisoners and prisoners of conscience.
Despite the “good-will” announcement concerns and questions remain.
A semantic trick left a backdoor open as Chinese authorities recategorized death row inmates as citizens with the right to donate organs. This unusual step is not only in violation of ethical standards, as clearly described by the World Medical Association, but also deceives those unfamiliar with Chinese law; in Chinese courts there is practically no chance for appealing a death sentence, and executions take place within 7 days of sentencing.
There is no effective legal change in sight. China’s 1984 provisions permitting the use of organs from executed prisoners were never abolished, and the good-will announcements from December 2014 are not yet written into law.
And surprisingly, Chinese officials did not include in their December 2014 announcement to also end organ harvesting from prisoners of conscience, leaving a dubious situation and open-ended questions to the attendees of the Guangzhou conference; will China stop harvesting organs from Falun Gong practitioners, Uighurs, Tibetans, and Christians? Or, will they continue or even increase this practice to compensate for the loss of other organ sources?
Chinese officials are aware of the loopholes and skillfully tackle them in advance. One of these evasive maneuvers was the statement recently made by Huang Jiefu, describing China’s organ donation system as a “newborn baby.“
Similar to the semantic trick of redefining death row prisoners as citizens with the right to donate organs, Huang Jiefu recently described China’s organ donation system as a newborn baby despite the fact that it is poised to perform about 12,000 transplants in 2015. China is the second largest transplant market in the world after the United States. Implying that its organ donation system is fragile like a newborn baby might aim at propitiating medical doctors and organizations on the international stage, when instead we would like to see this level of protectiveness towards the prisoners and prisoners of conscience who are killed for their organs.
In December 2014, Huang Jiefu traveled to Taiwan to propose to establish an organ exchange platform in Taiwan, which would conveniently save Taiwanese patients travel efforts to China as China would bring organs directly across the straights to Taiwan.
Of primary concern is that there is no opportunity for western doctors and organizations to scrutinize, ensure transparency, or utilize traceability (WHO Guiding Principles 10 and 11). To date China has never admitted, acknowledged, nor announced to end organ harvesting from prisoners of conscience and there is no promise that China will not forcibly enroll prisoners of conscience in its newly established public organ donation system.
Chinese officials state that the newly established organ donation system is able to provide organs for the 12,000 transplants predicted for 2015. Yet the system lacks ethical integrity. It is claimed that the Red Cross Society of China is able to mobilize donors; yet its method is to dispatch hospital staff to patients on their death beds and offer financial incentives worth an annual salary as compensation. This approach violates 3 out of the 11 Guiding Principles of the WHO on organ donation and transplantation. It would be an act of self-imposed ignorance if WHO officials were to attend the upcoming Guangzhou conference and applaud China for its empty promises that are built upon systematic violations of WHO Guiding Principles.
China’s organ donation system is only 3-4 years in the making rendering the promise of such a large supply of organs beyond questionable. It would take many years for a truly voluntary organ donation system to yield organs to this degree. In the United States, the public organ donation system is said to have grown over 25 years. The rapid yield of organs in China suggests that organ donors pass away soon after their registration, indicating coercion rather than voluntary organ procurement practices. Executed prisoners and prisoners of conscience remain at risk.
Attendees of the Guangzhou conference should be aware that in addition to attending the conference they may also become unwitting participants in Chinese media reports; they might become supernumeraries in the propaganda machine, used to convince the Chinese populace that the transplant field in China is up to par with international standards.
Chinese officials appear to express vague, nonspecific concerns such as, “China is a big country. No one can say for sure that there are no bad people out there.” While this sounds rational, it also raises questions. Instead of saying one word of apology for three decades of unethical organ harvesting from executed prisoners and prisoners of conscience, Chinese officials skirt accountability and hide behind a few bad people. Tens of thousands of people have been killed for their organs. Can this crime be forgotten and trivialized by pointing towards a few bad people? The decades-long state-sanctioned forced organ harvesting needs to be properly disclosed to the victims and their families before moving forward.
The reference to a few bad people, is misleading. DAFOH receives information from doctors around the world (e.g. Taiwan, Malaysia, Russia, Libya, and Saudi-Arabia) indicating that despite the growing global awareness of the problem, doctors continue to send their patients to China for transplants. Such a large transplant market, with short wait times and excess organs for sale cannot be explained by a few bad people. It suggests a widespread pattern.
Guangzhou 2015 is not the moment to applaud China for superficial and sugarcoated changes. Human lives are at stake.
If medical professionals and officials decide to attend the Guangzhou conference they are advised to apply due diligence. Attending the conference in Guangzhou without asking the host scrutinizing questions is lacking due diligence. China has failed to comply with internationally recognized ethical standards in transplant medicine for three decades. It would be unthinkable for distinguished medical professionals to applaud the current incomplete, holey organ procurement system, where abuse, lack of transparency, bypassing of transplant laws, and many other concerns are still omnipresent.
We suggest that attendees of the Guangzhou conference, especially representatives of organizations such as TTS, DICG and WHO, raise the following questions to the conference organizers, either before or during the conference:
Why did China not include ending organ harvesting from prisoners of conscience in the December 2014 announcements?
Why did China perform thousands of implausible medical exams and blood drawings from Falun Gong practitioners in detention camps while they are subject to forced labor, brainwashing, and even torture?
How can conference participants verify that unethical organ harvesting in China has truly ceased and avoid complicity with an ongoing disregard for WHO guiding principles and in the cover up of organ harvesting from prisoners of conscience?
A panelist at the “Organ Harvesting in China” workshop organized by the European Parliament’s Committee on the Environment, Public Health, and Food Safety in Brussels on April 21, claimed that organ harvesting from executed prisoners is now illegal in China as of January 1, 2015. To our knowledge, the 1984 provisions are still in place with no new law to prohibit it. Thus the question remains, is there a law in place that prohibits organ harvesting from executed prisoners, or was the claim from the April 21 workshop inaccurate?
Are organs from prisoners, on death row or in custody, still used for transplantation if the prisoner and the relatives give consent since, according to Huang Jiefu, prisoners are considered to be citizens with the right to donate organs?
Why does China close its gates for transparency and scrutiny in the organ procurement chain?
Are transplant regulations, supervision and openness for scrutiny the same for civilian and military hospitals?
What might reassure conference attendees that China now follows WHO guiding principle 11, demanding that the process of organ donation and transplantation be transparent and open to scrutiny?
While medical doctors and organizations have been working hard to stop organ trafficking and marketing of organs from the poor, the Red Cross Society of China offers financial incentives to poor families making organ sales a twisted form of organ procurement? It is implausible that this approach is combatted in most regions, while tolerated and praised in another region. How can conference attendees express concern over this discrepancy to the organizing host of this conference?