The 2019 book Stealth War by retired Brigadier General Robert Spalding, former member of the National Security Council, is a thorough analysis of efforts by the People’s Republic of China to gain global influence and presents a holistic view of how methods used to gain influence over an enemy are not limited to the use of military force, but can be expanded to other areas of society, including the media, telecommunications, business, education and research. By presenting the various methods China has implemented to influence and control the West, the author provides readers with profound insights into China’s intentions and actions. Stealth War paves a path for us to intercept, deflect, and reverse the Chinese Communist Party’s influences. The establishment of transparency and communication of true data is the key to dismantle stealth activities, including the forced organ harvesting from prisoners of conscience.
Stealth War can also be interpreted as a response to “Unrestricted Warfare,” a military manifesto of the People’s Liberation Army. Although seemingly unrelated to medical ethics and forced organ harvesting, the observations and analyses of events described by Brigadier General Spalding can help us understand the mechanisms that led to the forced harvesting of organs from Chinese prisoners of conscience. Additionally, these insights might enable us to respond to and take action against China’s transplant abuse.
The book’s title describes the characteristics of concealed actions that relate to Sun Tzu’s The Art of War where a battle, or any other objective, should be won without a fight. Although not mentioned in the book, the title also describes China’s practice of forced organ harvesting that occurs in secret, with hundreds of thousands of people who were medically examined while in detention subsequently disappearing without a trace. The title is also a reminder that we should not dismiss the existence of forced organ harvesting just because it is concealed by the CCP. Irrefutable evidence and testimonies tell us it truly exists.
In the absence of an ethical organ donation program and with the pretense of a recently fabricated donation program, China has been able to achieve its objective of performing hundreds of thousands of transplants over the past two decades. An academic paper published in June 2018, Cold Genocide: Falun Gong in China, introduced a new understanding that can be described as one of the objectives of the stealth war being conducted by China, the slow-moving eradication of the once mainstream spiritual practice Falun Gong. Since 1999, the former president, Jiang Zemin, and the Chinese Communist Party (CCP) have framed the group as an enemy of the party state in a persecution or war against them. The CCP leads not only a public, but also a covert campaign against Falun Gong, weaponizing the transplant profession in China in order to secretly eliminate its adherents.
Stealth War provides examples of CCP attempts to gain influence over foreign organizations, politicians and scientists. One such is China’s “Thousand Talents” program, a campaign where leaders in their field are put on China’s payroll under the banner of academic exchange. In the case of unethical, forced organ harvesting, there were times where leaders in the transplant field and of medical organizations appeared to lower their threshold for scrutiny regarding concerns about China. In 2016, China invited a selected group of doctors and organizations to visit transplant hospitals, however, the inspections were staged. Critics were not invited and questions about the use of Falun Gong prisoners of conscience as organ sources were not addressed.
Independent monitoring of China’s organ donation numbers revealed sudden increases of 25,000 organ donors within one day on December 31, 2015. Again, in the last week of December 2016, more than 88,000 organ donors were apparently added to the organ donation program. In 2017, China reported to have more than 5,000 organ donors coming from its pool of almost 400,000 registered donors. To put this into perspective, the donors-per-registered-donors rate, 5,146 donors/375,000 registered donors, was about 140 times larger than the comparable rate observed in either the United States or United Kingdom. A forensic statistical analysis of China’s organ donor numbers published at the end of 2019 concludes that the CCP regime’s official donor numbers appear to be fabricated.
It should be the obligation of the medical profession to review such serious allegations of medical ethics violations and examine whether officially reported transplant number have been manipulated or not, yet it was an international Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China that reviewed all the existing evidence and conducted two hearings on testimonies collected from witnesses and experts. The Tribunal concluded that forced organ harvesting from prisoners has taken place “on a substantial scale by state-supported or approved organizations and individuals” and that there is no indication that these practices have stopped.
Stealth War provides insights that might explain why the medical profession at-large has not investigated organ transplant abuse in China. The author recounts witnessing an event where business professionals were divided over how to deal with China. Surprisingly, some of them seemed willing to sacrifice the greater good of the United States in exchange for short-term profits.
It is well known that China has violated several of the WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation. Yet the medical community is divided in their response to China, with some sacrificing scrutiny for unchecked hopes of reforms while turning a blind eye to unethical practices. If engagement with China has indeed delivered measurable and verifiable changes, China should be happy to accommodate unannounced, independent international inspections of its transplant industry. Otherwise, we must ask whether some in the international medical community, while hoping to help reform of China’s transplant practices, may have inadvertently enabled China’s secret warfare.
In Stealth War, Spalding writes, “China seeks to portray itself as law-abiding and just.” But, on January 18, 2017, the Financial Times article “China’s top judge denounces idea of judicial independence” by Lucy Hornby quoted Supreme People’s Court President Zhou Qiang, saying “the Chinese Communist Party is formally above the Constitution.” In such a judicial environment, forced organ harvesting of prisoners of conscience, although considered criminal throughout the international community, could be considered legal in China if the CCP orders it done. The entirety of Stealth War conveys how the Chinese regime will exploit any and all facets of Chinese society to solidify its own influence and control.
Any good-will gesture to trust the People’s Republic of China’s judicial system without scrutiny is misplaced in the context of transplant medicine. Those Chinese citizens who did becoming involuntary organ donors had no rights. The medical community should be reminded that it is the ethical care of our patients, and in the case of transplant medicine, the ethicality of organ donation and procurement, that is our highest vocation.
When it comes to forced organ harvesting from prisoners of conscience, it is not only China’s medical ethics that are under scrutiny. The ethical standards of medicine for the entire world are also called into question. Investigators have concluded that China has killed more than a million prisoners for their organs over the past 20 years. How many more Falun Gong practitioners and other prisoners of conscience will be organ harvested before meaningful, independent, international action against transplant abuses in China is initiated?
Stealth War reiterates insights about China’s intellectual property theft and covert actions to gain knowledge from Western countries. It should therefore be noted that China has developed its transplant knowledge with the help of medical schools and professional journals from the West. Within two decades, and with the access to an abundance of unethically procured organs, China has now become a world leader in transplantation medicine with plans to dominate the discipline in the near future.
China’s strategy, revealed in Stealth War, to “win the battle without a fight,” has been used to take control of all aspects of Western society. Subsidized workers and currency manipulation allow China to outcompete any other country. The book describes how China hacked into a U.S. company’s computer system to gain access to its customer base, then proceeded to steal customers away and after crippling sales, offered to buy the weakened company. If members of the medical profession, who might be part of China’s “Thousand Talents” program, agree to any proposed open commercial transplant tourism, China will offer transplants within two weeks, like a commodity, to patients around the world. Transplant numbers in Western countries would decrease, reducing the ability of Western hospitals to sustain profitable transplant wards in their own countries. Stealth War does not talk about forced organ harvesting or any undermining of the global transplant market, but it lays out the same strategy and approach that should alert us to this as a real possibility.
Stealth War elaborates on how China controls regulations and uses them to their own advantage. International companies have invested billions of dollars in China despite being forcing to partner with Chinese companies, to reveal their proprietary technologies, and even to have a communist cadre on their boards. International companies are also prohibited from moving their profits outside of China. Business in China is a one-way street as money earned in China must stay in China, forcing foreign companies to reinvest.
How is this related to transplant medicine? China sends tens of thousands of students to the U.S. to receive medical training and its scientists and physicians participate in transplant conferences in the West and write articles for Western transplant journals. China earns billions of dollars from Western transplant tourists yet it does not allow independent scrutiny of its organ donation program or transplant statistics and refuses to allow independent investigative teams to inspect its transplant centers. China blocks transparency by covering up the number of transplants performed at individual transplant centers and by publishing only an annual transplant number for the entire country. China takes advantage of the international transplant community while at the same time deflecting scrutiny.
In Stealth War, Spalding writes, “American politicians who attempt to counter pro-CCP rivals will find themselves fighting against operatives who are bought and paid for, as the CCP uses its limitless cash to influence policies in Washington, DC.” Another example of influence peddling he describes is how, “more than 350,000 Chinese students were enrolled in U.S. universities in 2017.” This means about one third of all international students in the United States come from China. This translates into more than 10 billion dollars “pumped into the US higher education system.” This is the price tag, or bribe, that China has used to influence U.S. universities and medical schools, preventing them from hosting forums about the forced organ harvesting from Falun Gong practitioners in China. As soon as plans for such forums are circulated, Confucius Institutes, the Trojan horses of Chinese embassies, complain to institution leadership, pressuring them to block or cancel the events. The stifling of free speech on American campuses about transplant abuse in China is the antithesis of the Unites States Constitution’s First Amendment on Religion and Expression, and seriously erodes the teaching of ethical standards by example.
Stealth War illustrates the scope of the machinery that China deploys to undermine ethical values and institutions in the West which are the same mechanisms that have led to a cold genocide of Falun Gong practitioners in China.
It is up to us whether or not we lose the Stealth War that China has imposed upon us. If we want to win this battle of ethics, as Sun Tzu says “without a fight,” we simply need to raise awareness of forced organ harvesting and demand transplant transparency. A call for the end of forced organ harvesting from Falun Gong practitioners and other prisoners of conscience in China is, in reality, a call for upholding our own ethical values.
