Transplant Medicine at a Crossroads – Panel Discussion in Philadelphia

China’s forced organ harvesting methods clash with ethical standards in Western medicine.

PHILADELPHIA — “If we do nothing, we share the guilt,” said Dr. Gabriel Danovitch, professor and medical director of Kidney Transplant program at the University of California, Los Angeles (UCLA).

Speaking at the Doctors Against Forced Organ Harvesting (DAFOH) forum Sunday, May 1, 2011, Philadelphia, Danovitch was stern that medical doctors “do have some power by virtue of professional acceptance” to generate changes in the promotion of ethical practices in transplantation medicine and China’s methods of forced organ harvesting.

“Many of them [Chinese transplant surgeons] are trained in the West and in developed countries. They want to be accepted. They want to come to our meetings. They want to give their abstracts, they want to give their talks. But, we have to make it clear that they have to clean up their act before they can do that,” said Danovitch.

Danovitch was referring to a particular publication by Chinese doctors who wrote about the organ procurement in the methodology. Danovitch elaborated: “Cause of death within the China cohort donors was recorded as severe brain injury in all cases. In other words they’ve been shot in the head. – This is appearing in our journal by us.”

And further: “‘The livers were harvested using the standard DCD organ procurement technique.’ What is the standard technique? Shooting them in the head or anesthetizing them and murdering them. What is the standard technique? This is appearing in OUR journal. We’re not talking about China now. This is OUR journal. By US.”

Chaired by Dr. Dana Churchill, west coast representative of DAFOH, the forum comprised a panel of six speakers who conducted an in-depth discussion on organ procurement, the conduct of transplantation in China, and how it compromised medical ethics.

The speakers included Dr. Gabriel Danovitch, professor at UCLA, Dr. Arthur Caplan, professor at the University of Pennsylvania, Dr. Eric Goldberg, transplant surgeon and senior medical director for a global clinical research organization, Dr. Damon Noto, DAFOH’s spokesman, David Matas, Esq., human rights lawyer and co-author of “Bloody Harvest,” and Erping Zhang, director of the Association for Asian Research.

Both Danovitch and Caplan spoke against the use of executed prisoners as sources of organs and offered strategies for finding more organ donors.

“In the long run, the only solution to the cessation of the use of prisoners in China is for them to have a cadaver donor system,” said Caplan.

Caplan highlighted that “the ultimate responsibility for the ethics of transplantation is the transplant team. They have to verify that consent was obtained. They have to verify that the person did voluntarily give that organ up. They can’t say they don’t know where the organ came from. They can’t say they don’t care where the organ came from.”

In addition to the responsibility of each individual transplant surgeon, transplantation medicine itself has to uphold its ethical standards in the medical practice.

Caplan explains: “If you’re going to execute somebody by lethal injection in a chamber, you’re going to have the doctors running in to remove organs because these are not people on life support. The organs are not going to last long. You’re going to have to make the organ procurement a part of the execution. I don’t think that’s a position that the transplant community wants to be in. … It’s not a place that medical ethics allows you to participate. You can’t be hanging around the execution chamber or where the gunshot is going to take place, or where the death will occur, to pull parts without being complicit in part of the execution.”

Danovitch cited two statements from Jiefu Huang, vice health minister and professor of surgery, reiterating “this is not my [powerpoint] slide. This is the Chinese Vice-Minister of Health”:

“Illegal trading of human organs and organ intermediaries [has] emerged in China, forming tremendous profit chain that is against the principle of equity and goal of building a harmonious society.”

Huang acknowledged “over-reliance on deceased organs from executed prisoners, a source that does not comply with ethical and standard of practice,” according to Danovitch.

Danovitch conveyed a clear message to the attendees at the forum, which highlighted the potential of action that doctors can take.

“It seems to me that I cannot control what goes on in China. … But, we can control what goes on among ourselves. We can control what goes on in our journals, our meetings, our events, and our conferences. This is ours. At least we can control what goes on in our media,” said Danovitch.

David Matas highlighted in his presentation the increasing number of clinical trials in China. He referred to the pharmaceutical company Roche and quoted: “Asked by a newspaper why Roche produces this particular drug in China the former Roche CEO and present Chairman of the Board of Directors Franz Humer “… gave as reason that, contrary to Japan, in China there were no ethical or cultural stoppages for transplant medicine.”

In his conclusion Matas stated: “Pharmaceutical companies should not be participating in clinical trials in China unless they are satisfied beyond a reasonable doubt that the organs transplanted to the patients on whom the drugs are used are received from a proper source. Doctors should not participate in clinical trials in China unless the doctors themselves ensure beyond a reasonable doubt that the organs transplanted to the patients on whom the trials are conducted are received from a proper source. Regulatory authorities should not approve drugs based on data from clinical trials in China.”

Goldberg, who had 22 years experience in harvesting organs and had harvested over a thousand organs during his career as a transplant surgeon, also spoke of the need to put pressure on the Chinese professional organizations, the surgeons, and all transplant professionals.

“They should not be invited to meetings like these, and like what Gabe [Danovitch] pointed out—no literature should be accepted for publication in any mainstream journals because if you want to be a player like they do in China, they got to play by the rules,” stated Goldberg.

Goldberg discussed the ethical dilemma of transplant clinical research trials in China, reasons for the shift of clinical trials for drugs to Asia, particularly China, his role and responsibility in approaching pharmaceutical companies to stop these clinical research trials in China.

His stance was clear. “Unless until they are willing to abide by the rules and regulations that we all abide by in transplant, that the data coming out of there [China] should not be used, should be considered for drug approval.”

Goldberg got to the point when he stated that “organs that are harvested unethically or criminally will yield clinical trial data that is criminal or unethical”, which concurs with Danovitch’s remark that we share the guilt, if we do nothing.