Back in 2006, allegations first came to light that prisoners of conscience were being killed on demand for organ transplants throughout China, but in 2015 China said they had transitioned entirely to voluntary donations. A new report suggests this claim is simply not plausible, that this apparent overnight transition to ethical organ sourcing hides something far more unpleasant.
It has taken other countries years to develop transplant programmes using voluntary donation. Based on the proportion of registered and actual donors in the United States, China’s 373,536 registered donors (in 2017) would have yielded only dozens of donations.
A 2017 investigation by TV Chosun, a South Korean TV station, led to a full investigative report by The China Organ Harvest Research Center, released at a transplant conference in Madrid in July. COHRC investigators visited multiple hospitals and concluded that China is performing not the current 15000 annual transplants it claims, but around 70,000, with over one million since 2000. This is despite a declining rate of death-row executions.
China has not enacted laws governing ethical organ sourcing, donation, procurement and allocation or brain death. Agencies charged with regulatory oversight are empty shells, run inside ministry-approved transplant centers. Chinese hospitals advertise and quote waiting times for organs from living donors ranging from days to weeks, with extra cash for faster transplants, and promises of backup organs if the first fails. Dates on which matched organs are available are given well in advance. One hospital performed 10 heart transplants in one day in October 2016. Another offered investigators free liver transplants for the first ten children to register. There is an apparently unlimited stream of vital organs from still-living donors.
Who are they? The report’s awful conclusion is that, in China, those defined as enemies of the state are not tried for their ‘crimes,’ but logged on DNA databases as resources for harvesting. It alleges that the vast majority of organs are procured from prisoners of conscience in extrajudicial killings, allowing the government to destroy opponents without those embarrassing trials and sentences, whilst pleasing foreign dignitaries and wealthy ex-patriate Chinese, and allowing surgeons to pursue stellar careers. Claims that transplant tourism is forbidden are contradicted by the three floors of international transplant wards in one hospital. Nurses told investigators most recipients were from South Korea and the Middle East.
Falun Gong practitioners are the largest group of prisoners of conscience in China. They have been forcibly tissue typed both in state custody and in their homes since 1999, which is broadly when the transplantation drive began. They been protesting their claims of organ harvesting outside the Chinese embassy in London since 2002. In December 2017, Human Rights Watch reported that the Chinese government had also collected DNA samples and blood type data from 19 million Uyghurs in Xinjiang, calling it a public health program. The government now has a national database of more than 40 million, including dissidents and migrants, and plans to expand the number of DNA records to 100 million. The report expresses concerns that this information represents a product inventory.
The ethics of organ transplantation is based on donors of vital organs being indisputably dead prior to extraction. China’s transplant surgeons continue to appear at international transplantation conferences claiming to be participants an excellent, donation-based system restricted to Chinese nationals. The truth, it seems, may be hidden in plain sight.