The official Chinese claim of 10,000 transplants a year, with some years higher, bring the official total transplant volume to date to 150,000 to 200,000 transplants since the persecution of Falun Gong began. This number far exceeds all NGO estimates of death penalty numbers. There is no other plausible explanation for the sourcing of this number of organs than the killing of Falun Gong (and to a lesser extent, the killing of Uyghurs, Tibetans and House Christians) for their organs.
Our update shows that the actual number of transplants is far larger than the official figures, in the order of hundreds of thousands larger. Given the systematic efforts at cover up, it is impossible to affix an exact number to transplant volumes. We can state with some confidence that complete innocents, practitioners of a set of exercises with a spiritual foundation, a Chinese form of yoga, have been victims of mass killing for their organs. We can say further that this slaughter has been led by the Chinese Communist Party.
Ultimately, it does not fall to us to explain where China gets it organs for transplants. The duty to explain the sourcing of organs for transplantation falls on China. The United Nations rapporteurs on torture and religious intolerance asked in the years 2007 and 2008 for the Government of China to account for the large discrepancy between the volumes of transplants they claimed to have made and the volume of sources they were prepared to acknowledge.2074 The Government of China answered these queries in 2007 with silence, in 2008 with propaganda, and in 2015 with fiction.
The World Health Organization Guiding Principle 1 of the Guiding Principles on Human Cell, Tissue and Organ Transplantation requires consent from the donor to organ removal for the purpose of transplantation. Guiding Principle 10 requires traceability of organ transplants. Guiding principle 11 requires that donation activities be transparent and open to scrutiny.2075
The European Parliament passed a resolution in December 2013 on organ harvesting in China. That resolution, amongst other provisions, called for a full and transparent investigation by the European Union into organ transplant practices in China.2076 That resolution did not specify which component of the European Union was to do the investigation. But the logical component is the European Parliament itself. The relevant procedure for the Parliament would be the establishment of a special temporary committee to conduct the investigation and produce the report.
The Office of the United Nations High Commissioner for Human Rights was asked by petition in 2013 to conduct an independent investigation into organ transplant abuse in China. The petition has nearly one and a half million signatures.2077 China is a signatory to the Convention against Torture and has to report periodically to the expert committee established under the Convention. The Committee against Torture recommended in 2008 that “The State party should immediately conduct or commission an independent investigation of the claims that some Falun Gong practitioners have been subjected to torture and used for organ transplants and take measures, as appropriate, to ensure that those responsible for such abuses are prosecuted and punished.”2078 In the intervening seven years, the Government of China has neither conducted nor commissioned any such independent investigation. The Committee in 2015 reiterated this recommendation stating: “The State party [China] should also commission an independent investigation to look into claims that some Falun Gong practitioners may have been subjected to this practice [removal of organs without consent].”
What can one realistically do in this situation? We would answer that question by referring back to a different issue – slavery, a different country – Belgium, a different century – the early twentieth, and a different person – Edmund Morel, a shipping line clerk.
Edmund Morel came to the conclusion that King Leopold was engaged in slavery in the Congo from looking at shipments of goods between the Congo and Belgium. The goods to the Congo were guns, ammunition and explosives, which went to the state or its agents; no commercial goods were sent. The goods from the Congo were ivory and rubber, of much higher value than the goods sent. The locals were not allowed to use money. Edmund Morel asked, how were the ivory and rubber which were shipped to Belgium being purchased in the Congo? The answer, he concluded in research published first in 1901, was that they were not; the people producing the ivory and rubber were not being paid. They were slaves.
The conclusion was noteworthy because it was made without any eye witness evidence of slavery. It came just from shipping records. His work was initially met with official denials. Yet it was accurate.
Many people at the time were worried about offending Belgium by pressing the issue. The British Government nonetheless commissioned their consul in the Congo, Roger Casement, to conduct an independent investigation and write a report, which he did in 1904. Casement travelled throughout the Congo for three months and came back with a report which established the existence of slavery in the Congo beyond shadow of a doubt, despite, it should be said, the continuing denials of King Leopold of Belgium.
Where does this leave us today? There is as much of a discrepancy today between the volume of transplants in China and sources of organs the Government of China is prepared to admit – death penalty prisoners and voluntary organs – as there was in the early twentieth century between the commercial value of goods being shipped into the Congo and the commercial value of goods being shipped back to Belgium. The China discrepancy today points as much to a human rights violation as the Belgium discrepancy did yesterday. The need for an independent investigation is as great. As a Chinese saying goes, “paper cannot wrap fire.” Such a long-lasting, nationwide massacre cannot be concealed forever. What needs to be done today is what those concerned about slavery did after the publication of the Morel research and before the Casement report – demand accountability and call for an investigation.
The predecessor to the UN Human Rights Council, the Human Rights Commission, used to see presented, if not adopted, resolutions about the human rights situation in China. The Chinese government negotiated these resolutions away, offering bilateral human rights dialogue in exchange for abandonment of resolution proposals on human rights in China. All the proponents of the resolutions accepted this devil’s bargain and the dialogues have now existed for many years. Canadian academic Charles Burton evaluated in April 2006 the Canada China bilateral dialogue at the request of the Canadian Ministry of Foreign Affairs. He reported that Chinese participants in the dialogues were low level officials who spent much of the time of the meetings just reading scripts, and what is more, the same scripts year after year. There was no obvious connection between these dialogues and what actually happened in China. Senior Chinese Communist officials resisted taking the dialogue seriously; they saw it as an affront to China’s national dignity for China to be made to answer to foreigners for domestic policy decisions.2079
Katrin Kinzelbach reached a similar conclusion for the European Union China human rights dialogue.2080 She writes:
“Over the years, [Chinese officials] had become human rights dialogue professionals… [T]he regular confidential talks behind closed doors had served as intensive training for a small number of Chinese officials on how to engage with ‑ and effectively counter ‑ human rights related inquiries, criticism and recommendations.”
The futility of this dialogue is underlined by the Falun Gong experience. Many foreign affairs officials in various governments with whom we have spoken over the years indicate that they regularly raise the persecution of Falun Gong in these dialogues to no avail. They report that their Chinese counterparts are either unresponsive or rude. The persecution of Falun Gong, as a result of these dialogues, has not lessened one bit.
The United States, Canada, the United Kingdom and all other countries should pull out of these dialogues and return the issue of human rights violations in China to the UN Human Rights Council. Asking the Chinese Communist Party to investigate itself is a fool’s game. Instead the Western countries should ask the UN system to do the investigation. An example of an effective investigative effort can be found in the initiative to determine what had happened during the ending years of the civil war in Sri Lanka, from February 2002 to May 2009. The Government of Sri Lanka in November 2011 produced a report on this period which was, perhaps unsurprisingly, a whitewash of those in power. The United Nations Human Rights Council in March 2013 passed a resolution, led by the United States, asking Sri Lanka to conduct “an independent and credible investigation into allegations of violations of international human rights law and international humanitarian law” during the ending years of the civil war. When the Government of Sri Lanka did not do this, the Council in March 2014, again in a resolution led by the US, asked the Office of the High Commission for Human Rights to conduct the investigation the Government of Sri Lanka did not do. The resolution asked the Office “to undertake a comprehensive investigation into alleged serious violations and abuses of human rights and related crimes by both parties in Sri Lanka” during the ending years of the civil war. That investigation was done and a quality report issued in September 2015.
States alone are not the moral arbitrators of this tragedy. Neither is the World Health Organization or The Transplantation Society. The moral authority belongs to the families across China who have lost loved ones. Until we can hear their voices, states need, at a minimum, to follow their convictions. The first step is the basic hygiene of limiting the states’ own culpability.
When we testify in different countries around the world, we are often asked, “how many citizens of our country have gone to China for an organ?” We cannot answer that question with any certainty, yet the failure is not ours. Rather, it can be traced to a deeply misguided medical bureaucracy. It is obviously appropriate to ensure medical privacy between an AIDS patient and his or her employer. Yet medical privacy is necessarily elastic; in many jurisdictions, medical privacy ends when there is a gunshot wound involved. Why then do medical authorities across the world adhere to strict medical privacy when there is an organ sourced in China? Is not the potential crime heinous enough?
In fact, there are only two places where one can receive the full range of organs from a prisoner of conscience: China and more recently, the territory under the control of the Islamic State, commonly known as ISIS. The patients who return with new organs are dependent on anti-rejection drugs; so why is it that surgeons and the state cannot even make a proper estimate of who is exploiting these services? This is an obscenity; for an outsider to go to China–or to ISIS controlled territory–to receive an organ may be to participate in an ongoing crime against humanity. The medical community needs to be at the barricades, stopping that participation, working with government officials and medical stakeholders to make exceptions to the strict privacy requirements.
States, in turn, can play a critical role in stopping the Chinese harvesting juggernaut simply by limiting supply. Until the Chinese State offers the full and comprehensive accounting that the world demands, states should follow the example of Israel, Spain and now, just recently, Taiwan and ban organ tourism to ISIS controlled territory and China.
Finally, the work of promotion of respect for human rights is not solely or even primarily the work of governments. It is the work of individuals everywhere, those to whom human rights belong. The killing of innocents in China for their organs is an atrocity which must concern us all.
Those in particular who have further knowledge of the abuse can contribute that knowledge. We urge them to do so, anonymously if necessary, by contacting ChinaOrganHarvest.org in either Chinese or English, Doctors Against Forced Organ Harvesting, or EndTransplantAbuse.org in English.
Contact and Collaboration
A way into the labyrinth of Chinese organ transplant abuse is policies opposing contact and collaboration with Chinese transplant professionals who perpetrate the abuse. The Transplantation Society developed such a policy, directed specifically to China, dated November 2006.
The Society said about the presentation of transplant studies from China at Transplantation Society meetings:
“presentations of studies involving patient data or samples from recipients of organs or tissues from executed prisoners should not be accepted.”
The November 2006 treated collaboration on studies the same way. It stated:
“Collaboration with experimental studies should only be considered if no material derived from executed prisoners or recipients of organs or tissues from executed prisoners is used in the studies.”
The Society’s policy was to permit doctors from China to become members of the Society only if they “sign the Statement of The Transplantation Society for Membership agreeing to conduct clinical practice according to The Transplantation Society policy.” When it came to clinical or pre-clinical trainees from transplant programs that use organs or tissues from executed prisoners, the policy stated that
“Care should be taken to ensure, as far as possible, that it is their intention that their clinical career will comply with the standards of practice outlined in The Transplantation Society Policy & Ethics Statement.”
Ostracism has been a vehicle for change in China. The China Medical Tribune reported the refusal to allow 35 Chinese participants for ethical reasons to attend the World Transplant Congress in San Francisco in July 2014.2081 It also noted that for the most recent Hangzhou, China transplant conference that “many overseas transplant experts failed to attend.” A year before, in October 2013, the China Transplant Congress, also held in Hangzhou, had an abundance of foreign expert attendees.
The NGO Doctors Against Forced Organ Harvesting (DAFOH) on October 20th released a statement which provided that
“we would consider it unethical for any foreign transplant professional to attend this transplant congress in Hangzhou given the rampant and unrepentant transplant abuse in China, unless the person is going with the express and sole purpose of speaking out against it.”
This statement, along with other developments, would have been a drag on overseas transplant expert attendance.
Doctors Danovitch, Shapiro, and Lavee, in a 2011 article, wrote
“Training of Chinese transplant professionals by the international community must be conditioned on commitments that trainees will not engage, directly or indirectly, in the use of organs from executed prisoners.”2082
Yet, another form of avoiding complicity is refusal to publish research of Chinese transplant professionals using data garnered from organ transplant abuse. The Editors and Associate Editors of the journal Liver Transplantation, wrote in 2007 that they
“have decided that original publications dealing with clinical liver transplantation outcomes submitted to this journal should explicitly exclude the use of executed prisoners or paid organs as a source of organs.”2083
The American Journal of Transplantation issued as instructions to authors a new policy effective May 2011 which states:
“AJT will not accept manuscripts whose data derives from transplants involving organs obtained from executed prisoners. Manuscripts writing about this practice (e.g. an editorial or a report recounting the secondary consequences of this practice) may be considered at the discretion of the Editorial Board, but require a written appeal to the Board prior to submission of the manuscript.”
Danovitch, M.E. Shapiro, and J. Lavee, in the article just cited, state:
“International and national professional medical societies and journals should not accept abstracts, publications or presentations from Chinese transplant centres unless the authors clearly indicate that the data presented is in concordance with the most recent Chinese government regulations regarding transplant tourism and that executed prisoners were not the source of organs.”
The refusal to allow 35 Chinese participants for ethical reasons to attend the World Transplant Congress in San Francisco in July 2014 and failure of many overseas transplant experts to attend the Hangzhou, China transplant conference on October 2014 had a profound impact on Chinese transplant officials. Many attendees to the 2014 Hangzhou conference were likely asking where all the overseas transplant experts were. Those doctors who applied to attend and participate in the World Transplant Congress in San Francisco in July 2014 and were rejected, and their colleagues who knew they were applying to attend, also needed an explanation.
The Communist Party may have felt that they could ignore the evidence of the killing of Falun Gong, Uyghurs and Tibetans for their organs. However, they could not ignore the fact that Chinese transplant doctors were denied admission to an international transplant congress or that foreign transplant doctors who had come before to China were no longer coming.
In response to this ostracism, the Party made no substantive changes but did make a wide variety of contradictory statements about how the situation either is better now or would get better in the future. David Matas set out these statements, at length, in a talk he gave in April 2015 in Bern, Switzerland to the International Society of Human Rights.2084
The bottom line driving all the remarks was a desire to end the ostracism. The peer pressure of the international profession, at the very least, got the attention of Chinese authorities in a way that no other initiative had.
The criteria for reconnection between the Chinese and international transplant community should be:
- an admission of past wrongdoing, including full disclosure of the sourcing of organ transplants in the past;
- a commitment to bring to justice all perpetrators of past organ transplant abuse and commencement of proceedings;
- expulsion from the Chinese Medical Association of transplant professionals who cannot establish beyond a reasonable doubt that their sourcing of organs is proper;
- cooperation with an international investigation into present and past sourcing of organs for transplant;
- publication of present and past death penalty statistics;
- public access to the past and present aggregates of the four Chinese transplant registries – lung, liver, heart and kidney;
- full, independently verifiable transparency of current sourcing of organs for transplant;
- establishment of a system of traceability of sources for transplants and use of that system;
- cooperation with an outside, independent verification system for compliance with international standards; and
- repeal of the 1984 law which allows for organ sourcing from prisoners without either their consent or the consent of their families.
This update draws these conclusions:
- Organ transplantation volume in China is far larger than official Chinese government statistics indicate;
- The source for most of the massive volume of organs for transplants is the killing of innocents: Uyghurs, Tibetans, House Christians and primarily, practitioners of the spiritually based set of exercises Falun Gong;
- Organ pillaging in China is a crime in which the Communist Party, State institutions, the health system, hospitals and the transplant profession are all complicit;
- The global intergovernmental community should establish an institution-based, independent investigation into organ transplant abuse in China;
- The global transplant community should connect and collaborate with the Chinese transplant community only if and when set criteria are met;
- Organ tourism to China should not be shielded by medical confidentiality, but openly monitored;
- No nation should allow their citizens to go to China for organs until China has allowed a full investigation into the organ harvesting of prisoners of conscience, both past and present.
2074 Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Addendum,
Manfred Nowak U.N. Document A/HRC/4/33/Add.1, 20 March 2007, paragraph 40; Report of the Special Rapporteur on freedom of religion or belief Addendum, Asma Jahangir, U.N. Document A/HRC/4/21/Add.1, 8 March 2007, paragraphs 107 to 111.Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Addendum, Manfred Nowak, U.N. Document, A/HRC/7/3/Add.1, 19 February 2008, paragraph 36; Report of the Special Rapporteur on freedom of religion or belief, Addendum, Asma Jahangir, U.N. Document A/HRC/7/10/Add.1, 28 February 2008, paragraphs 40 and 41.
2075 WHO GUIDING PRINCIPLES ON HUMAN CELL, TISSUE AND ORGAN TRANSPLANTATION
2076 December 12, 2013 European Parliament document number P7_TA(2013)0603 resolution number 2013/2981
2077 Petition to the United Nations at
2078 United Nations document number CAT/C/CHN/CO/4, 12 December 2008
2079 Assessment of the Canada-China Bilateral Human Rights Dialogue
2080 Katrin Kinzelbach, The EU’s Human Rights Dialogue with China: Quiet Diplomacy and its Limits Routledge, 2014, Page 214.
2082 G.M. Danovitch, M.E. Shapiro, and J. Lavee “The Use of Executed Prisoners as Sources of Organ Transplants in
China Must Stop” Volume 11 pages 426 428.
2083 Liver Transplantation in China, Jorge Rakela, M.D. and John J. Fung, Ph.D., M.D.Issue 13:182, 2007
2084 ORGAN SOURCING IN CHINA: THE OFFICIAL VERSION