Perspective Article published in the Journal of Heart and Lung Transplantation
Transplant Ethics and Forced Organ Harvesting
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In this Perspective article, the authors comment on the recent statement from the International Society for Heart and Lung Transplantation (ISHLT) regarding transplant ethics. The article concludes that this statement distinguishes ISHLT from other professional transplantation societies in relation to clinical and academic interactions with fellow transplant professionals from the People’s Republic of China.
“The lack of openness and transparency from the PRC, plus their chequered track record of human rights abuses, renders any blind acceptance of claimed reforms a leap of faith despite supportive statements from professional societies like The Transplantation Society (TTS). (6,7)”
“Building professional networks is well intentioned and has been common among transplantation institutions, groups and societies for many decades. However, collaborative engagement with Chinese transplant professionals is premature and stands in stark contrast with the ISHLT position.”
The article addresses the importance of critically appraising claims of reform by the PRC, outlining a number of reviews conducted including but not limited to:
- Robertson and colleagues examining the availability, transparency, integrity, and consistency of official transplant data from the PRC. Their analysis led to results that indicated “human-directed manipulation of data rather than an accurate reflection of voluntary organ donations from individuals dying of natural causes.” (9)
- A critical review by Rogers and colleagues of 445 Chinese transplant-related studies published between January 2000 and April 2017 found that over 90% of published papers failed to comply with international ethical standards that prohibit the use of organs from executed prisoners.(3)
- Summarizing extensive documented evidence, the China Tribunal concluded “forced organ harvesting has been committed for years throughout China on a significant scale and that Falun Gong practitioners have been one—and probably the main—source of organ supply… The Tribunal has had no evidence that the significant infrastructure associated with China’s transplantation industry has been dismantled….”
Acknowledging these concerns, the article emphasises that “Collaborating [with the PRC to encourage reform] has not brought meaningful change and, considering transplant abuse allegations in the PRC have under international law been defined by the China Tribunal as crimes against humanity, such collusion exposes transplant clinicians, industrial partners and/or professional societies to the risk of complicity.”
“It is possible that within the PRC there will be organ procurement and transplant professionals who either work within accepted ethical standards or are involved with unethical practice under duress, their identity cannot be verified… we would argue that the sanctions imposed by ISLHT strengthen the hand of those who would wish for their profession to abandon such unethical practice.”
“The Advisory provides a pragmatic human rights due diligence framework for universities, learned societies, grant awarding bodies, journals and transplant professionals to assess activities that may cause, contribute or be linked to organ trafficking or forced organ harvesting.”
“The ISHLT has firmly aligned itself to these ethical principles, which we applaud, and implore others to follow their principled lead.”
References (see full article or further details)
3. Huang J, Mao Y, Millis JM. Government policy and organ transplantation in China. Lancet 2008;372:1937-8. https://doi.org/10.1016/S0140-6736(08)61359-8.
6. Delmonico F, Chapman J, Fung J, et al. Open letter to Xi Jinping, President of the People’s Republic of China: China’s fight against corruption in organ transplantation. Transplantation 2014;97:795-6. https://doi.org/10.1097/TP.0000000000000150.
7. O’Connell PJ, Ascher N, Delmonico FL. The transplantation society believes a policy of engagement will facilitate organ donation reform in China. Am J Transplant 2016;16:3297-8. https://doi.org/10.1111/ajt.14050.
9. Robertson MP, Hinde RL, Lavee J. Analysis of official deceased organ donation data casts doubt on the credibility of China’s organ transplant reform. BMC Med Ethics 2019;20:79. https://doi.org/10.1186/s12910-019-0406-6.