New Developments in Organ Transplantation in China

(E-Poster at the 30th International Congress of The Transplantation Society, September 22nd to 25th, 2024)

by David Matas

Click HERE to view the full E-Poster.

Additional links to pages 2,5,9 and 10, text only:

• Page 2 – Introduction, Method, Results and Conclusion
• Page 5 – Comments on the e-mail from Drs. Delmonico and Ascher
• Page 9 – Bibliography
• Page 10 – Recommendations

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Introduction: The Chinese Government acknowledged in 2006 that it was sourcing organs from prisoners sentenced to death and then executed. The Government in 2014 indicated that they would stop this sourcing starting from January 2015. Evidence points to the reality that the Government of China continues to source organs from prisoners, killing them for their organs on an industrial scale.

The University of Harvard Medical School hosted a forum on March 8th 2024 on forced organ harvesting. Dr. Francis Delmonico and Dr. Nancy Ascher, both former presidents of The Transplantation Society (TTS), by e-mail sent in advance of the event, asked that information and requests be distributed to those to whom the March 8th event invitation was sent. An extract from the webpages promoting the forum, the e-mail from the former presidents, and a commentary on that e-mail additional to this text, are separate slides in this presentation.

Method: The presentation encapsulates current evidence that organ sourcing from prisoners continues in China. In addressing this evidence, the presentation addresses two cognate issues -onus and remedy.

Results:  Evidence of sourcing of organs from prisoners in China since January 1, 2015 is voluminous, hundreds of pages, thousands of cited sources, much larger than the limitations of this presentation (10 slides ) allows. A bibliography is attached as a separate slide. The China Tribunal, an independent expert people’s tribunal, in its March 2020 judgment, provided this statement about the evidence:

“There has been a population of donors accessible to hospitals in the PRC [People’s Republic of China] whose organs could be extracted according to demand for them, and this has coincided with the long-term practice in the PRC of forced organ harvesting [of death penalty prisoners] and of many Falun Gong, along with Uyghurs, being compelled to have medical tests, focused on their organs; the PRC would have no difficulty in committing Falun Gong practitioners to any fate and could readily use them as the population of donors accessible to hospitals in the PRC whose organs could be extracted according to demand for them by means of forced organ harvesting.

This process of step-by-step reasoning leads inexorably from: the clear evidence of a supply chain of organs over many years but from an unaccountable source; the fact that Falun Gong practitioners once incarcerated could be a useable source; and there being no other source identified, to the Tribunal being satisfied that:

In the long-term practice in the PRC of forced organ harvesting it was indeed Falun Gong practitioners who were used as a source – probably the principal source – of organs for forced organ harvesting.” (Paragraphs 460 and 461).

The former presidents of TTS, in their e-mail about the Harvard Forum, asked for “the current evidence … regarding the use of organs recovered from executed prisoners and from specific transplant centers within China today.” This request suffers from category confusion. The request is made about executed prisoners. The subject matter of the Harvard Forum was prisoners of conscience.

There is a difference between prisoners sentenced to death and then executed in conformity with their sentences and prisoners of conscience killed through organ extraction. Prisoners sentenced to death for serious crimes are common criminals. Prisoners of conscience are either not charged, convicted or sentenced at all, or convicted for minor, non-death penalty offences, such as “disturbing social order”.

Prisoner of conscience victims of forced organ harvesting have not been and are not being executed pursuant to a sentence. The Government of China has never acknowledged that they were sourcing organs from prisoners of conscience not sentenced to death and never said that they would stop doing so.

Evidence of absence is not absence of evidence. The China Tribunal wrote further that, as of March 2020: “There is no evidence of the practice [of the killing of Falun Gong for their organs] having been stopped and the Tribunal is satisfied that it is continuing.” (Paragraph 467). The conclusion that “There is no evidence of the practice having been stopped” includes, of course, no evidence from the Government of China. That observation, accurate in March 2020, remains accurate today.

In light of the findings of the China Tribunal as late as March 2020, that, as of that date, the forced organ harvesting of Falun Gong practitioners was continuing, the onus does not lie on outsiders to provide evidence of the use of organs recovered from political prisoners and from specific transplant centers within China today. The onus lies on China to comply with the World Health Organization Guiding Principles on Human Cell, Tissue and Organ Transplantation of transparency, traceability and openness to scrutiny. The Government of China has not provided that evidence.

The e-mail from TTS former presidents stated: “The current direction of China is clearly altered from the past abuses as it pertains to organ transplantation. BEIJING, Dec. 14, 2023 – Chinese Premier Li Kiang has signed a decree of the State Council to unveil rules on human organ donation and transplantation, which will take effect on May 1, 2024…. These regulations fulfill WHO Guiding Principles of transparency and oversight.”

The new law, the Regulation on Donation and Transplantation of Human Organs, does not mention the words “transparency”, “traceability” and “openness to scrutiny”. The law asserts, in Article 3 that “Supremacy of the people shall be insisted on in the work of donation and transplantation of human organs.” The relevant component of the Regulation forms another slide of this presentation.

In China, “supremacy of the people” is another way of saying “supremacy of the Chinese Communist Party”. The very first substantive provision of the Constitution of China states: “The People’s Republic of China is a socialist state under the people’s democratic dictatorship led by the working class and based on the alliance of workers and peasants …. Leadership by the Communist Party of China is the defining feature of socialism with Chinese characteristics….”

The regulatory oversight for which the new law provides is Government of China/ Chinese Communist Party “dictatorship” oversight. The new law does not allow oversight by those independent from the Government of China/ Chinese Communist Party.

The China Tribunal observed that “Doctors speaking in support of the PRC [the People’s Republic of China] were effectively complicit in the denial by their failure to highlight the fact that essential material was missing.” The relevant excerpt from this judgment is another slide in this presentation.

Conclusion: The Transplantation Society 2006 Ethics Committee policy on the Chinese Transplantation Program, in light of subsequent developments, needs updating. There is a separate slide suggesting what that updating should be.

Recommendations

The Transplantation Society, in addressing political abuse of organ transplantation in China, should follow the example of what the World Psychiatric Association did to address political abuse of psychiatry in the former Soviet Union.

The Transplantation Society should:

1) recognize that organ transplant abuse in China with prisoners sentenced to death as sources is not the only form of organ transplant abuse in China with prisoner victims;

2) acknowledge that prisoners of conscience not sentenced to death and in most cases not convicted of anything have been and, absent evidence to the contrary, continue to be the primary source of organs for transplantation in China;

3) condemn organ transplant abuse in China with prisoner of conscience organ sourcing;

4) call on all transplant health professionals in China or visiting China to renounce and disassociate themselves from organ transplant abuse in China with prisoner of conscience organ sourcing;

5) acknowledge that the onus falls upon the Government of China to establish that the sourcing of organs from prisoners of conscience has stopped, that the onus does not fall on The Transplantation Society to establish that this abuse continues;

6) establish its own review committee mandated to address political abuse of organ transplantation in China by examining, factually, whether the Government of China and its transplantation system have discharged the onus which falls upon them to establish that the sourcing of organs from prisoners of conscience for transplantation has ceased,

7) impose as a pre‑condition for participation at TTS events, including Congresses, whether it be presentations or just registration, of anyone involved in the Chinese transplantation system, that the to be established TTS review committee determine that

• a) the would‑be participants are sincerely cooperating with The Transplantation Society in ending organ transplant abuse in China with prisoner of conscience victims,
• b) the Government of China and its transplantation system
  • i) have unconditionally accepted The Transplantation Society review committee as a valid instrument of review;
  • ii) have acknowledged organ sourcing for transplant not just from executed prisoners but also from prisoners of conscience;
  • iii) have provided concrete evidence the sourcing of organs from prisoners of conscience has stopped,
  • iv) have reviewed with the review committee every case identified by the review committee where there is evidence of organ transplant abuse with prisoner of conscience sourcing; and
  • v) have allowed on‑site visits by the review committee and an unimpeded access to all relevant documents and witnesses.

There are further steps that The Transplantation Society could take. In principle, all perpetrators in China of organ transplant abuse with prisoner of conscience victims are guilty of crimes against humanity and arguably genocide and should be brought to justice. However, no such requirement was imposed by the World Psychiatric Association on the Soviet Union for its abuse of psychiatry. So, if The Transplantation Society were to limit themselves to following the World Psychiatric Association model, the actions above would suffice.

These actions, though, are not all that can be done. Bringing to justice the perpetrators could and should happen. Following the World Psychiatric Association model should, for The Transplantation Society, be a bare minimum.

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Click HERE to view the full E-Poster