Organ Sourcing in China: The Official Version, Part II

(Remarks prepared for delivery to a seminar in the UK Parliament September 11, 2019)

I gave a talk to a symposium in Bern, Switzerland in April 2015 where I went through chronologically with commentary the various official versions of organ sourcing in China. More than four years have passed since I made that presentation. I want today to bring that presentation up to date.^[1]

April 2015

Wang Haibo, then director of the Shenzhen Organ Coordination Centre, stated in a German radio interview:

“The question is, when can China solve the problem of lack of donor organs? I wish we could stop it tomorrow, but it takes a process. Many things are beyond our control, so we can not give a timeline.”

“since September last year (2014), organs can only be allocated through the new system, everything else is prohibited.”

“In November, 38 hospitals agreed to give up the organs of executed inmates because it’s so controversial, it’s a big step forward, and the time is drawing near that the whole country will give it up.”

Wang did not want to say how many organs are harvested from the executed.^[2]

Commentary

In this interview, Wang Haibo makes no distinction between prisoner organs and other organs when it came to allocation through the new system. He is saying that prisoner organs are being allocated through the new system.

The number of 38 hospitals which agreed to give up the organs of executed inmates has to be considered in context. In 2007, there were more than 1,000 medical institutions in China engaged in transplants.^[3]

Wang Haibo refuses to commit to any timeline because many things are beyond the control of his team. What is beyond his control? Presumably it is organ sourcing by hospitals from prisoners. He can not control that.

The 38 hospitals which gave up sourcing organs from prisoners did not do so because Wang Haibo and his team controlled them and ordered them to do so. They gave up that sourcing only because of voluntary agreement.

It may well be true that Wang Haibo does not control the hospital system and that he and his team can not impose on hospitals the end of sourcing of organs from prisoners. However, the Communist Party surely can. The fact that ending the sourcing of organs from prisoners is something that Wang Haibo and his team can not control means that the Communist Party itself has not decided to end the sourcing of organs from prisoners but rather left the end of that sourcing as a local hospital option.

November 2015

Huang Jiefu, a former Chinese deputy health minister, director of China Organ Donation and Transplantation Commission, and chair of the China Organ Transplantation Development Foundation, denied that he said his statements that prisoners were also citizens and therefore should be allowed to donate organs under the new rules. He stated

“I never said that, … It is a lie. It distorts my words. The context, the words are from a philosophical level. … As a doctor, we cannot reject the kindness and the conscience of the prisoners …. However, on a practical level, we cannot do that, to put them into the civilian donation.”^[4]

It is worth pointing out here exactly what were the words he said were distorted. A China Daily USA report of March 7, 2014 stated:

“China is set to further strengthen the regulation of organ donations from executed prisoners and integrate it into the existing public voluntary organ donation and allocation system, according to a political adviser close to the situation.

Huang Jiefu, director of the China Organ Donation Committee and former vice‑minister of health, made the remarks on Tuesday on the sidelines of the ongoing two sessions.

‘By doing that, organs from death‑row inmates used for life‑saving operations are secured in a fair, transparent, and corruption‑free manner, … we will regulate the issue by including voluntary organ donations by executed prisoners in the nation’s public organ donation system to help ensure an open and fair practice … China is gradually moving away from a long‑term reliance on executed prisoners as a major source for organ donations.’ He [Huang] expects that procedures that include the procurement and allocation of organs from inmates who have been executed will be integrated into the national system soon. ‘We’ve reached consensus with the legal and law enforcement departments on that,’ he said.

To ensure that donations are voluntary, written consent from the inmate and the family is required, he said.

Another source who didn’t want to be named but is close to the situation said written consent from the executed prisoner’s lawyer will be added as well.

Also, only designated organ procurement organizations will be allowed to approach law enforcement departments regarding the issue, Huang said.

Most importantly, ‘donated organs from executed prisoners will be put into a computerized system to ensure fair allocation’, he said. ‘Any organ donations, including those by executed prisoners, have to go through the system and the computerized allocation process,’ he added.^[5]

Commentary

For Huang Jiefu to say in November 2015 that what he said in March 2014 was theoretical is not accurate. In March 2014, Huang Jiefu was not just theorizing. He was stating not only what might be done, but what had been done.

In particular, he stated that he and his colleagues had reached consensus with the legal and law enforcement departments that procedures for the procurement and allocation of organs from inmates who have been executed would be integrated into the national system. The article added several details about this consensus or agreement.

One was that written consent from the inmate and the family would be required. A second was that written consent from the executed prisoner’s lawyer would be added. A third was that only designated organ procurement organizations would be allowed to approach law enforcement departments about procurement and allocation of organs from inmates. A fourth was that donated organs from executed prisoners would have to be put into a computerized system to ensure fair allocation.

The contradiction in the statements of Huang Jiefu raises two questions. One is, what is the reality behind the contradiction? The second is, why was it generated?

Determining reality in China, when so much effort is directed towards hiding it, is not easy. The level of detail Huang Jiefu presented in March 2014 about the agreement with law enforcement, indicates that there was such an agreement. Moreover, practicality would have necessitated it.

Because organ sourcing, from the beginning of transplantation in China, was prisoners, the organ distribution system was run through law enforcement. In many cases, when the investigators David Kilgour and I used were calling hospitals to ask about sourcing of organs, they were referred to the courts. Because organ distribution in China was being run through law enforcement, any change in organ distribution would need the agreement of law enforcement.

There are two possibilities. Either the system Huang Jiefu set up incorporated, at least in part, the pre-existing system. Or, the pre-existing system continued on its own and the system Huang Jiefu set up operated independently.

Huang Jiefu and his team could have, in theory, set up a separate organ distribution system independent from the existing system, relying only on non-prisoner donations. However, the numbers generated by such a system would have been tiny. As well, the continuation of the pre-existing system in its pre-existing form would have meant not even a modicum of reform of that system.

The notion that the pre-existing system would have shut down and that a whole new system would have been set up without any organ sourcing from prisoners is not a realistic possibility, because it would have meant shutting down, not just the transplantation business in China, but the whole Chinese health system. The health system had become financially dependent on selling organs simply to keep its doors open. The only realistic alternatives for China were the sort of agreement with the old system Huang Jiefu outlined in March 2014 and no change in the old system at all.

Given that what Huang Jiefu said in March 2014 is likely to be closer to the truth than what he said in November 2015, why did he walk away from it, at least verbally, if not in substance? The answer lies in the two faces of Communist politics, one looking outward and the other looking inward.

Inward, Party success comes from maintaining and strengthening the hold of the Party on power. Outward, Party success comes from dissimulating the brutality necessary to maintain and strengthen that hold. The efforts of Huang Jiefu have been focused on this outward component.

Huang Jiefu has historically been trying to do two things at once. On the one hand, he has been telling gullible outsiders what he thinks they want to hear. On the other hand, he has been attempting to live within and accommodate the Chinese Communist system as it actually is.

Outsiders, of course, do not want to hear that innocents are being killed for their organs. Yet, the Communist health system depends on it. So, how does Huang Jiefu, or for that matter, anyone, try at one and the same time to please mass killers and those who abhor mass killing of innocents?

Admitting that organ sourcing came from prisoners of conscience is out of bounds. There was no way that would have flown with either constituency.

Generally, the most plausible lie is one that conforms most closely to the truth. It was impossible to deny credibly that organs in China were coming from prisoners. The Communist Party had tried this, vociferously, for many years, but it got no traction, no outside acceptance. The evidence to the contrary was just too overwhelming.

So, Huang Jiefu tried something else – admitting that virtually all organs came from prisoners, but adding that they were prisoners sentenced to death and, in an implausible defense of prisoners’ rights, claiming that prisoners should not be denied the right to donate their organs. He further claimed that donations came from prisoners who wished to atone for their crimes, not realizing how Communist that sounded. That claim, among outsiders, unsurprisingly, went nowhere.

He then in March 2014, as we can see, claimed that, in addition to the consent of the prisoners, their families would be consenting, that even their lawyers would be consenting, that only designated organ procurement organizations would be allowed to procure these prisoner organs and that prisoner organs would have to go through the allocation system he set up. However, unfortunately, for him, all that did not win international acceptance either.

So, he just walked away from that, saying that all organs would come from donors outside the prison system, that everything he said before was just theoretical, philosophical. One would have to be both ignorant of China and easily fooled to accept those statements at face value. However, there is no shortage of people, even within the transplant profession, who fit within both categories.

Transplant professionals, to be sure, know transplantation. However, there is no necessary connection between knowledge of transplantation and knowledge of China, or history, or Communism or human rights.

Moreover, there are some people vain and naive enough to believe that they can make Chinese Communists better people. It is, no doubt, tempting to think that people who say they agree with you are honest and sincere. In any case, it is a temptation which the Communist Party of China commonly exploits.

Among outsiders, there are those who are all too willing to accept as real what they want to hear. People should be careful about what they wish, because it may happen. Beyond that, people should be be careful what they wish to hear, because they may hear it.

All too many outsiders would like to think that they have had a real impact on the evolution of events in China. The reality is that outsiders may have an impact on Communist Party discourse, the external face of China. However, they will have no impact on Communist Party reality, the maintaining and strengthening of the Communist Party hold in China. That impact is reserved solely for Chinese Communists.

There is a historical irony in the evolution of these events. The original Communist Party strategy, when it came to cover up the killing of prisoners of conscience for their organs, was to claim that all organs came from donors, even though there was no donation system and no organ distribution system. Huang Jiefu thought he knew better and advised the Party on what he suggested was a better narrative for the outside world – that sourcing was indeed prisoners but only prisoners who were going to be executed anyways.

The Party bought into this revised narrative. But it went nowhere, in terms of international acceptability. Eventually, Huang Jiefu had to admit that the original Party narrative of donations was the better one. So, he reverted to it.

What changed in the interim was not the victimization on the ground. On the contrary, the mass killing of prisoners of conscience for their organs during this period accelerated.

What changed was the plausibility of the denial of that abuse. A donation system was set up; so was an organ allocation and distribution system. A hospital registration system was instituted. Laws were passed requiring consent from sources and banning of purchasing (without repealing the laws stating consent was not necessary for the sourcing of organs from unclaimed bodies of prisoners). A policy giving priority to organs to Chinese over foreign nationals was adopted. Potemkin village/ Theresienstadt visits were arranged. Some outliers were prosecuted.

The ultimate lesson Huang Jiefu and the Party learned was to stay away from anything close to the truth. Anything resembling the truth was going to be unpalatable to the outside world.

August 2016

Huang Jiefu referred to the 2016 update that David K, Ethan Gutmann and I wrote as “nonsense … ridiculous”. He said that transplantation surgeries performed in China annually accounted for 8.5 percent of the total number of transplantation surgeries worldwide and that consumption of anti‑rejection medications account for 8 percent of global consumption.

“The two numbers match, which is evidence that the speculation is groundless … Some organizations are just demonizing China in order to fulfil their political purposes. … China has and will have zero tolerance for any violation of the country’s regulations in organ donation and transplantation”. He added that the country will not tolerate behaviour such as retrieving organs from executed people.^[6]

Commentary

The reference to zero tolerance suggests that sourcing of organs from prisoners is not happening at all. This is contrary to statements Wang Haibo made earlier and that Huang Jiefu himself makes later.

Huang Jiefu refer to what is in reality the massive cross checked evidence of transplant numbers coming from official sources in China as speculation. Yet, there is no speculation involved in tabulating these numbers. By ignoring the data on which the conclusions of numbers are based, he avoids addressing the reality of actual numbers.

The matching of the figures for anti-rejection drug purchases and his claim of Chinese transplant volumes has these methodological faults:

• the local sales of anti-rejection drugs does not account for transplant tourism, since transplant tourists obtain anti-rejection drugs back home and not, except for an initial batch, in China;

• if the sales value of anti-rejection drugs in China were an indication of transplant numbers, one would expect that to be so for other countries also. Yet, for other countries, there it is not so. For instance, Japan’s anti‑rejection drug sales, according to Quintiles IMS report from which Huang Jiefu drew his anti‑rejection drug sales figures, was, at the time Huang Jiefu made his comparison, 38% higher than China’s. Yet, its transplant numbers were only 15 to 20% of the official Chinese transplant numbers.

• Local Chinese producers of anti-rejection drugs do not post publicly their production volumes and sales.

• The Quintiles IMS report sets out total sales by value, not total volumes. Anti-rejection drug costs in the US are 2.5 to 4.0 times those costs in China. That means that the same dollar figure for sales in the US and China represents 2.5 to 4.0 fewer transplants in the US than in China.

• In China, unofficial pharmacies in 2016 comprised 70% of the market. The Quintiles IMS report does not capture these unofficial pharmacy sales.

February 2017

Huang Jiefu at a Vatican summit in Rome designed to tackle illicit organ trafficking told reporters at the conference that the use of organs from prisoners is now

“not allowed … There is zero tolerance. However, China is a big country with a 1.3 billion population so I am sure, definitely, there is some violation of the law”.^[7]

Commentary

Again, the zero tolerance remark surfaces, but with a twist. He personally has zero tolerance for the use of organs from prisoners. But he is sure, he is definite, that the use of organs from prisoners is happening.

The connection between 1.3 billion people and violation of the law is not obvious. We are not talking here about a random crime among a large population. We are talking of state institutions – prisons and hospitals.

There are in China a lot of prisons and hospitals, but not 1.3 billion. As noted, there were about 1,000 hospitals doing transplants in 2007. The Government of China reports about 700 prisons.^[8]

In reality, what Huang Jiefu was saying was that the use of organs from prisoners is now

“not allowed … There is zero tolerance. However, China is a big country with 1,000 hospitals and 700 prisons. So, I am sure, definitely, there is some violation of the law.”

The notion that the Communist Party of China and the Government of China can not control its own prison system and hospitals is farfetched. The Communist Party of China has many weaknesses. But inability to control state institutions, particularly its own prison system, is not one of them. The suggestion that the Chinese prison system violates Chinese law about the use of organs from prisoners despite zero tolerance on the use of organs from prisoners is not credible.

Huang Jiefu must be saying something different from what he appears to be saying. Insofar as one can make any sense out of what he is saying at all, it must be that he personally has zero tolerance for the sourcing of organs from prisoners. But he does not control the prison system and the hospitals and, he is sure, he is definite, that the prison system and the hospitals are sourcing organs from prisoners.

This might be true. Wang Haibo and Huang Jiefu both might personally prefer that there be no sourcing of organs from prisoners. But they are just individuals whose job it is to beguile foreigners, cosmeticians putting lipstick on a pig. They do not control the system; indeed, they have little influence over it. They have an impact on the shaping of the narrative told to foreigners; but that is all. Because that narrative diverges substantially from the reality, all they can say is what we have seen – no timeline, beyond our control, we wish and so on.

May 2018

Huang Jiefu during a press conference in Geneva, Switzerland, on May 25, 2018, responding to the evidence that China has a yearly organ transplantation volume of up to 60,000 to 100,000 and harvests organs from Falun Gong practitioners said that these are rumours not grounded in fact. Wang Haibo, at the time a member of the China National Organ Donation and Transplantation Committee, said that organ trafficking is a serious crime in China. Wang said that from 2007 to 2017, some 220 criminal suspects were captured and over 100 people were brought to justice.^[9]

Commentary

This claim of rumour is a constant Chinese government refrain. At a symposium on organ transplants at Beilinson hospital near Tel Aviv in May, 2007 where I went to speak, a representative of the Chinese embassy in Israel read out a statement at the symposium that the report David Kilgour and I wrote on organ harvesting of Falun Gong practitioners contained:

“verbal evidence without sources, unverifiable witnesses and huge amount of unconvincingly conclusive remarks based on words like ‘probably’, ‘possibly’, ‘maybe’ and ‘it is said’, etc. All these only call into question the truth of the report.”

Yet, the report to which the Chinese official was referring at the time and all the subsequent work David Kilgour and I have done has had no verbal evidence without sources, or unverifiable witnesses. All verbal evidence is sourced. Indeed, the verbal evidence is often recorded and recordings have been posted. All witnesses are verifiable. Where we rely on witnesses, we identify them and quote what they say.

Even stranger are the words in quotation marks. At no place do we do link the words “probably”, “possibly”, “maybe” or the phrase “it is said” to our conclusions. Our various versions of our reports are all word searchable on the internet.

Fabricating quotes is intellectually dishonest. It is particularly brazen when, at an event where I am sitting there listening, I am quoted as writing words I never wrote.

When the criticism of our work is so divorced from the reality of the work, one has to conclude that Huang Jiefu and company have been handed a script and, like actors in rehearsal, just read it out. They know it is fiction and the issue for them is not its reality but just how well they can act.

How can Chinese officials interacting with the outside world address the inconvenient and irrefutable? The answer they have devised is to pretend it is not there. The claim of rumour is as good a pretence as any.

As for the arrests and prosecutions, again here there is an assertion without evidence. Who was arrested? Who was prosecuted? What did they do? What were their sentences? Were any of the accused convicted of anything?

Were the accused part of the state run system? Were any of them part of the prison system, a system Huang Jiefu is sure, is definite has been involved in sourcing organs from prisoners?

In addition to the state run killing of prisoners of conscience for their organs, there has been a private traditional black market in organs in China, on a much smaller scale. Were these prosecutions just targeting the private black market and not the state run killing of prisoners for their organs?

July 2018

In 2017, a South Korean television team went to a hospital in Tianjin, where journalists spoke to foreign patients who had been told their transplant could take place within weeks. Huang Jiefu said at The Transplantation Society’s congress in Madrid that this practice was now illegal except as ‘humanitarian aid’ and would be punished.

“China used to be the hotspot for organ transplant tourism” he said. But that had since changed, and more than 60 doctors had been “punished by law”.^[10]

Commentary

Huang Jiefu states that there is a humanitarian aid exception in the law against transplant tourism. However, there is no such exception stated in the law.^[11]

Moreover, does not every transplant have a humanitarian dimension, in the sense that the patient who receives the organ needs the organ? This appears to be an exception which swallows the rule. The humanitarian exception is like many of the other things that he and others spokespersons are saying about the Chinese system, weasel words, a way of saying two opposite things, abuse and no abuse, at one and the same time,

September 2018

At a China‑International Organ Donation Congress, held in Xi’an on September 21, China Medical Board President Lincoln Chen stated that implementing effective transplant policies in China will need to take into account Chinese culture, where the body of the deceased is viewed as a gift from parents, with parts not easily volunteered to others. Policies also will need to be harmonious with global ethical standards, which prohibit such practices as the use of prisoner organs and transplantation foreign tourism.^[12] Huang Jiefu, director of the China National Organ Donation and Transplantation Committee said that China is expected to have the most organ transplant surgeries in the world in 2020.^[13]

Commentary

The statement that implementing effective transplant policies in China will need to take into account Chinese culture where the body of the deceased is viewed as a gift from parents, with parts not easily volunteered to others is a statement that current transplant policies in China are not now effective, because they do not take into account Chinese culture where the body of the deceased is viewed as a gift from parents, with parts not easily volunteered to others.

What is the policy to which Lincoln Chen is referring? Presumably it is the policy of replacing prisoner with donor sources for organs. So, he is in effect saying, do not pretend that organs coming from donors will replace organs from prisoners. It is not happening. And it is not going to happen. Any effective transplant policy in China is going to have to take into account a dearth of donors.

The statement of Lincoln Chen that policies will need to be harmonious with global ethical standards, which prohibit such practices as the use of prisoner organs and transplantation foreign tourism is a statement that policies right now are not harmonious with global ethical standards, which prohibit such practices as the use of prisoner organs and transplantation foreign tourism. Lincoln Chen is saying that voluntary organ donors are not available and not going to be available. And China should not be sourcing from prisoners. But if organs can not be coming from donors and should not be coming from prisoners, what is left?

There is a third potential source, buying organs from relatives of patients in hospital and China has indeed gone into this sourcing.^[14] They have skirted the concept of brain death to up the numbers from this source.^[15] However, the numbers available from this source comes nowhere near to replacing the numbers coming from prisoners. Many people at or near brain death are going to have a lot more than their brains damaged. As well, these sources are not available on demand.

The statement of Huang Jiefu that China is expected to have the most organ transplant surgeries in the world in 2020 projects the present into the future. China right now has the most organ transplant surgeries in the world, by far.

Huang Jiefu both denies the figures for transplant volumes which independent researchers have tabulated and says, give us time, we are getting there. His way of denying reality is to say, not now, soon. Actual figures and official figures are converging. For officials, this convergence is a convenient way of reconciling what is now for them an embarrassing divergence.

February 2019

At a conference on organ donation and transplantation held in Wuhan, Hubei province, Fan Jing, an official in medical supervision and evaluation at National Health Commission, stated that China will revise its regulation on organ donation and transplants.

The new regulation aims to be more effective in holding accountable medical institutions and local health authorities found to have violated laws and regulations. The Commission will introduce rules to ensure legal practices are used. Fan did not say when the new regulation will be released.^[16]

Huang Jiefu said that the existing regulation needs revision to specify voluntary donation as the only source for organs. He noted that

“there are … some uncertified clinics where uncertified doctors perform surgeries and patients should not choose them.”

Commentary

These statements run contrary to official assertions that organ sourcing from prisoners has ended. The notion of Fan Jing that new regulations aim to be more effective in holding accountable medical institutions and local health authorities found to have violated laws and regulations carries with it the implication that the present regulations are less effective in holding accountable medical institutions and local health authorities found to have violated laws and regulations.

Put bluntly, Fan Jing is saying that medical institutions and local health authorities are violating laws and regulations on organ transplantation and are not being held to account for those violations. The solution devised for this problem is new regulations some time in the indefinite future.

Altogether apart from the fact that no timeline is given for the enactment of these regulations, how can the enactment of new regulations address the failure to hold institutions to account for violating old regulations? One would have thought that the remedy for the failure to hold institutions to account for violating regulations would be to hold them to account for the regulations, to implement the regulations.

If old regulations are not being implemented, why would new regulations be any different? The proposed cure is perplexing; but the disease is plain. The regulations on organ transplant reform, to the surprise of no one who follows the system closely, are not being implemented.

The statement of Huang Jiefu that the existing regulation need revision to specify voluntary donation as the only source for organs, is equally perplexing. Do not the existing regulations say that now, that donations must be voluntary? Does Huang Jiefu mean to suggest that the existing regulations now allow both voluntary donations and forced organ harvesting? Which regulatory provision does he have in mind which now explicitly allows forced organ harvesting?

Perhaps he has in mind the 1984 law which allows for sourcing of organs of prisoners without their consent or the consent of their families if their bodies are unclaimed. Huang Jiefu appears to be admitting, in a backhanded sort of way, that this law is being used to engage in forced organ harvesting despite the 2007 regulation to the contrary.

His further statement that patients should not choose uncertified clinics where uncertified doctors perform surgeries is equally odd. It is an admission that transplants do not occur only through the certified system. But is it really only up to the patients? Are the state and the Party really powerless even when organs are being sourced from prisoners?

Patients, perhaps understandably, are likely going to think of themselves and their need for organs rather than compliance with a system Huang Jiefu and his colleagues have set up. A requirement that organ sources be voluntary where compliance depends on the choice of patients rests on a thin reed.

Moreover, is the voluntary system able to supply all organs demanded? One can assume that patients who can choose between certified clinics with certified doctors and uncertified clinics with uncertified doctors, where certification is the only difference between them, would choose certified clinics with certified doctors every time. There must be some other difference than certification which precipitates the choice towards the uncertified.

Could that difference perchance be the availability of organs, which the uncertified can supply, but the certified can not, at least in sufficient numbers? Is Huang Jiefu inviting patients to go without organs rather than choose the uncertified?

What we are talking about here is the killing of innocents for their organs. Is the solution that Huang Jiefu proposes to this mass murder asking the patients to choose not to participate in it? That is, at best, an ineffective way of combatting mass murder.

In any case, if the invitation of Huang Jiefu is to have any hope of success, he would have to be a more explicit about what the problem is than he has stated. He is so indirect in his invitation to compliance it would be difficult to impossible for a patient to figure out what he is saying if one did not know the situation already.

April 2019

Guo Yanhong, vice director of the medical administration division of the National Health Commission, in the past four years, China’s organ donation volume has increased by 32 percent annually.^[17]

September 2019

The Red Cross Society of China released a plan which provides that the number of registered organ donors in China is expected to exceed 3 million by the end of 2024. In 2010, the year China began to pilot organ donations, the number of domestic registered organ donors was only 1,087.^[18]

Commentary

In the United States in 2018 there were 145 million people over the age of 18 who had registered as donors. Also, in 2018 there were 10,722 deceased donors (adults and children). That means that there was one deceased donor for every 13,524 adult registrants.^[19]

Three million people sounds like a lot of people. But, if we take the figure of three million registrants, and use the ratio of 13, 524 to one we get 222 deceased donors in China by 2024. Even if we take into account that a donor may donate more than one organ, China is not going to be getting a lot of organs from donations. The Chinese donation system can not now or in the foreseeable future account for the huge volume of organs being transplanted in China.

Conclusion

Walter Scott, in writing “oh, what a tangled web we weave when first we practice to deceive”, implied that, with practice deception, gets less tangled. The chronological presentation of the official version of Chinese transplantation set out in the 2015 presentation and this text belie that implication. The official version today is as tangled as it was at its inception.

The reason is the competing demands on the officials. If all they had to do was please their Communist bosses or beguile outsiders, it might have been possible over time for the officials to develop a better narrative. Doing both at once presents the spectacle we see now – persistent contradictions, denials that they said what they are on record as having said, and the claims both that reforms have happened and that they will happen some time in the indefinite future.

The combination of willful blindness, propaganda and cover-up which the official voices of Chinese transplantation in China presents does not provide a lot of information about what is actually happening in transplantation in China. Nonetheless, the combination deserves attention.

Any mass crime presents a panorama, from the hands on perpetrators locally to the indifferent abroad. A full explanation of how the crime manages to happen needs to include these official dissimulating, denying voices.

…………………………………………………………………………………………………………………….David Matas is an international human rights lawyer base in Winnipeg, Manitoba, Canada.

1.      http://www.david‑kilgour.com/2015/Matas_04162015.pdf ↑
2.      Radio station Deutschlandradio Kultur on April 09, 2014

   https://web.archive.org/web/20140906154220/http://www.tagesschau.de/ausland/china2158.html ↑

3.      Wuhan University Research Institute of Hepatobiliary Diseases: A Race against Time

   www.people.com.cn ‑ Hubei Channel May 21, 2015 Zhang Pei

   http://www.transplantation.org.cn/zyienizhonghe/2015‑05/7432.htm

   https://archive.is/SzewF ↑

4.      Didi Kirsten Tatlow, Transplant Chief in China Denies Breaking Vow to Ban Prisoners’ Organs The New York Times Nov. 25, 2015 ↑
5.      Shan Juan “Govt seeks fairness in organ donor system for inmates” 2014 March 07, China Daily USA,

   http://usa.chinadaily.com.cn/epaper/2014‑03/07/content_17331138.htm ↑

6.      Willa Wu And Honey Tsang in Hong Kong, Organ harvesting rumours slammed, China Daily USA, 2016‑08‑19 ↑
7.      Stephanie Kirchgaessner in Rome, Huang Jiefu, in charge of overhauling the Chinese transplant network, angers rights activists as Vatican trafficking talks begin The Guardian, 7 Feb 2017 ↑
8.      https://www.prisonstudies.org/country/china ↑
9.      Spotlight: Experts introduce China’s organ donation and transplantation model, refute rumours, Xinhua, 2018‑05‑25 ↑
10.      Once banned, Chinese scientists now at heart of organ transplant conference, Agence France‑Presse, 6 Jul, 2018 ↑
11.      http://www.chinadaily.com.cn/m/chinahealth/2014‑06/05/content_17566177_7.htm ↑
12.      China Medical Board China Transplant Conference Focuses on the ‘China Model’ January 4, 2019 ↑
13.      China to become world’s largest country of organ transplants in 2020, Xinhua, 2018‑09‑21 ↑
14.      http://news.cnhubei.com/xw/sh/201509/t3372789.shtml ↑
15.      P107B “Abuse of Brain Death Concept in Organ Procurement in China” H. Li, N. Paul https://archive.is/Puwtn#selection-13053.1-13089.1 ↑
16.      Rules to be revised on organ donations China Daily, Friday, March 01, 2019 ↑
17.      Across China: More Chinese become organ donors, Xinhua, 2019‑04‑03 ↑
18.      Red Cross plans spike in donor registration 2019‑09‑04 China Daily ↑
19.      https://www.organdonor.gov/statistics‑stories/statistics.html ↑