Organ harvesting from Falun Gong practitioners in China
Reports
of organ harvesting from Falun Gong practitioners and other political prisoners in China have
raised increasing concern by some groups within the international community.
According to the reports,[1]
political prisoners, mainly Falun Gong practitioners, are
being executed "on demand" in order to provide organs for transplant to
recipients. The organ harvesting is said to be taking place both as a result of
the Chinese Communist Party's persecution of Falun Gong and
because of the financial incentives available to the institutions and
individuals involved in the trade.
Reports
on systematic organ harvesting from Falun Gong prisoners first emerged in 2006,
though the practice is thought by some to have started six years earlier.
Several researchers—most notably Canadian human
rights lawyer David Matas, former
parliamentarian David Kilgour and
investigative journalist Ethan Gutmann—estimate that
tens of thousands of Falun Gong prisoners of conscience have
been killed to supply a lucrative trade in human organs and cadavers and that
these abuses may be ongoing.[2]
These conclusions are based on a combination of statistical analysis;
interviews with former prisoners, medical authorities and public security
agents; and circumstantial evidence, such
as the large number of Falun Gong practitioners detained extrajudicially in
China and the profits to be made from selling organs.
The
Chinese government has
consistently denied the allegations. However, the perceived failure of Chinese
authorities to effectively address or refute the charges has drawn attention
and public condemnation from some governments, international organizations and
medical societies. The parliaments of Canada
and the European Union, as well as the
Foreign Affairs Committee of the U.S. House of
Representatives, have adopted resolutions
condemning organ harvesting from Falun
Gong prisoners of conscience. United Nations Special
Rapporteurs have called on the Chinese government to account for the
sources of organs used in transplant practices, and the World Medical Association, the
American Society of
Transplantation and the Transplantation Society have called for
sanctions on Chinese medical authorities. Several countries have also taken or
considered measures to deter their citizens from travelling to China for the
purpose of obtaining organs. A documentary on organ harvesting from Falun Gong
practitioners, Human Harvest, received a
2014 Peabody
Award recognizing excellence in broadcast journalism.[3]
China
has one of the largest organ transplant programs in
the world. Although China does not keep nationwide statistics on transplant
volume, Chinese officials estimated that as many as 20,000 organ transplants
were performed in 2006[4],
and approximately 9,000 of these were kidney and liver transplants[5].
Some sources say the actual number of transplants is significantly higher,
based on detailed analysis of hospital records.[6]
As a matter of culture and custom, however, China has extremely low rates of
voluntary organ donation. Between 2003
and 2009, for instance, only 130 people volunteered to be organ donors.[7]
In 2010 the Chinese Red Cross launched a
nationwide initiative to attract voluntary organ donors, but only 37 people
signed up.[8]
Due to low levels of voluntary organ donation, most organs used in transplants
are sourced from prisoners. The Chinese government approved a regulation in
1984 to allow the removal of organs from executed criminals, provided they give
prior consent or if no one claims the body.[9]
Despite
the absence of an organized system of organ donation or allocation, wait times
for obtaining vital organs in China are among the shortest in the world—often
just weeks for organs such as kidneys, livers, and hearts. This has made it a
destination for international transplant tourism[10]
and a major venue for tests of pharmaceutical anti-rejection drugs.[11][12][13]
The commercial trade in human organs has also been a lucrative source of
revenue for the Chinese medical, military and public security establishments.[14][15]
Because there is no effective nationwide organ donation or allocation system,
hospitals source organs from local brokers, including through their connections
to courts, detention centers and prisons.[16]
Organ
transplant recipients in China are generally not told the identity of the organ
donor, nor are they provided with evidence of written consent. In some cases
even the identity of the medical staff and surgeons may be withheld from
patients. The problem of transparency is compounded by the lack of any ethical
guidelines
for the transplant profession or system of discipline for surgeons who violate
ethical standards.[15]
By
the 1990s, growing concerns about possible abuses arising from coerced consent
and corruption
led medical groups and human rights organizations to start condemning China's
use of prisoner organs. These concerns resurfaced in 2001, when a Chinese
military doctor testified before U.S. Congress that he had taken part in organ
extraction operations from executed prisoners, some of whom were not yet dead.[17]
In December 2005, China's Deputy Health Minister
Huang Jiefu acknowledged that up to 95% of transplant organs from deceased
donors, which make up 65% of all transplantations, came from executed prisoners
and promised steps to prevent abuse.[18][19]
Huang reiterated these claims in 2008 and 2010, stating that over 90% of organ
transplants from deceased donors are sourced from prisoners.[20][21][22]
In 2006 the World Medical Association demanded that China cease harvesting
organs from prisoners, who are not deemed able to properly consent.[23]
In 2014, Huang Jiefu said that reliance on organ harvesting from death row
inmates was declining, while simultaneously defending the practice of using
prisoners’ organs in the transplantation system.[24][25]
In
addition to sourcing organs from death-row inmates, international observers and
researchers have also expressed concern that prisoners of conscience are killed
to supply the organ transplant industry.[26]
These individuals were not convicted of capital crimes, and in many cases were
imprisoned extrajudicially on the basis of their political or religious
beliefs.
Falun
Gong is a Chinese qigong discipline involving meditation and a moral
philosophy rooted in Buddhist tradition. The practice rose to popularity in the
1990s in China, and by 1998, Chinese government sources estimated that as many
as 70 million people had taken up the practice.[27][28]
Perceiving that Falun Gong was a potential threat to the Party's authority and
ideology, Communist Party leader Jiang
Zemin initiated a nationwide campaign to eradicate the group in July
1999.[29]
An
extra-constitutional body called the 6-10
Office was created to lead the persecution of Falun Gong,[30][31]
and authorities mobilized the state media apparatus, judiciary, police force,
army, education system, families, and workplaces to “struggle” against the
group.[32][33]
Since
1999, Falun Gong practitioners have been the targets of systematic torture,
mass imprisonment, forced
labour, and psychiatric abuse, all with
the aim of forcing them to recant their beliefs.[34][35]
As of 2009, the New York Times reported
that at least 2,000 Falun Gong practitioners had been killed amid the
persecution campaign;[36]
Falun Gong sources documented over 3,700 named death cases by 2013. Due to the
difficulty in accessing and relaying information from China, however, this may
represent only a portion of actual deaths.[34]
The
first allegations of large-scale organ harvesting from Falun Gong practitioners
were made in March 2006 by three individuals claiming knowledge of involuntary
organ extractions at the Sujiatun Thrombosis Hospital
in Shenyang,
Liaoning
province. One of the whistleblowers, the wife of a surgeon at the hospital,
claimed her husband had performed numerous operations to remove the corneas of
Falun Gong practitioners for transplant.[15][37]
Representatives
of the U.S. State Department were
dispatched to the Sujiatun hospital to investigate the claims. They were given
a tour of the facilities and found no evidence to prove the allegations were
true, but said they remained concerned over China's treatment of Falun Gong and
the reports of organ harvesting.[38]
Soon thereafter, in May 2006, the Coalition
to Investigate the Persecution of Falun Gong asked former Canadian
parliamentarian David Kilgour and human rights lawyer David Matas to
investigate the broader allegations of organ harvesting from Falun Gong
practitioners in China. Kilgour and Matas agreed to conduct an investigation as
volunteers.[39]
Kilgour-Matas report
Main article: Kilgour-Matas report
David
Kilgour and David Matas released the results of their preliminary investigation
on 20 July 2006, in a report titled "Report into Allegations of Organ
Harvesting of Falun Gong Practitioners in China".[40]
Although the pair were denied visas
to travel to China, they nonetheless compiled over 30 distinct strands of evidence
which were consistent with allegations of organ harvesting from Falun Gong
practitioners. These included an analysis of statistics on organ
transplantation in China, interviews with former Falun Gong prisoners, and
recorded admissions from Chinese hospitals and law enforcement offices about
the availability of Falun Gong practitioners’ organs.[15]
David Matas, senior legal
counsel of B'nai Brith Canada, international human rights
lawyer, coauthor of Bloody Harvest.
In
the absence of evidence that would invalidate the organ harvesting allegations—such
as a Chinese government registry showing the source of transplant organs—
Kilgour and Matas concluded that the Chinese government and its agencies “have
put to death a large but unknown number of Falun Gong prisoners of conscience.
Their vital organs, including kidneys, livers, corneas and hearts, were seized
involuntarily for sale at high prices, sometimes to foreigners, who normally
face long waits for voluntary donations of such organs in their home
countries.” They estimated that from 2000 to 2005, the source for 41,500 organ
transplants was unexplained, and that Falun Gong prisoners were the most
plausible source for these organs.[15][41][42]
The authors qualified their report by noting the inherent difficulties in
verifying the alleged crimes: no independent organizations are allowed to
investigate conditions in China, eyewitness evidence is difficult to obtain,
and official information about both organ transplantation and executions is
often withheld or is contradictory.[15]
In
2007, Kilgour and Matas presented an updated report under the title "Bloody
Harvest: Revised Report into Allegations of Organ Harvesting of Falun Gong
Practitioners in China". The findings were subsequently rewritten as a
book released in October 2009.[43]
The reports received international media coverage, and the authors travelled
internationally to present their findings to governments and other concerned
organizations.
State Organs: Transplant Abuse in China
In
2012, State Organs: Transplant Abuse in China, edited by Matas and Dr.
Torsten Trey, was published with essays from Dr. Gabriel Danovitch, Professor
of Medicine,[44]
Arthur
Caplan, Professor of Bioethics,[45]
Dr. Jacob Lavee, cardiothoracic surgeon,[46]
Dr. Ghazali Ahmad,[47]
Professor Maria Fiatarone Singh,[48]
Dr. Torsten Trey,[49]
Ethan
Gutmann and Matas.[50][51][52][53][54]
Ethan Gutmann
Ethan Gutmann with Edward
McMillan-Scott at Foreign Press Association press conference, 2009
Ethan
Gutmann, an investigative journalist and author specializing in China,
initiated his own investigation into the allegations of organ harvesting from
Falun Gong practitioners in 2006. Over the span of several years, he conducted
interviews with over 100 refugees from China's labor camp and prison system, as
well as with Chinese law enforcement personnel and medical professionals.[55]
Based on his research, Gutmann concluded that organ harvesting from prisoners
of conscience became prevalent in the northwestern province of Xinjiang
during the 1990s, when members of the Uyghur ethnic group were targeted in
security crackdowns and “strike hard campaigns.”[56][57]
Enver Tohti, an exiled pro-Uyghur independence activist, claims to have carried
out the first live organ transplant on a Uyghur Muslim prisoner in 1995. He
said that the first time he performed the transplant procedure, he was taken to
a room near the execution ground in Urumqi
to remove the liver and kidneys of an executed prisoner. He claimed that the
man's heart was still beating as he removed the liver and kidneys.[58]
By
1999, Gutmann says that organ harvesting in Xinjiang began to decline
precipitously, just as overall rates of organ transplantation nationwide were
rising. The same year, the Chinese government launched a nationwide suppression
of the Falun Gong spiritual group. Gutmann suggests that the new Falun Gong
prisoner population overtook Uyghurs as a major source of organs.[2]
He estimated that approximately 65,000 Falun Gong practitioners had been killed
for their organs between 2000 and 2008, and notes that this figure is similar
to that produced by Kilgour and Matas when adjusted to cover the same time
period.[2][59]
These
findings have been published in a variety of journals and periodicals,
including the World Affairs Journal, the
Weekly Standard, the Toronto
Star, and the National
Review, among others. Gutmann has also provided testimony on his
findings before U.S. Congress and European Parliament, and in August 2014
published his investigation as a book titled “The Slaughter: Mass Killings,
Organ Harvesting and China’s Secret Solution to Its Dissident Problem.”[60]
Verdict by the China Tribunal
On June 17, 2019, China
Tribunal, an independent People's
Tribunal located at London, had pronounced its verdict on Organ Harvesting in
China, and the Chinese government was found guilty[61][62].
Evidence
Several distinct strands of
evidence have been presented to support allegations that Falun Gong practitioners
have been killed for their organs in China. Researchers, human rights advocates
and medical advocacy groups have focused in particular on the volume of organ
transplants performed in China; the disparity between the number of transplants
and known sources of organs; the significant growth in the transplant industry
coinciding with the mass imprisonment of Falun Gong practitioners; short wait
times that suggest an “on demand” execution schedule; and reports that Falun
Gong prisoners are given medical exams in custody to assess their candidacy as
organ suppliers.
Increase in nationwide organ transplants after 1999
The
number of organ transplants performed in China grew rapidly beginning in 2000.
This timeframe corresponds with the onset of the persecution of Falun Gong,
when tens of thousands of Falun Gong practitioners were being sent to Chinese
labor camps, detention centers and prisons.[63][64]
In
1998, the country reported 3,596 kidney transplants annually. By 2005, that
number had risen to approximately 10,000.[15]
The number of facilities performing kidney transplants increased from 106 to 368
between 2001 and 2005. Similarly, from 1999 to 2006, the number of liver
transplantation centers in China rose from 22 to over 500.[4]
The volume of transplants performed in these centers also increased
substantially in this period. One hospital reported on its website that it
performed 9 liver transplants in 1998, but completed 647 liver transplants in
four months in 2005. The Jiaotong University Hospital in Shanghai recorded
seven liver transplants in 2001, 53 in 2002, 105 in 2003, 144 in 2004, and 147
in 2005.[15]
Kilgour
and Matas write that the increase in organ transplants cannot be entirely
attributed to improvements in transplant technology: “kidney transplant
technology was fully developed in China long before the persecution of Falun
Gong began. Yet kidney transplants shot up, more than doubling once the
persecution of Falun Gong started...Nowhere have transplants jumped so
significantly with the same number of donors simply because of a change in
technology.”[15]
Furthermore,
they note that during this period of rapid expansion in China's organ
transplant industry, there were no significant improvements to the voluntary
organ donation or allocation system, and the supply of death row inmates as
donors also did not increase.[15][26]
Although it does not prove the allegations, the parallel between rapid growth
in organ transplants and the mass imprisonment of Falun Gong practitioners is
consistent with the hypothesis that Falun Gong practitioners in custody were
having their organs harvested.
Discrepancy in known sources of organs
Chinese
officials reported in 2005 that up to 95% of organ transplants are sourced from
prisoners.[18]
However, China does not perform enough legal executions to account for the
large number of transplants that are performed, and voluntary donations are
exceedingly rare (only 130 people registered as voluntary organ donors
nationwide from 2003 to 2009[7]).
In
2006, the number of individuals sentenced to death and executed was far fewer
than the number of transplants. Based on publicly available reports, Amnesty
International documented 1,770 executions in 2006; high-end estimates put the
figure closer to 8,000.[65]
Because China lacks an organized organ matching and allocation system, and in
order to satisfy expectations for very short wait times, it is rare that
multiple organs are harvested from the same donor. Moreover, many death row
inmates have health conditions such as hepatitis B that would frequently
disqualify them as organ donors. This suggests the existence of a secondary
source for organs.[16]
United Nations Special
Rapporteur on Torture Manfred
Nowak says “the explanation that most of these organs come from
death row inmates is inconclusive...If so, the number of executed felons must
then be much higher as so far assumed.”[66]
In
a statement before the U.S. House of Representatives, Damon Noto said “the
prisoners sentenced to death cannot fully account for all the transplantations
that are taking place in China [...] Even if they executed 10,000 and
transplanted 10,000 a year, there would still be a very large discrepancy. Why
is that? It is simply impossible that those 10,000 people executed would match
perfectly the 10,000 people that needed the organs.”[67]
David Kilgour and David Matas similarly write that traditional sources of
transplants such as executed prisoners, donors, and the brain dead "come
nowhere near to explaining the total number of transplants across China."
Like Noto, they point to the large number of Falun Gong practitioners in the
labor camp and prison system as a likely alternative source for organs.[15]
Organ transplant wait times
Wait
periods for organ transplants in China are significantly shorter than elsewhere
in the world. According to a 2006 post on the China International
Transplantation Assistance Center website, "it may take only one month to
receive a liver transplantation, the maximum waiting time being two months. As
for the kidney transplantation, it may take one week to find a suitable donor,
the maximum time being one month...If something wrong with the donor's organ
happens, the patient will have the option to be offered another organ donor and
have the operation again in one week."[68]
Other organ transplant centers similarly advertised average wait times of one
or two weeks for liver and kidney transplants.[15][69][70]
This is consistent with accounts of organ transplant recipients, who report
receiving organs a matter of days or weeks.[10][71][72]
By comparison, median wait times for a kidney in developed countries such as
the United States, Canada and Great Britain typically range from two years to
over four years, despite the fact that these countries have millions of
registered organ donors and established systems of organ matching and
allocation.[73][74][75]
Researchers
and medical professionals have expressed concern about the implications of the
short organ transplant wait times offered by Chinese hospitals. Specifically,
they say these wait times are indicative of a pool of living donors whose
organs can be removed on demand.[26]
This is because organs must be transplanted immediately after death, or must be
taken from a living donor (kidneys must be transplanted within 24–48 hours;
livers within 12 hours, and hearts within 8 hours).[76]
Kirk
C. Allison, Associate Director of the Program in Human Rights and Medicine at
the University of Minnesota, wrote
that the "short time frame of an on-demand system [as in China] requires a
large pool of donors pre-typed for blood group and HLA matching," which is
consistent with reports of Falun Gong prisoners having blood and tissue tested
in custody. He wrote that China's short organ wait times could not be assured
on a “random death” basis, and that physicians he queried about the matter
indicated that they were selecting live prisoners to ensure quality and
compatibility.[76]
Dr. Jacob Lavee, Director of the Heart Transplant Unit at the Sheba Medical
Center in Israel, recounts one of his patients traveling to China for a heart
transplant. The patient waited two weeks for a heart, and the surgery was
scheduled in advance—meaning the organ could not have been procured on the
basis of a random death.[77]
Franz Immer, chairman of the Swiss National Foundation for organ donation and
transplantation, reports that during a visit to Beijing in 2007, he was invited
by his Chinese hosts to observe a heart transplantation operation: “The
organizer asked us whether we would like to have the transplantation operation
in the morning or in the afternoon. This means that the donor would die, or be
killed, at a given time, at the convenience of the visitors. I refused to
participate.”[2]
Editors
of the Journal of Clinical
Investigation write that “The only way to guarantee transplant of a
liver or heart during the relatively short time period that a transplant
tourist is in China is to quickly obtain the requisite medical information from
prospective recipients, find matches among them, and then execute a person who
is a suitable match.”[26]
Noto similarly says that China's organ transplant wait times and the ability to
schedule transplants in advance can only be achieved by having a large supply
of “living donors that are available on demand.” Death row inmates alone are
not numerous enough to meet this demand.[67]
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