BLOODY HARVEST
Revised Report into Allegations of Organ Harvesting of
Falun Gong Practitioners in China
by David Matas and David Kilgour
31 January 2007
Table of Contents
A. INTRODUCTION - 1
B. THE ALLEGATION - 1
C. WORKING METHODS - 2
D. DIFFICULTIES OF PROOF - 3
E. METHODS OF PROOF - 5
F. ELEMENTS OF PROOF AND DISPROOF - 6
a) General Considerations - 6
1) Human rights violations - 6
2) Health financing - 8
3) Army financing - 9
4) Corruption - 11
b) Considerations specific to organ harvesting - 12
5) Technological development - 12
6) Treatment of prisoners sentenced to death - 13
7) Organ donations - 14
8) Waiting times - 15
9) Incriminating Information on Websites - 16
10) Donor recipient interviews - 20
11) The money to be made - 21
12) Chinese transplant ethics - 22
13) Foreign transplant ethics - 23
14) Chinese transplant laws - 24
15) Foreign transplant laws - 24
16) Travel Advisories - 25
17) Pharmaceuticals - 26
18) Foreign state funding for care - 27
C) Considerations specific to Falun Gong - 27
19) A perceived threat - 27
20) A policy of persecution - 30
21) Incitement to hatred - 31
22) Physical persecution - 32
23) Massive arrests - 34
24) Deaths - 35
25) Unidentified - 36
26) Blood testing and organ examination - 39
27) Sources of past transplants - 40
28) Sources of future transplants - 44
29) Corpses with missing organs - 46
30) Admissions - 48
31) A confession - 55
32) Corroborating studies - 56
33) Government of China responses - 57
i
G. FURTHER RESEARCH - 59
H. CONCLUSIONS - 60
I. RECOMMENDATIONS - 61
J. COMMENTARY - 64
K. APPENDICES (IN A SEPARATE DOCUMENT) - 66
1. Letter of Invitation from CIPFG - 66
2. Biography of David Matas - 66
3. Biography of David Kilgour - 66
4. Letter to the Embassy of China - 66
5. The Recipient Experience - 66
6. Ethics of Contact with China on Transplants - 66
7. Statements of the Government of China - 66
8. Edmonton Police Report of Willful Promotion of Hatred by Chinese
Consular Officials against Falun Gong -
66
9. Physical Persecution of Falun Gong - 66
10. Names of the Dead - 66
11. Witness Statements on the Unidentified - 66
12. Names of the Missing - 66
13. Blood Testing of Falun Gong Prisoners - 66
14. Transcript of Telephone Investigations - 66
15. Canada, Us and Japan Transplant Statistics in 10 Years - 66
16. Sujiatun - 66
17. Matas-Kilgour Response to the Chinese Government Statements - 66
18. A Confession - 66
19. AI's Records of Number of Executed Prisoners in China Each Year - 66
20. Corpses with Missing Organs - 66
ii
A. Introduction
The Coalition to Investigate the Persecution of the Falun Gong in China
(CIPFG), has
asked us to investigate allegations of organ harvesting of Falun Gong
practitioners in
China. The coalition is a non-governmental organization registered in
Washington,
D.C., U.S.A. with a branch in Ottawa, Canada. The request came formally
by letter
dated May 24, 2006 attached as an appendix to this report.
The request was to investigate allegations that state institutions and
employees of the
government of the People's Republic of China have been harvesting
organs from live
Falun Gong practitioners, killing the practitioners in the process. In
light of the
seriousness of the allegations as well as our own commitment to respect
for human
rights, we accepted the request.
David Matas is an immigration, refugee and international human rights
lawyer in
private practice in Winnipeg. He is actively involved in the promotion
of respect for
human
rights as an author, speaker and participant in several human rights
non-governmental organizations.
David Kilgour is a former member of Parliament and a former Secretary
of State of the
Government of Canada for the Asia Pacific region. Before he became a
parliamentarian, he was a Crown prosecutor. The biographies of both
authors are
attached as appendices to this report.
B. The Allegation
It is alleged that Falun Gong practitioners are victims of live organ
harvesting
throughout China. The allegation is that organ harvesting is inflicted
on unwilling
Falun Gong practitioners at a wide variety of locations, pursuant to a
systematic
policy, in large numbers.
Organ harvesting is a step in organ transplants. The purpose of organ
harvesting is to
provide organs for transplants. Transplants do not necessarily have to
take place in
the same place as the location of the organ harvesting. The two
locations are often
different; organs harvested in one place are shipped to another place
for
transplanting.
The allegation is further that the organs are harvested from the
practitioners while
they are still alive. The practitioners are killed in the course of the
organ harvesting
operations or immediately thereafter. These operations are a form of
murder.
Finally, we are told that the practitioners killed in this way are then
cremated. There
is no corpse left to examine to identify as the source of an organ
transplant.
C. Working Methods
We conducted our investigation independently from the Coalition to
Investigate the
Persecution of the Falun Gong in China, the Falun Dafa Association, any
other
organization, and any government. We sought to go to China
unsuccessfully, but
would be willing to go even subsequently to pursue the investigation.
When we began our work, we had no views whether the allegations were
true or
untrue. The allegations were so shocking that they are almost
impossible to believe.
We
would have much rather found the allegations to be untrue than to be
true. The
allegations, if true, represent a disgusting form of evil which,
despite all the
depravities humanity has seen, are new to this planet. The very horror
made us reel
back in disbelief. But that disbelief does not mean that the
allegations are untrue.
- 2
We were well aware of the statement of U.S. Supreme Court Justice Felix
Frankfurter
1943 to a Polish diplomat in reaction to being told by Jan Karski about
the Holocaust.
Frankfurter said:
"I did not say that this young man was lying. I said that I was unable
to believe
what he told me. There is a difference."
After the Holocaust, it is impossible to rule out any form of
depravity. Whether an
alleged evil has been perpetrated can be determined only by considering
the facts.
After the first version of our report was released, on July 7, 2006 in
Ottawa, we
travelled extensively, publicising the report and promoting its
recommendations. In
the course of our travels, and as a result of the publicity surrounding
the first version,
we acquired substantial additional information. This second version
incorporates this
new information.
Nothing we subsequently discovered shook our conviction in our original
conclusions.
But much which we later discovered reinforced it. This version
presents, we believe,
an even more compelling case for our conclusions than the first version
did.
D. Difficulties of proof
The allegations, by their very nature, are difficult either to prove or
disprove. The
best evidence for proving any allegation is eye witness evidence. Yet
for this alleged
crime, there is unlikely to be any eye witness evidence.
The people present at the scene of organ harvesting of Falun Gong
practitioners, if it
does occur, are either perpetrators or victims. There are no
bystanders. Because the
victims,
according to, the allegation are murdered and cremated, there is no
body to
be found, no autopsy to be conducted. There are no surviving victims to
tell what
- 3
happened to them. Perpetrators are unlikely to confess to what would
be, if they
occurred, crimes against humanity. Nonetheless, though we did not get
full scale
confessions, we garnered a surprising number of admissions through
investigator
phone calls.
The scene of the crime, if the crime has occurred, leaves no traces.
Once an organ
harvesting is completed, the operating room in which it takes place
looks like any
other empty operating room.
The clampdown on human rights reporting in China makes assessment of the
allegations difficult. China, regrettably, represses human rights
reporters and
defenders. There is no freedom of expression. Those reporting on human
rights
violations from within China are often jailed and sometimes charged with
communicating state secrets. In this context, the silence of human
rights
non-governmental organizations on organ harvesting of unwilling Falun
Gong
practitioners tells us nothing.
The International Committee of the Red Cross is not allowed to visit
prisoners in
China. Nor is any other organization concerned with human rights of
prisoners. That
also cuts off a potential avenue of evidence.
China has no access to information legislation. It is impossible to get
from the
Government of China basic information about organ transplants - how many
transplants there are, what is the source of the organs, how much is
paid for
transplants or where that money is spent.
We did seek to visit China for this report. Our efforts went nowhere.
We asked in
writing for a meeting with the embassy to discuss terms of entry. Our
letter is
attached as an appendix to this report. Our request for a meeting was
accepted. But
the person who met with David Kilgour was interested only in denying
the allegations
- 4
and not in arranging for our visit.
E. Methods of proof
We have had to look at a number of factors, to determine whether they
present a
picture, all together, which make the allegations either true or
untrue. None of these
elements on its own either establishes or disproves the allegations.
Together, they
paint a picture.
Many of the pieces of evidence we considered, in themselves, do not
constitute
ironclad proof of the allegation. But their non-existence might well
have constituted
disproof. The combination of these factors, particularly when there are
so many of
them, has the effect of making the allegations believable, even when
any one of them
in isolation might not do so. Where every possible element of disproof
we could
identify fails to disprove the allegations, the likelihood of the
allegations being true
becomes substantial.
Proof can be either inductive or deductive. Criminal investigation
normally works
deductively, stringing together individual pieces of evidence into a
coherent whole.
The limitations our investigation faced placed severe constraints in
this deductive
method. Some elements from which we could deduce what was happening
were,
nonetheless, available, in particular, the investigator phone calls.
We also used inductive reasoning, working backwards as well as
forwards. If the
allegations were not true, how would we know it was not true? If the
allegations
were true, what facts would be consistent with those allegations? What
would explain
the reality of the allegations, if the allegations were real? Answers
to those sorts of
questions helped us to form our conclusions.
- 5
We also considered prevention. What are the safeguards that would
prevent this sort
of activity from happening? If precautions are in place, we could
conclude that it is
less likely that the activity is happening. If they are not in place,
then the possibility
that
the activity is happening increases.
F. Elements of Proof and Disproof
a) General Considerations
1) Human rights violations
China violates human rights in a variety of ways. These violations are
chronic and
serious. Besides Falun Gong, other prime targets of human rights
violations are
Tibetans, Christians, Uighurs, democracy activists and human rights
defenders. Rule
of Law mechanisms in place to prevent human rights violations, such as
an
independent judiciary, access to counsel on detention, habeas corpus,
the right to
public trial, are absent in China. China, according to its
constitution, is ruled by the
Communist Party. It is not ruled by law.
Communist China has had a history of massive, jaw dropping cruelty
towards its own
citizens. The Communist regime has killed more innocents than Nazi
Germany and
Stalinist Russia combined1. Girl children are killed, abandoned and
neglected in
massive numbers. Torture is widespread. The death penalty is both
extensive and
arbitrary. China executes more people than all other countries
combined. Religious
belief is suppressed2.
This pattern of human rights violations, like many other factors, does
not in itself
1 The Black Book of Communism, Harvard University Press (1999), Jung
Chand
and Jon Halliday Mao: The Unknown Story, Knopf, 2005.
2 See Amnesty International and Human Rights Watch annual reports for
China.
- 6
prove the allegations. But it removes an element of disproof. It is
impossible to say
of these allegations that it is out of step with an overall pattern of
respect for human
rights in China. While the allegations, in themselves, are surprising,
they are less
surprising with a country that has the human rights record China does
than they
would be for many other countries.
When there are so many violations of human rights in China, it is
invidious to point to
only
one victim. We nonetheless draw the attention to the victimization of
human
rights lawyer Gao Zhisheng as an example or a case study. It was Gao
who wrote to
us last summer, inviting us to come to China to investigate the
stealing of vital organs
from Falun Gong prisoners of conscience. No visa was subsequently
issued by its
embassy in Ottawa to do so; he was detained not long afterwards.
Gao wrote three open letters to President Hu and other leaders,
protesting a range of
abuses against the Falun Gong, including specific cases of torture and
murder. Gao
also wrote about and condemned the extraction and sale of organs from
Falun Gong
practitioners. He expressed his willingness to join the Coalition to
Investigate Organ
Harvesting from Still Alive People3.
He was convicted of inciting subversion and on December 2, 2006 given a
three-year
prison sentence. His removal to custody, however, was suspended for
five years; his
political rights were removed for a year by the Beijing court. This
repression of
someone whose only concern is respect for human rights in general and
the
persecution of Falun Gong practitioners in particular in itself
reinforces his concerns
and ours.
The International Olympic Committee, in 2001, awarded Beijing the 2008
Olympics.
3 "The CCP Should Be Condemned for Criminalizing Gao Zhisheng for
Writing to
The Epoch Times" The Epoch Times, December 24, 2006
- 7
Liu Jingmin, Vice President of the Beijing Olympic Bid, in April 2001,
said: "By allowing
Beijing to host the Games you will help the development of human
rights."
Yet, the result has been just the opposite. Amnesty International, in a
statement
released September 21, 2006 said:
"In its latest assessment of the Chinese government's performance in
four
benchmark areas of human rights ahead of the Olympics, Amnesty
International found that its overall record remained poor. There has
been
some
progress in reforming the death penalty system, but in other crucial
areas
the government's human rights record has deteriorated."
The international community, by carrying on with the Olympics in
Beijing despite the
deterioration of human rights in China in crucial areas, sends to China
a message of
impunity. The impression China must get is that it does not matter how
much it
violates human rights; the international community seems not to care.
2) Health financing
When China moved from a socialist to a market economy, the health
system was part
of the shift. From 1980, China began withdrawing government funds from
the health
sector, expecting the health system to make up the difference through
charges to
consumers of health services. Since 1980, government spending dropped
from 36%
of all health care expenditure to 17%, while patients' out-of-pocket
spending rocketed
up from 20% to 59%.4 A World Bank study reports that reductions in
public health
coverage were worsened by increases in cost by the private sector5.
According to cardiovascular doctor Hu Weimin, the state funding for the
hospital
where he works is not enough to even cover staff salaries for one
month. He stated:
"The high price of illness in China", Louisa Lim, BBC News, Beijing,
2006/03/025 "Public Health in China: Organization, Financing and
Delivery of Services".
- 8
"Under the current system, hospitals have to chase profit to survive."
Human Rights
in China reports: "Rural hospitals [have had] to invent ways to make
money to
generate sufficient revenue".6
The sale of organs became for hospitals a source of funding, a way to
keep their
doors open, and a means by which other health services could be
provided to the
community.
One could see how this dire need for funds might lead first to a
rationalization that
harvesting organs from prisoners who would be executed anyways was
acceptable
and
second to a desire not to question too closely whether the donors
wheeled in by
the authorities really were prisoners sentenced to death.
3) Army financing
The military, like the health system, has gone from public financing to
private
enterprise. The military in China is a conglomerate business. This
business is not
corruption, a deviation from state policy. It is state sanctioned, an
approved means of
raising money for military activities. In 1985, then President Deng
Xiaoping issued a
directive allowing the People's Liberation Army units to earn money to
make up the
shortfall in their declining budgets.
Many of the transplant centres and general hospitals in China are
military institutions,
financed by organ transplant recipients. Military hospitals operate
independently from
the Ministry of Health. The financing they earn from organ transplants
does more
than pay the costs of these facilities. The money is used to finance
the overall military
budget.
July 27, 2005, Jeffrey P. Koplan
"Implementation of the International Covenant on Economic Social and
Cultural Rights in the People's Republic of China", April 14, 2005,
paragraph 69, page 24.
- 9
There is, for instance, the Organ Transplant Center of the Armed Police
General
Hospital in Beijing. This hospital boldly states:
"Our Organ Transplant Center is our main department for making money.
Its
gross income in 2003 was 16,070,000 yuan. From January to June of 2004
income was 13,570,000 yuan. This year (2004) there is a chance to break
through 30,000,000 yuan."7
Military involvement in organ harvesting extends into civilian
hospitals. Recipients
often tell us that, even when they receive transplants in civilian
hospitals, those
conducting the operation are military personnel.
Here is one example. When we were in Asia promoting our report, we met
a man
who
in 2003 flew to Shanghai to obtain a new kidney for the RMB 20,000 price
negotiated before his departure. He was admitted to the No 1 Peoples'
Hospital-a
civilian facility-and during the ensuing two weeks four kidneys were
brought for
testing against his blood and other factors. None proved compatible
because of his
anti-bodies; all were taken away.
He subsequently went to his home country, returning to the hospital
about two
months later. Another four kidneys were similarly tested; when the
eighth proved
compatible, the transplant operation was successfully completed. His
eight days of
convalescence was done at No 85 hospital of the Peoples' Liberation
Army. His
surgeon was Dr. Tan Jianming of the Nanjing military region, who wore
his army
uniform at times in the civilian hospital.
7 <
http://www.309yizhi.com/webapp/center/intro.jsp>.
This page was
available in early July, 2006 and has been removed afterwards. The
archived page is at
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fwww.309yizhi.com%2Fwe
bapp%2Fcenter%2Fintro.jsp&x=0
&y=0.
- 10
Tan carried sheets of paper containing lists of prospective "donors�,
based on various
tissue and blood characteristics, from which he would select names. The
doctor was
observed at various times to leave the hospital in uniform and return
2-3 hours later
with containers bearing kidneys. Dr. Tan told the recipient that the
eighth kidney
came from an executed prisoner.
The military have access to prisons and prisoners. Their operations are
even more
secretive than those of the civilian government. They are impervious to
the rule of
law.
4) Corruption
Corruption is a major problem across China. State institutions are
sometimes run for
the benefit of those in charge of them rather than for the benefit of
the people.
Occasionally, China engages in "Strike Hard" against corruption.
But, in the absence of rule of law and democracy, where secrecy holds
sway and
public accounting of public funds is absent, these anti-corruption
campaigns seem to
be more power struggles than true anti-corruption drives. They are
attempts to
placate public concern about corruption, politicized public relations
drives.
The sale of organs is a money driven problem. But that is different
from saying that it
is a corruption problem. The sale of organs from unwilling donors
combines hatred
with greed. A state policy of persecution is acted out in a financially
profitable way.
Former Chinese president Deng Xiaoping said: "To get rich is glorious".
He did not
say that some ways of getting rich are shameful.
Profiteering hospitals take advantage of a defenceless captive prison
population in
their regions. The people are in prison without rights, at the
disposition of the
- 11
authorities. The incitement to hatred against prisoners and their
dehumanization
means that they can be butchered and killed without qualms by those who
buy into
this official hate propaganda.
b) Considerations specific to organ harvesting
5) Technological development
Albert Einstein wrote:
"The release of atom power has changed everything except our way of
thinking...the solution to this problem lies in the heart of mankind.
If only I had
known, I should have become a watchmaker."
Technological developments do not change human nature. But they do
change the
ability to inflict harm.
The development of transplant surgery has done much to improve the
ability of
humanity
to cope with failing organs. But these developments in transplant
surgery
have not changed our way of thinking.
There is a tendency to think of any new medical development as a
benefit to
humanity. That is certainly the intent of its developers. But medical
research, no
matter how far advanced, comes face to face with the same old capacity
for good and
evil.
More advanced techniques in transplant surgery do not mean a more
advanced
Chinese political system. The Chinese Communist system remains.
Developments in
transplant surgery in China fail prey to the cruelty, the corruption,
the repression
which pervades China. Advances in transplant surgery provide new means
for old
cadres to act out their venality and ideology.
- 12
We do not suggest that those who developed transplant surgery should
instead have
become watchmakers. We do suggest that we should not be so naive as to
think that
just because transplant surgery was developed to do good, it can do no
harm.
On the contrary, the allegation made against the development of
transplant surgery in
China, that it is being used to harvest organs from unwilling Falun
Gong practitioners,
would be just the acting out, in a new context, of the lesson Albert
Einstein was
teaching. We have seen before that modern technologies developed for
the benefit of
humanity have been perverted to inflict harm. We should not be
surprised if this has
also happened to transplant surgery.
6) Treatment of prisoners sentenced to death
Deputy Health Minister Huang Jiefu, speaking at a conference of
surgeons in the
southern city of Guangzhou in mid November 2006 acknowledged that
executed
prisoners sentenced to death are a source of organ transplants. He
said: "Apart from
a small portion of traffic victims, most of the organs from cadavers
are from executed
prisoners." Asia News wrote:
"'Under-the-table
business must be banned,' Mr Huang said cognizant
that too often organs come from non consenting parties and are sold for
high fees to foreigners."
China has the death penalty for a large number of offences including
strictly political
and economic crimes where there is no suggestion that the accused has
committed a
violent act. To go from executing no one to killing Falun Gong
practitioners for their
organs without their consent is a large step. To go from executing
prisoners
sentenced to death for political or economic crimes and harvesting
their organs
without their consent to killing Falun Gong practitioners for their
organs without their
consent is a good deal smaller step.
- 13
It would be difficult to believe that a state which killed no one,
which had no death
penalty, which harvested the organs of no one else without their
consent, would
harvest the organs of Falun Gong practitioners without their consent.
It is a good
deal easier to believe that a state which executes prisoners sentenced
to death for
economic or political crimes and harvests their organs without their
consent would
also kill Falun Gong practitioners for their organs without their
consent.
The Falun Gong constitutes a prison population who the Chinese
authorities vilify,
dehumanize, depersonalize, marginalize even more than executed
prisoners sentenced
to death for criminal offences. Indeed, if one considers only the
official rhetoric
directed against the two populations, it would seem that the Falun Gong
would be a
target for organ harvesting even before prisoners sentenced to death.
7) Organ donations
China has no organized system of organ donations.89 In this it is
unlike every other
country engaged in organ transplant surgery. Donations from living
donors are
allowed for family members.
We are told that there is a Chinese cultural aversion to organ
donation. Yet, Hong
Kong
and Taiwan, with essentially the same culture, have active organ
donation
programs.
The absence of an organ donation system in China tells us two things.
One is that
organ donations are not a plausible source for organ transplants in
China.
8 http://www.chinadaily.com.cn/china/2006-05/05/content_582847.htm
(2006-05-05, China Daily) English
Archived page:
http://archive.edoors.com/content5.php?uri=http://www.chinadaily.com.cn/china/2006-05/05/content_582847.htm
9 http://www.transplantation.org.cn/html/2006-04/467.html
Life weekly, 2006-04-07
Archived page:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fwww.transplantation.org.cn%2Fhtml%2F200604%2F467.html+&x=26&y=11
- 14
Because of the culture aversion to organ donation in China, even an
active organ
donation system would have difficult supplying the volume of
transplants now
occurring in China. But the problem is compounded when there is not
even an active
effort to encourage donations.
Donations matter in other countries because donations are the primary
source of
organs for transplants. We can conclude that from the absence of a
serious effort to
encourage donations in China that, for China, donations do not even
matter. China
has
such a plethora of organs available for transplants without donations
that
encouraging organ donations becomes superfluous.
The absence of a serious effort to encourage organ donations in
combination with
short waiting times for transplant surgery in China and the large
volume of transplants
tells us that China is awash in living organs for transplant; people
the authorities have
ready on hand to be killed for their organs for transplants. That
reality does nothing
to dispel the allegation of organ harvesting of unwilling Falun Gong
practitioners.
8) Waiting times
Hospital web sites in China advertise short waiting times for organ
transplants.
Transplants of long dead donors are not viable because of organ
deterioration after
death. If we take these hospital's self-promotions at face value, they
tell us that there
are a large number of people now alive who are available on demand as
sources of
organs.
The wait times for organ transplants for organ recipients in China are
much lower than
anywhere else. The China International Transplantation Assistant Centre
website says,
"It may take only one week to find out the suitable (kidney) donor, the
maximum time
- 15
being one month...�10. It goes further, "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." 11 The site of the Oriental Organ
Transplant Centre
in early April, 2006, claimed that "the average waiting time (for a
suitable liver) is 2
weeks." 12 The website of the Changzheng Hospital in Shanghai says:
"...the average
waiting time for a liver supply is one week among all the patients". 13
In contrast, the median waiting time in Canada for a kidney was 32.5
months in 2003
and in British Columbia it was even longer at 52.5 months.14 The
survival period for a
kidney
is between 24-48 hours and a liver about 12 hours.15 The presence of a
large
bank of living kidney-liver "donors" must be the only way China's
transplant centres
can assure such short waits to customers. The astonishingly short
waiting times
advertised for perfectly-matched organs would suggest the existence of
a large bank
of live prospective 'donors'.
9) Incriminating Information on Websites
Some of the material available on the websites of various transplant
centres in China
before March 9, 2006 (when allegations about large-scale organ seizures
resurfaced in
10 http://en.zoukiishoku.com/list/qa2.htm
Archived page:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Fqa2.htm&x=19&y=1
1
11 http://en.zoukiishoku.com/list/volunteer.htm
Archived at:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Fvolunteer.htm+&x=8&y=9
12 The front page has been altered. The archived page is at:
http://archive.edoors.com/content5.php?uri=http://www.ootc.net/special_images/ootc1
.png
13 http://www.transorgan.com/apply.asp
Archived at :
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fwww.transorgan.com%2Fapply.asp&x=15&y=8
14 Canadian Organ Replacement Register, Canadian Institute for Health
Information,
(http://www.cihi.ca/cihiweb/en/downloads/CORR-CST2005_Gill-rev_July22_2005.ppt),
July 2005
15 Donor Matching System, The Organ Procurement and Transplantation
Network (OPTN)
http://www.optn.org/about/transplantation/matchingProcess.asp
- 16
Canadian and other world media) is also inculpatory. Understandably, a
good deal of it
has since been removed. So these comments will refer only to sites that
can still be
found at archived locations, with the site locations being identified
either in the
comments or as footnotes. A surprising amount of self-accusatory
material was still
available as of the final week of June, 2006 to web browsers. We list
here only four
examples:
(1) China International Transplantation Network Assistance Centre
Website
(http://en.zoukiishoku.com/)
(Shenyang City)
This website as of May 17, 2006 indicated in the English version (the
Mandarin one
evidently disappeared after March 9) that the centre was established in
2003 at the
First
Affiliated Hospital of China Medical University "...specifically for
foreign friends.
Most of the patients are from all over the world." The opening sentence
of the site
16 introduction declares that "Viscera (one dictionary definition:
"soft interior
organs...including the brain, lungs, heart etc") providers can be found
immediately!"
On another page17 on the same site is this statement: "...the number of
kidney
transplant operations is at least 5,000 every year all over the
country. So many
transplantation operations are owing to the support of the Chinese
government. The
supreme demotic court, supreme demotic law - officer, police,
judiciary, department of
health and civil administration have enacted a law together to make
sure that organ
donations are supported by the government. This is unique in the world."
16 The original page has been altered. Older versions can still be
found at Internet Archive:
http://web.archive.org/web/20050305122521/http://en.zoukiishoku.com/
17 http://en.zoukiishoku.com/list/facts.htm
or use archived version at:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Ffacts.htm&x=24&y=
- 17
In the 'question and answer' section of the site are found:
"Before the living kidney transplantation, we will ensure the donor's
renal function...So
it is more safe than in other countries, where the organ is not from a
living donor." 18
. "Q: Are the organs for the pancreas transplant(ed) from brain death
(sic) (dead)
patients?"
"A: Our organs do not come from brain death victims because the state
of the
organ may not be good." 19
(2)Orient Organ Transplant Centre Website
(http://www.ootc.net)
(Tianjin City)
On a page we were informed was removed in mid-April (but can still be
located as an
archive 12) is the claim that from "January 2005 to now, we have done
647 liver
transplants - 12 of them done this week; the average waiting time is 2
weeks." A
chart also removed about the same time (but archive still available20)
indicates that
from virtually a standing start in 1998 (when it managed only 9 liver
transplants) by
2005 it had completed fully 224821 .
18 http://en.zoukiishoku.com/list/qa.htm
or use archived version:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Fqa.htm&x=27&y=10
19 http://en.zoukiishoku.com/list/qa7.htm
or use archived version:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Fqa7.htm&x=35&y=1
20 The front page has been altered. Archived at:
http://archive.edoors.com/content5.php?uri=http://www.ootc.net/special_images/ooct_achievement.jpg
http://archive.edoors.com/content5.php?uri=http://www.ootc.net/special_images/ootc2.png
21 The front page has been altered. Archived at:
http://archive.edoors.com/content5.php?uri=http://www.ootc.net/special_images/ooct_case.jpg
http://archive.edoors.com/content5.php?uri=http://www.ootc.net/special_images/ootc1.png
- 18
In contrast, according to the Canadian Organ Replacement Register 14,
the total in
Canada for all kinds of organ transplants in 2004 was 1773.
(3) Jiaotong University Hospital Liver Transplant Centre Website
(http://www.firsthospital.cn/hospital/index.asp)
(Shanghai - This is #5 in the list of telephoned centres)
In a posting on April 26, 2006, 22
(http://www.health.sohu.com/20060426/n243015842.shtml),
the website says in part:
"The liver transplant cases (here) are seven in 2001, 53 cases in 2002,
105 cases in
2003,
144 cases in 2004, 147 cases in 2005 and 17 cases in January, 2006," .
(4) Website of Changzheng Hospital Organ Transplant Centre, affiliated
with No. 2
Military Medical University
(http://www.transorgan.com/)
(Shanghai)
A page was removed after March 9, 2006. (Internet Archive page is
available.23) It
contains the following graph depicting the number of liver transplant
each year by this
22 http://www.health.sohu.com/20060426/n243015842.shtml
Archived at:
http://archive.edoors.com/content5.php?uri=http://health.sohu.com/52/81/harticle15198152.shtml
23 The URL of the removed page as of March 2005 in the Internet Archive
is
http://web.archive.org/web/20050317130117/http://www.transorgan.com/about_g_intro.asp
- 19
Centre:
In the "Liver Transplant Application" form 24, it states on the top,
"...Currently, for the
liver transplant, the operation fee and the hospitalization expense
together is about
200,000 yuan ($66,667 CND), and the average waiting time for a liver
supply is one
week among all the patients in our hospital...."
10) Donor recipient interviews
For the first version of our report, we did not have time to engage in
donor recipient
interviews, people who went to China from abroad for transplants. For
this version,
we
engaged in extensive interviews of a number of these recipients and
their family
members. Summaries of their experience are attached as an appendix to
this report.
Organ transplant surgery, as described by the recipients and their
relatives, is
conducted in almost total secrecy, as if it were a crime which needed
cover up. As
much information as possible is withheld from the recipients and their
families. They
are not told the identity of the donors. They are never shown written
consents from
the donors or their families. The identity of the operating doctor and
support staff are
24 http://www.transorgan.com/apply.asp
, Archived at :
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fwww.transorgan.com%2Fapply.asp&x=15&y=8
- 20
often not disclosed, despite requests for this information. Recipients
and their families
are commonly told the time of the operation only shortly before it
occurs. Operations
sometimes occur in the middle of the night. The whole procedure is done
on a "don't
ask, don't tell" basis.
When people act as if they have something to hide, it is reasonable to
conclude that
they have something to hide. Since organ sourcing from prisoners
sentenced to death
is widely known and even acknowledged by the Government of China,
Chinese
transplant hospitals can not be trying to hide that. It must be
something else. What
is it?
11) The money to be made
In China, organ transplanting is a very profitable business. We can
trace the money
of the people who pay for organ transplants to specific hospitals which
do organ
transplants,
but we can not go further than that. We do not know who gets the
money the hospitals receive. Are doctors and nurses engaged in criminal
organ
harvesting paid exorbitant sums for their crimes? That was a question
it was
impossible for us to answer, since we had no way of knowing where the
money went.
China International Transplantation Network Assistance Centre Website
(http://en.zoukiishoku.com/)
(Shenyang City)
Before its indicated removal from the site 25 in April, 2006, the size
of the profits for
transplants was suggested in the following price list:
Kidney US$62,000
Liver US$98,000-130,000
25 Yet, one can still go to the Internet Archive to find the
information on this website from March 2006:
http://archive.edoors.com/render.php?uri=http%3A%2F%2Fen.zoukiishoku.com%2Flist%2Fcost.htm+&x=16&y
=11
- 21
Liver-kidney US$160,000-180,000
Kidney-pancreas US$150,000
Lung US$150,000-170,000
Heart US$130,000-160,000
Cornea US$30,000
A standard way of investigating any crime allegation where money
changes hands is
to follow the money trail. But for China, its closed doors mean that
following the
money trail is impossible. Not knowing where the money goes proves
nothing. But it
also disproves nothing, including these allegations.
12) Chinese transplant ethics
Chinese transplant professionals are not subject to any ethical
strictures separate from
the laws which govern their work. Many other countries have self
governing
transplant professions with their own disciplinary systems. Transplant
professionals
who
violate ethical guidelines can be ejected from their profession by
their colleagues
without any state intervention.
For transplant professionals in China, we found nothing of the sort.
When it comes to
transplant surgery, as long as the state does not intervene, anything
goes. There is
no independent supervisory body exercising disciplinary control over
transplant
professionals independent of the state.
The Wild West system of transplant surgery in China makes it easier for
abusive
practices to occur. State involvement and criminal prosecution are
inevitably less
systematic than professional discipline. Because the penalties for
criminal
prosecution are greater than the penalties for professional discipline
- potential jail
time rather than just barring someone from the profession - prosecution
cases are
more rare than discipline cases.
- 22
The absence of a functioning transplant professional discipline system
does not mean
that abuses are occurring. But it certainly makes it more likely that
they will occur.
13) Foreign transplant ethics
There are huge gaps in foreign transplant ethics. In many of the
countries from
which transplant tourism to China originates, transplant professionals
have organized
ethical and disciplinary systems. But it is rare for these systems to
deal specifically
with either transplant tourism or contact with Chinese transplant
professionals or
transplants from executed prisoners. The watch words here seem to be
"out of sight,
out of mind".
On transplant tourism, the Professional Code of Conduct of the Medical
Council of
Hong Kong has two principles, in particular, worth emphasizing. One is
that, "if there
is doubt" as to whether the consent is given freely or voluntarily by
the donor, the
profession should have nothing to do with the donation. And, the very
least one can
say about China, in light of the fact that "almost all" transplants
come from prisoners,
is
that there is doubt in almost every case whether the consent is given
freely or
voluntarily by the donor.
The second is that the onus is on the foreign professionals to
ascertain the status of
the Chinese donor. The foreign professional is not acting ethically as
long as he or
she makes no inquiries or only cursory ones. The foreign professional,
after
investigation, has to be satisfied beyond any doubt before referring a
patient to China
that consent was given freely or voluntarily by the donor.
The organ harvesting market in China, in order to thrive, requires both
a supply and a
demand. The supply comes from China, from prisoners. But the demand, in
large
part, in big bucks, comes from abroad.
- 23
In an appendix, we present a critical analysis of the ethics of contact
with China on
transplants. The Hong Kong principles are the exception rather than the
rule. Global
professional ethics do little or nothing to staunch the foreign demand
for organs from
China.
14) Chinese transplant laws
Until July 1st, 2006, the practice of selling organs in China was
legal. A law banning
their sale came into effect on that date.
In China there is a huge gap between enacting legislation and enforcing
it. To take
one example, the preamble of the Constitution of China promises for
China a "high
level" of democracy. But, as the Tiananmen square massacre
demonstrated, China is
not democratic.
Indeed from what we can tell, the law on organ transplants is not now
being
enforced. Belgian senator Patrik Vankrunkelsven, in late November 2006,
called two
different hospitals in Beijing pretending to be a customer for a kidney
transplant.
Both hospitals offered him a kidney on the spot for 50,000 euros.
As noted earlier, Deputy Health Minister Huang Jiefu in November 2006
decried the
selling of organs from executed prisoners sentenced to death saying
"Under-the-table
business
must be banned". Yet, it was already banned, on July 1. His speech must
be taken as an official acknowledgment that the ban is not working.
15) Foreign transplant laws
The sort of transplants in which the Chinese medical system engages is
illegal
everywhere else in the world. But it is not illegal for a foreigner in
any country to go
to China, benefit from a transplant which would be illegal back home,
and then return
- 24
home. Foreign transplant legislation everywhere is territorial. It does
not have
extraterritorial reach.
Many other laws are global in their sweep. For instance, child sex
tourists can be
prosecuted not just in the country where they have sex with children,
but, in many
countries, back home as well. This sort of legislation does not exist
for transplant
tourists who pay for organ transplants without bothering to determine
whether the
organ donor has consented.
There have been some legislative initiatives. For instance, Belgian
senator Patrik
Vankrunkelsven is proposing an extraterritorial criminal law which
would penalize
transplant tourists who purchase organs abroad where the donors are
prisoners or
missing persons. But these legislative proposals are still in an early
stage.
16) Travel Advisories
Many states have travel advisories, warning their citizens of the
perils in travel to one
country to another. The advisories often warn of political violence, or
even weather
related problems. But no government has posted a travel advisory about
organ
transplants in China, warning its citizens that, in the words of The
Transplantation
Society, "almost all" organs in China come from prisoners.
Some, and we would hope, many would-be recipients of organ transplants
would
hesitate to go to China for transplants if they knew that their organs
were coming
from people who were non-consenting prisoners. But right now there is
no systematic
communication
to would be recipients of the source of organs in China, either through
governments or the medical profession
For instance, the Canadian travel advisory for China, posted on the
Foreign Affairs
web site gives extensive information, almost 2,600 words, and has a
section about
- 25
health. But organ transplants are not mentioned.
17) Pharmaceuticals
Organ transplantation surgery relies on anti-rejection drugs. China
imports these
drugs from the major pharmaceutical companies.
Transplant surgery used to require both tissue and blood type matching
for the
transplant to succeed. The development of transplant anti-rejection
drugs has
allowed for transplant surgery to circumvent tissue matching. It is
possible, with
heavy use of anti-rejection drugs, to transplant from a donor to a
recipient whose
tissues do not match. Only blood type matching is essential. Tissue
matching is
preferable, to avoid heavy reliance on anti-rejection drugs, but no
longer essential.
The Chinese medical system relies heavily on anti-rejection drugs.
International pharmaceutical companies behave towards the Chinese
transplantation
system the same way everyone else does. They ask no questions. They
have no
knowledge whether their drugs are being used in recipients who received
organs from
involuntary donor prisoners or not.
Many countries have export control acts, forbidding the export of some
products
altogether and requiring state permission for the export of other
products. But no
state, to our knowledge, prohibits export to China of anti-rejection
drugs used for
organ transplant patients.
For instance, the Canadian Export and Import Permits Act provides:
"No person shall export or attempt to export any goods included in an
Export
Control List or any goods to any country included in an Area Control
List except
under
the authority of and in accordance with an export permit issued under
- 26
this Act."26
But anti-rejection drugs for transplants are not included in the Area
Control list for
China.
18) Foreign state funding for care
Some state administered health plans pay for health care abroad in the
amount that
would be paid if the care were administered in the home country. Where
that
happens, there is not, to our knowledge, in any country a prohibition
of payment
where the patient obtains an organ transplant in China.
Transplant tourists need aftercare in their home country. They continue
to need
prescription and administration of anti-rejection drugs. States which
provide
government funding for health services typically provide funding for
this sort of after
care.
Again here, to the funders how the organ recipient got the organ is a
matter of
indifference. The fact that the organ may have came from an
unconsenting prisoner
in China who was killed for the organ is simply not relevant to foreign
state funding of
aftercare for the recipient.
C) Considerations specific to Falun Gong
19) A perceived threat
The overwhelming majority of prisoners of conscience in Chinese prisons
are Falun
Gong. An estimated two thirds of the torture victims in Chinese prisons
are Falun
Gong. The extremes of language the Chinese regime uses against the
Falun Gong are
unparalleled, unmatched by the comparatively mild criticisms China has
of the victims
26 Section 13.
- 27
the West is used to defending. The documented yearly arbitrary killings
and
disappearances of Falun Gong exceed by far the totals for any other
victim group.
Why does the Chinese government denounce so viciously and repress so
brutally this
one group, more so than any other victim group? The standard Chinese
refrain about
the Falun Gong is that it is an evil cult.