Now, a paper just published in the American Journal of Transplantation — one of the world’s most respected medical journals — lays out a convincing case that Chinese doctors are not only harvesting from executed prisoners, but that organ removal was often the means of execution.
First, they explain how killing by organ retrieval violates the “dead donor rule.” From “Execution by Organ Procurement: Breaching the Dead Donor Rule in China:”
A core value in medical ethics is the principle of ‘do no harm,’ famously captured in the Hippocratic Oath. This principle motivates two widespread professional medical prohibitions: the dead donor rule (DDR), which forbids the procurement of vital transplant organs from living donors, and the injunction against physician participation in executions.
But in China, almost all organ donations come from prisoners, raising the worry that the organ-removal surgeon was also the executioner. To discern whether this abhorrent practice is happening in China, the authors reviewed published papers by Chinese organ-procurement surgeons. They focused on heart and lung “donations” and found that 71 papers published between 1980 and 2015 involved cases that pointed to organ removal as the cause of death because a proper “brain death” determination could not have been made (my emphasis):
The 71 papers we identify almost certainly involved breaches of the DDR because in each case the surgery, as described, precluded a legitimate determination of brain death, an essential part of which is the performance of the apnea test, which in turn necessitates an intubated and ventilated patient. In the cases where a face mask was used instead of intubation—or a rapid tracheotomy was followed immediately by intubation, or where intubation took place after sternal incision as surgeons examined the beating heart—the lack of prior determination of brain death is even more apparent…
Apart from the timing of intubation around BDD, there are two other indications of problematic BDD in the papers. These are: (1) establishing venous lines for introducing heparin around intubation time, and (2) injecting heparin intramuscularly. If the donor was a genuine brain-dead patient, venous lines would already have been established before BDD as part of antemortem treatment—they are never established just before organ procurement. The reference to intramuscular injection of heparin suggests that the donor had no peripheral venous lines before surgery and may even have been ambulant. This is consistent with eyewitness testimony about organ procurement from prisoners but it is not consistent with standard procurement procedures in brain dead donors.
Oops. There’s no such thing as a perfect crime.
Interestingly, perhaps indicating a guilty conscience, Chinese doctors ceased writing such papers after 2015:
There are several potential explanations for this. The most benign is that the reform program indeed ceased the use of prisoners, and thus these abuses. Alternatively, it may be because grassroots human rights activists and researchers exposed DDR violations in September 2014, and PRC officials are attentive to international perceptions. Instructions to state-managed medical journals to cease publishing such details could have been issued, and this could explain the absence of such admissions past 2015.
Another indication is the continuing short waiting times for organs in China:
In the medical literature, China is thought to be the second-largest transplant country in the world as measured by absolute transplant volume, behind the United States. According to human rights researchers however, China performs even more transplants than the United States (which reported over 39 000 in 2020).
PRC hospitals continue to advertise transplant waiting times of weeks, whereas wait times in the United States are measured in months and years. Hospitals continue to advertise organs to transplant tourists with websites in English, Russian, and Arabic. Chinese authorities now say they will be performing 50 000 transplants by 2023—allegedly all from voluntary donors. If this transpires, China will be operating the most successful and rapidly growing voluntary transplant program in the world.
To all of that, I would add that a country that engages in genocide and the enslavement of Uyghurs is not going to be overly concerned with medical ethics.
Oh yes. It is worth noting that some utilitarian bioethicists have suggested that with the legalization of euthanasia that organ removal be allowed to be the means of causing death. They would object, I assume, to killing prisoners in this manner because there would be no assurance of consent. And there is no indication such barbarism actually happens in the West.
But wrong is wrong. Doctors killing people by removing their organs is plain wrong regardless of the circumstances.