Falun Gong Practitioners Systematically Murdered for Their Organs: Refuting the Chinese Regime’s “Death Row” Explanation, Chapter VI

by Ouyang Fei, Sun Sixian, Lin Zhanxiang

(Clearwisdom.net) In 2006, The Epoch Times newspaper broke a stunning story about what is undoubtedly one of the most horrible atrocities to be committed by any government, not only in modern times, but in all of recorded history. As documented in the investigative report, “Bloody Harvest,” by noted human rights lawyer David Matas and former Canadian Secretary of State for the Asia-Pacific region David Kilgour, there is overwhelming evidence of the Chinese Communist regime’s chilling role in systematically murdering Falun Gong practitioners, harvesting their organs while they are alive, and making huge profits from doing so. In response to the international outcry, the Chinese regime has attempted to explain away one of the main pieces of circumstantial evidence–the meteoric rise in the number of organ transplantations in recent years and the extremely short wait times in a culture notoriously averse to organ donation–by stating that it has harvested organs from executed criminals after their deaths. Faced with undeniable evidence, it has attempted to escape culpability for a monstrous atrocity by admitting to a lesser crime. In this report, we will show evidence that directly contradicts this claim and lends further credence to the serious charges leveled against the Chinese regime.

Unprecedented market conditions for organ transplants between 2003 and 2006

By now, the readers may ask: Where did all the extra organs come from? Let us take a look at some unique features of the organ transplant market in China between 2003 and 2006.

1. Extraordinarily short waiting periods previously unseen

According to data published by the United States Department of Health and Human Services, the average waiting period for organs in the U.S. is two years for a liver and three years for a kidney. [27] In China, the waiting period for these organs at some hospitals is calculated in weeks.


The following table shows the average waiting period for organs published by three major organ transplant centers in China during the period of 2003 and 2006 versus that in the U.S. Such an extraordinarily short waiting period points to an extraordinary source of organs.

Average Waiting Period for Organs in China and the U.S.

Oriental Organ Transplant Center

(Tianjin No. 1 Central Hospital)

Organ Transplant Institute of the People’s Liberation Army

(Shanghai Changzheng Hospital)

CITNAC, China International Transplantation Network Assistance Center

(The First Hospital of China Medical University in Shenyang)

U.S. data fromhttp://www.organdonor.gov
Average Waiting Period 2 weeks 1 week for a liver transplant 1-2 months for a liver.

1 week to 1 month for a kidney. If 1stsurgery fails, 2nd surgery within 1 week.

(Liver 2 yrs; Kidney 3 yrs)

230 days for a heart

501 days for a pancreas

796 days for a liver

1,068 days for a lung

1,121 days for a kidney

 

(Source: See Appendix 7)

2. Expensive fees make organ transplants tremendously profitable

While fees for organ transplants vary between different hospitals, they are high across the board. Here is an example of fees for different organ transplants published by CITNAC.

Fees for Organ Transplants (U.S. Dollars)

Kidney transplant $62,000
Liver transplant $98,000 – $130,000
Liver and kidney transplant $160,000 – $180,000
Kidney and pancreas transplant $150,000
Lung transplant $150,000 – $170,000
Heart transplant $130,000 – $160,000

(Source: See Appendix 8)

According to a Phoenix Weekly report in 2006, as more and more overseas patients came to China for organ transplants, the fees gradually increased as well. In 2004, the fee for a liver transplant at the Oriental Organ Transplant Center was USD 32,000 (approximately 250,000 yuan). In 2005, it was over USD 40,000 (approximately 330,000 yuan). Some intermediary agencies charged a brokering fee as high as USD 13,000. In addition, overseas patients had to pay monthly fees to interpreters. Staying in the hospital also cost extra. [28] These extra fees explain the higher numbers listed in the table above.

Expensive fees, along with the cheap supply of organs, made organ transplants tremendously profitable. The Organ Transplant Center of the 309th Hospital of the People’s Liberation Army stated, “The Organ Transplant Center is one of the most profitable departments. Gross income was 16,070,000 yuan for 2003 and 13,570,000 yuan for January through June in 2004. It is expected that the gross income will exceed 30,000,000 yuan in 2005.” [29]

Southern Weekend [Nanfang Zhoumo] reported, “The Oriental Organ Transplant Center’s rapid growth has brought about huge revenue and profits. According to previous media reports, liver transplants alone bring the Center an annual income of 100 million yuan (with the exchange rate at 8.11 yuan per US dollar).” [30] In September 2006, the Center put to use a new building with a price tag of 130 million yuan. The new building has 500 beds with a more than 10,000 overall annual turnover rate. The surgery center in the new building can support the operation of nine liver transplants and eight kidney transplants simultaneously. It is the largest, vertically integrated organ transplant center in Asia.”

Such profit from organ transplants bore a grave consequence. On the one hand, people with financial means are willing to buy organs at a high cost. On the other hand, the huge profit pushes the hospitals to pursue new sources of organs by all means. Given China’s political and legal environment, certain groups of people become especially susceptible targets.

3. China turns into a center for global organ transplant tourism

Given the fees involved, the majority of organ transplant patients in China are made up of:

  1. Overseas patients (global organ transplant tourists)
  2. Rich business owners, celebrities, and Communist government officials in mainland China
  3. A small group of desperate, ordinary patients who exhaust all their financial resources for an organ transplant

According to a Lifeweek magazine report in 2004, most of the domestic patients are those who “have their own businesses or enterprises,” or those who “have positions in the government.” The report also stated that within a few years, thousands of overseas patients had gone to China for organ transplants, turning China into “a center for global organ transplant tourism.” “Besides Korean patients, there are patients from more than 20 countries and regions in Asia such as Japan, Malaysia, Egypt, Pakistan, India, Saudi Arabia, Oman, Hong Kong, Macau, and Taiwan who have come to the Tianjin No. 1 Central Hospital (also known as the Oriental Organ Transplant Center) for organ transplants… The ward café looks like an international conference center where patients of different colors and ethnic backgrounds gather to share their medical experiences.” [31] (In July 2007, the Ministry of Public Health in China put a stop on Chinese hospitals performing organ transplant surgeries on foreign patients.)

4. A niche market within China’s limited organ market takes off

Exorbitant fees did not make the organ transplant market inaccessible. On the contrary, there was an unexpected, rapid growth in China’s organ transplant market starting in 2003, with an annual growth of 5,000 to 10,000 or even more cases of organ transplants.

Every year, approximately 150 million people in China need organ transplants due to late-stage organ failures. The scarcity of organs was worse than that in the United States and other countries that have advanced organ transplant procedures. However, starting in 2003, China turned into a center for global organ transplant tourism due to its abundant source of organs. In a 2004 interview withLifeweek magazine, Zheng Hong, deputy director of the Oriental Organ Transplant Center, proudly stated, “The availability of organs in China is in fact much better than that in other countries.” [32]

So what was happening here?

In China’s unregulated, overall limited organ market (small market), there is a niche market with abundant availability of organs for special patients (big market). We have to understand this “big market within the small market” phenomenon before we can fully understand the true situation of China’s organ market.

In its denial of the allegations of live organ harvesting, the Chinese Communist regime claimed that there were more than 100 million patients in China waiting for organs. It used this as an argument that it was not possible to get matching organs within a short period of time. However, this denial was contradicted by claims at various organ transplant hospitals.

5. High quality organs used for overseas recipients

There were many abnormal phenomena in China’s organ market during the 2003-2006 period. Besides the features discussed above, there is another one worth mentioning. The quality of the organs was not compromised as the quantity of organs increased. On the contrary, the quality of the organs supplied between 2003 and 2006 was superb. During the peak of China’s global organ transplant tourism, the majority of China’s organ transplant recipients were overseas patients. Similar to exported products, the organs used for these patients had much higher requirements.

In the Q&A section on its website, CITNAC provided this answer to the question on organ quality: “The live donor kidney transplant provided in China is completely different from the cadaver donor kidney transplant provided by hospitals and dialysis centers in Japan.” “The key to kidney transplants is tissue matching. Before the live donor kidney transplant surgery, we test the functions of the donor kidney as well as the donor’s white blood cells to ensure the safety of the donor kidney. It is safe to say that compared to a cadaver donor kidney transplant in Japan, kidney transplants are much safer and more reliable here.” (See Appendix 9 for reference.) The ‘live donor’ characteristic is the selling point to attract overseas patients.

Some independent overseas investigators have phoned organ transplant hospitals in mainland China, posing as patients or patient family members, to inquire about organ transplant information. The answers given were similar: “Donors are all healthy,” “Donors are around 30 years old,” “Quality is guaranteed to be the best.” [33]

6. Sudden disappearance of the abundant donor resources after 2006

Under normal conditions, the availability of organs is rather steady, which, as we discussed earlier, is the case for Canada and the United States, where there has been no major increase or sudden decrease in the past decade. A drastic increase of organs was seen between 2003 and 2006 in China. But after the allegations of live organ harvesting of Falun Gong practitioners surfaced and attracted international attention in March 2006, there was a sudden drop in organ transplants in 2007 in China.

While denying the allegations of live organ harvesting of Falun Gong practitioners, the Chinese Communist regime accelerated the reorganization of its organ transplant market. It introduced several acts to regulate organ transplants and restricted the number of organ transplant hospitals to be by “permission only.” Out of more than 600 previously existing organ transplant hospitals, only 160 received permission to continue operations.

Is the reduction in the number of organ transplant hospitals the reason for the reduction in organ transplants? It is certainly not. At least, this is not the root cause. The reduction in the number of permitted hospitals should lessen the competition for organs. If there is no major change to the source of organs, there should now be more organs available to those major hospitals. Yet, the number of organ transplants at these major hospitals has decreased drastically. Therefore, the issue lies in the disappearance of donor resources, rather than the number of organ transplant hospitals.

In an interview with Science Times in May 2007, Shi Bingyi, director of the Organ Transplant Center of the People’s Liberation Army and member of the standing committee of the Chinese Medical Association Organ Transplant Society, said, “The number of organ transplants in China reached a historic peak in 2006, in which nearly 20,000 cases of organ transplants were performed. For the first five months in 2007, the number of organ transplants has decreased compared to that of the same period in 2006, largely due to the shortage in organ donors.” [34]

An article published in Nanfang Zhoumo in July 2007 describes the issue further: “Organ transplant surgeons complained about the shortage of organ donors.” “Zhu Zhijun is the deputy director of the Orient Organ Transplant Center. In his office on the second floor of the Center, Zhu appeared to be worried. He told the reporter that since the Chinese New Year, the Center, which is the biggest organ transplant facility in Asia, has performed only 15 liver transplants in nearly six months, while in 2006, the Center had set a record of more than 600 liver transplants in one year.” [35]

Relatively Stable Supply of Death Row Organs

Earlier we assumed that the number of organs from death row inmates is relatively stable. Prior to 2003 and after 2006, the number was around 6,000. Several factors contributed to this stability:

1) Organ transplant technology and the use of immune depressants matured in the late 1990s. There was no sudden increase in the number of organ transplants as a result of breakthroughs in technology.

2) Matching requirements for organ transplants remain high; technology has not lessened these requirements, making the same organ resource relatively stable.

3) Lack of an organ sharing network in China, which means most of the matches take place between a local hospital and local death row inmates. This and local protectionism have limited the scope of matching.

4) Death row sentencing is in lock-step with political direction. With no recent Strike-Hard campaigns, the number of death row executions is relatively stable.

5) The legitimacy of using death row organs, as well as the moral acceptance among Chinese due to years of indoctrination that organ donation is the least contribution death row inmates could make to society, have allowed the organ transplant hospitals in China to care less about pressures from the international community.

Based on the above reasons, it can be concluded that organs from executed death row inmates are a relatively stable source of organs, and not responsible for the spike in 2003-2006, or for the subsequent sharp decline.

Impact of the Supreme People’s Court’s Ruling on Death Row Organs

On January 1, 2007, the Supreme People’s Court reclaimed the right to review death row sentences from the provincial supreme courts, resulting in the reduction of death row sentences. Was this the cause for the severe shortage of organ donors in 2007? It had an impact but was not the root cause. According to a Xinhua News Agency report on March 10, 2008, after the Supreme People’s Court’s reclamation of reviewing death sentences, 15% of death row sentences were overturned in 2007. [36] This percentage (likely to be overestimated) indicates that the recovery did not have a large impact on organs available from the executed death row inmates. This can be supported by the actual number of organ transplants performed. In the section, “Reference to Historic data” in Chapter I, we quotedChina Daily that 65% of organs came from death row inmates in 2008 and 2009, in which close to 10,000 cases of organ transplants were performed each year. That means that approximately 6,000 organs came from death row inmates, which is close to the level between 2000 and 2002.

Therefore, the sudden decrease in organs in 2007 has to be due to the sudden disappearance of other organ resources (although it is still uncertain whether they have completely disappeared).

In conclusion, the rapid growth between 2003 and 2006 and the ensuing quick disappearance of organ resources in China are unprecedented in history and bear unique features that are not supported by the theory that death row inmates were the main source of organs during the years in question.

Since 2007, due to the shortage of organ donors, live related donors have become a new source of organs. Chinese media have also carried out extensive campaigns on this subject in an effort to raise awareness. According to a People’s Net report, the Oriental Organ Transplant Center in Tianjin performed 84 cases of live donor liver transplants in 2007 (with a relative donating a partial liver). [37] However, since live donors did not become a major organ resource until after 2006, this does not help explain the period between 2003 and 2006, when China’s organ market skyrocketed.

[27] U.S. Department of Health and Human Services, “The Matching Process — Waiting List,” website maintained by the Health Resources and Services Administration (HRSA), Healthcare Systems Bureau (HSB), Division of Transplantation, an agency of the U.S. Department of Health and Human Services,http://www.organdonor.gov/transplantation/matching_process.htm

[28] Chen Yanhui, “Investigation on Global Organ Transplants – Thousands of Foreigners Rushing to China for Organ Transplants, Mainland China Becoming New Center for Global Organ Transplants,”Phoenix Weekly, 2006, No, 5,http://news.phoenixtv.com/phoenixtv/83932384042418176/20060222/751049.shtml

[29] Organ Transplant Center of the 309th Hospital of the PLA, “Brief Introduction of the Organ Transplant Center of the 309th Hospital of People’s Liberation Army,” the Center has deleted certain contents in its introduction, but Chinaaffairs.org has saved all related information,http://www.chinaaffairs.org/gb/detail.asp?id=61744 or http://www.aibang.com/detail/828118414-695423180

[30] Southern Weekend [Nanfang Zhoumo], China stops organ transplant tourism, July 18, 2007,http://www.infzm.com/content/9556

[31] Wang Hongliang, “Investigation in Tianjin: No. 1 Organ Transplant [Facility] in Asia,” LifeweekMagazine, September 22, 2004, http://www.lifeweek.com.cn/2004-09-23/000019783.shtml

[32] Wang Hongliang, “Investigation in Tianjin: No. 1 Organ Transplant [Facility] in Asia,” LifeweekMagazine, September 22, 2004, http://www.lifeweek.com.cn/2004-09-23/000019783.shtml

[33] World Organization to Investigate the Persecution of Falun Gong (WOIPFG), “Telephone Messages: Evidences of Harvesting Organs from Live Falun Gong Practitioners in China,”http://www.zhuichaguoji.org/en/index2.php?option=content&task=view&id=168&pop=1&page=0

[34] Science Times, “Shortage of Organ Donors is the Bottleneck in Developing Organ Transplants,”http://www.sciencenet.cn/html/showsbnews1.aspx?id=182075

[35] Southern Weekend [Nanfang Zhoumo], China stops organ transplant tourism, July 18, 2007,http://www.infzm.com/content/9556

[36] Xinhua News Agency, “China’s Death Row Sentences with Immediate Execution Dramatically Reduced,” March 10, 2008. http://news.xinhuanet.com/misc/2008-03/10/content_7761537.htm

[37] The People’s Daily website, “Tianjin Orient Organ Transplant Center Performed 84 Cases of Live Donor Liver Transplants in 2007,” Windows on Tianjin section, http://www.022net.com/2007/12-25/425567353391331.html

 

Falun Gong Practitioners Systematically Murdered for Their Organs: Refuting the Chinese Regime’s “Death Row” Explanation, Chapter V

By Ouyang Fei, Sun Sixian, and Lin Zhanxiang

(Clearwisdom.net) In 2006, The Epoch Times newspaper broke a stunning story about what is undoubtedly one of the most horrible atrocities to be committed by any government, not only in modern times, but in all of recorded history. As documented in the investigative report, “Bloody Harvest,” by noted human rights lawyer David Matas and former Canadian Secretary of State for the Asia-Pacific region David Kilgour, there is overwhelming evidence of the Chinese Communist regime’s chilling role in systematically murdering Falun Gong practitioners, harvesting their organs while they are alive, and making huge profits from doing so. In response to the international outcry, the Chinese regime has attempted to explain away one of the main pieces of circumstantial evidence–the meteoric rise in the number of organ transplantations in recent years and the extremely short wait times in a culture notoriously averse to organ donation–by stating that it has harvested organs from executed criminals after their deaths. Faced with undeniable evidence, it has attempted to escape culpability for a monstrous atrocity by admitting to a lesser crime. In this report, we will show evidence that directly contradicts this claim and lends further credence to the serious charges leveled against the Chinese regime.

V. China’s organ transplant market skyrocketed in 2003

According to Huang Jiefu, deputy Minister of Public Health, “The number of organ transplants in China has grown rapidly in the past ten years between 1997 and 2007.” [24] In a story published by Nanfang Zhoumo, “China stops organ transplant tourism,” Huang criticized the explosive growth of organ transplants in hospitals: “There are more than 600 hospitals and over 1,700 doctors engaged in organ transplant surgeries. This is way too many!” [25] By comparison, there are approximately 100 hospitals in the United States specialized in liver transplant surgery and less than 200 specialized in kidney transplant surgery. In Hong Kong, there are only three hospitals, and each is specialized in liver, kidney, and heart transplant surgery respectively. The statistics published by the Tianjin Oriental Organ Transplant Center and the No. 2 Hospital of the Second Military Medical University (also known as Shanghai Changzheng Hospital), two hospitals that have close ties to the Chinese military, provide a glimpse into the rapid growth of China’s organ transplant market. (Appendix 2)

Chinese experts’ figures on organ transplants, although they vary, clearly indicate the massive growth in China’s organ market in the past ten years. (Refer to Appendix 3 for exact data.) Between 2003 and 2006, underground hospitals emerged as well (Appendix 4). The organ transplants from these underground hospitals are very likely not included in the public statistics. Therefore, the number of actual organ transplants during this period should be higher than the public data.

Using the data provided by Huang Jiefu, and Shi Bingyi, director of the Organ Transplant Center of the People’s Liberation Army, as well as reports by the Chinese media, we have created the following table to show the trend in China’s organ transplant market. (See Appendices 3 and 5 for detailed background information.) In it, we have divided the period from 2000 to 2008 into three phases: prior to 2003, between 2003 and 2006, and after 2006.

2000 – 2008: Three phases in China’s Organ Transplant Market

Timeframe Annual No. of Organ Transplants Main source of donors
Phase I Prior to 2003 Averaged around 6,000 since 2000 (with even lower numbers prior to 2000) Death row inmates
Phase II Between 2003 and 2006 12,000 in 2004; other estimates placed the 2005 number at 15,000, and 2006 numbers at 20,000; no conclusive national data available for 2003, however, in a leading military organ transplant hospital, there was an increase of nearly 60% from 2002 to 2003 (with 801 cases), which then almost doubled to 1,601 cases in 2004 (claimed by the hospital website to be the highest number of organ transplant operations in the world in 2004) Death row inmates and other unknown sources
Phase III 2007 and later Dropped approximately 40% by 2008 (no conclusive national data available for 2007) Death row inmates and living donors among relatives

Although the number has dropped significantly since 2007, it is still higher than the period prior to 2003. According to the Chinese government, the higher number is due to the increase of living donors among relatives as a result of vigorous promotions. At present, 40% of organs come from living donors among relatives. [26]

But this doesn’t address the sudden, large increase in transplants from 2003 to 2006.

The question is, who was the source of organs that caused China’s organ transplant market to skyrocket?

The number of organ transplants during the ten-year period between 1997 and 2007 was relatively stable in other countries around the world. In Canada, the number of organ transplants rose from 1,500 in 1997 to 2,200 in 2007, while in the United States the number rose from 20,000 in 1998 to 27,000 in 2008 (Appendix 6). Yet in China, after a relatively stable period between 1997 and 2002, there was a sudden, rapid growth of transplants. After the allegations of live organ harvesting of Falun Gong practitioners emerged in 2006, the number of transplants dropped drastically. China does not fit the worldwide pattern.

[24] Huang Jiefu, Mao Yilei, and J. Michael Millis. “Policy of organ transplant in China,” The Lancet,http://download.thelancet.com/flatcontentassets/series/china/comment11.pdf

[25] Southern Weekend [Nanfang Zhoumo], “China stops the organ transplant tourism,”http://www.infzm.com/content/9556

[26] China Daily, “Public Call for Organ Donations,” August 26, 2009,

http://www.chinadaily.com.cn/china/2009-08/26/content_8616938.htm

Falun Gong Practitioners Systematically Murdered for Their Organs: Refuting the Chinese Regime’s “Death Row” Explanation, Chapter IV

Estimating the upper limit on suitable organs that can be derived from death row “donors”

by Ouyang Fei, Sun Sixian, Lin Zhanxiang

(Clearwisdom.net) In 2006, The Epoch Times newspaper broke a stunning story about what is undoubtedly one of the most horrible atrocities to be committed by any government, not only in modern times, but in all of recorded history. As documented in the investigative report, “Bloody Harvest,” by noted human rights lawyer David Matas and former Canadian Secretary of State for the Asia-Pacific region David Kilgour, there is overwhelming evidence of the Chinese Communist regime’s chilling role in systematically murdering Falun Gong practitioners, harvesting their organs while they are alive, and making huge profits from doing so. In response to the international outcry, the Chinese regime has attempted to explain away one of the main pieces of circumstantial evidence–the meteoric rise in the number of organ transplantations in recent years and the extremely short wait times in a culture notoriously averse to organ donation–by stating that it has harvested organs from executed criminals after their deaths. Faced with undeniable evidence, it has attempted to escape culpability for a monstrous atrocity by admitting to a lesser crime. In this report, we will show evidence that directly contradicts this claim and lends further credence to the serious charges leveled against the Chinese regime.

In this section, we will explain why we are assuming that the number of death row inmates with organs suitable for transplantation is 30% the total.

1. Tissue matching – a bottleneck with death row “donors”

In Chapter II and Appendix 1, we have shown that HLA matching is extremely complex. There are seven groups of HLA, with a total of 148 antigens. The possible permutations number well over 2,000,000. Except for twins from the same egg, it is practically impossible to locate a supplier and a recipient with identical HLA. As a result, rejection reaction always follows a homograft. It has to be treated with intense immune suppression. The probability of unrelated people meeting minimum matching HLA requirements (for immunosuppressant drugs to be effective after transplantation) is between 20-30%. Thus, the percentage of death row inmates with matching organs cannot exceed 30% with any significant sample size.

2. Critical time window dictated by cold ischemia

When an organ leaves the human body, the tissue will break down. When a person’s heart stops beating, his or her organs will be useful for a 15-minute window, and must be procured promptly and preserved by a special medium at very low temperatures. Even under optimal conditions, the organ must be transplanted within a critical time window because of cold ischemia (cooling of an organ with a cold perfusion solution after organ procurement surgery). With current technology, the critical time window is 24 hours for a kidney, 15 hours for a liver, and 6 hours for a heart. Therefore, in addition to tissue matching, cold ischemia is a second critical restraint. It is simply not yet possible to preserve organs suitably for future needs.

In addition to these technical limitations, there are other important considerations when using organs from death row inmates that will be explained below.

3. Death row inmates’ organs, a one-time resource

Organs from death row inmates are a one-time resource. Unlike organs hosted by a pool of living people, organs from death row inmates cannot be reserved for future use. Of course, there are reports that some courts have stayed executions until the hospital found a matching recipient. However, in most cases, executions of death row inmates are a political act for the Chinese Communist regime to maintain its power, and therefore, not every execution can be put on hold for medical reasons. For example, due to perceived political needs, the Chinese Communist regime makes a habit of executing death row inmates on national holidays, such as New Year’s Day, May Day, or National Day, to get the most exposure from the event. Quite often, the dictated times of such executions mean that the inmates’ organs are not used. Wang Guoqi, formerly a burn specialist at the Paramilitary Tianjin General Hospital in Tianjin, testified before the Subcommittee on International Operations and Human Rights of the United States House of Representatives. In a written statement he stated, “I have removed skin from the corpses of executed prisoners,” and further described how he went to the places of execution to remove the organs. Among four inmates executed, only one was a match for organs. Dr. Wang was told to take the corpse to an ambulance within 15 seconds of the gunshot. He and another doctor then took 13 seconds to remove the skin. [21]

4. Factors limiting death row inmate organs

Execution of death row inmates happens in different locations and at various times. Since China does not have an organ sharing network, such as the United Network for Organ Sharing in the United States, the tissue matching of organs from the executed inmates can only take place in or near the area of execution. Therefore, death row inmates are considered a rare resource. Some scholars have pointed out that local courthouses often team up with the local hospitals to protect local interests. This phenomenon makes it much harder for hospitals outside the area to get access to organs. It was not until August 2009 that China announced an experimental organ donation system in ten selected provinces and cities.

The following chart illustrates how death row inmates can be divided into four different groups based on their location and times of execution. In principle, in any given location at any given time, the organs from the executed death row inmates can only be matched with the patients in that specific location at that specific time. Thus, the number of wasted organs is likely to be very high.

For this reason, we fear that detained Falun Gong practitioners have become a reservoir for large scale matching and live organ harvesting, which we will discuss in later sections.

5. Harvesting of death row inmate organs follows the “court-driven model”

On October 9, 1984, China’s Supreme People’s Court, Supreme People’s Procuratorate, Ministry of Public Security, Ministry of Justice, Ministry of Public Health, and Ministry of Civil Affairs promulgated and implemented the “Interim Provisions on Using Cadavers or Organs from the Cadavers of Death Row Inmates,” providing legal authority for using organs from executed death row inmates.

While the court, the procuratorate, the detention center, and the hospital are integral parts of the process to harvest the death row inmates’ organs, the key party is the court, since it hands down the death sentences and carries out the executions. Prior to execution, the death row inmate is required to undergo blood tests with approval from the detention center. Then the court carries out the execution under the procuratorate’s supervision. Both the court and the procuratorate restrict access to the execution site and assist the doctors in harvesting organs from the executed inmates. The Chinese Communist government adopted this process when China’s organ transplant market was in its earliest stage and introduced the aforementioned 1984 Interim Provisions to give the process legal authority. It has been following this process since. Phoenix Weekly (number 21, 2005) quoted a source as saying, “Without the Justice Department’s approval, it would be impossible for hospitals to harvest organs from executed death row inmates.” [22]

The courts play a key role in procuring organs from executed death row inmates

The court-driven model renders the process of using organs from executed death row inmates a rather public, programmed, and sometimes even bureaucratic one, in which the court, the procuratorate, the detention center, and the hospital play integral roles with their own interests in mind. This process is known to human rights watchers, despite the Chinese Communist government’s consistent denials until recent years (see Preface). It should be made clear that doctors cannot simply go to the detention center and ask the prison guards for executed death row inmates to harvest the organs. The more parties and steps involved, the less efficient the process of organ harvesting.

6. Legal requirements for an “unclaimed bodies” classification

The 1984 Interim Provisions provided the following guidelines for accepting organs from unclaimed cadavers or those from executed inmates; the guidelines stipulate that cadavers are acceptable if:

  1. They are unclaimed or refused by the family of the executed;
  2. They are voluntarily donated by the death row inmates;
  3. Family of the executed gives consent.

Inevitably, driven by potentially huge financial benefits, some people have found ways to exploit loopholes in these guidelines. For example, in some cases, families were not notified of the time of execution and the bodies remained unclaimed as a consequence. Nevertheless, these guidelines do impose legal restrictions on the use of death row inmate’s organs.

Reactions from families of the executed to the embezzlement of death row inmate organs

Since 2000, families of executed inmates have openly complained about the removal of organs without consent. Some have even filed lawsuits. This has increased the uncertainty surrounding the use of death row inmates’ organs.

In September 2000, Yu Yonggang from Taiyuan City, Shanxi Province was sentenced to death for robbery and murder. Yu’s mother repeatedly stated that the hospital and the court had taken away her son’s organs without her consent. She wrote a letter entitled “A Citizen’s Tearful Complaint” to bring the matter out into the open, pointing fingers at the relevant government bodies.

In May 2000, Fu Xingrong, a farmer from Jiangxi Province, was executed for murder. The local court sold his kidneys to one of the major hospitals in Jiangxi Province without Fu’s family’s consent. Out of grief and indignation, Fu’s father committed suicide. Fu’s sister hired an attorney and filed a lawsuit against the local court.

On September 23, 2003, Lanzhou Morning News reported a case in which a detention center in Gansu Province had “donated” organs from an executed death row inmate without his consent. The local court later ruled that the detention center must pay the family 2,000 yuan as compensation. The director of the detention center admitted to the media that organ donation must have written consent from the death row inmate, and that the detention center did not have any written document from the inmate in this case. [23]

The reactions of families such as these have created hesitation about the use of death row prisoners’ organs, at least to a certain degree, and at this time, death-row-derived organs can no longer be considered a broad and readily-available resource.

Other considerations include age (ideally, the ‘donor’ should be between 20 and 30) and health status. Many inmates are addicted to cigarettes, alcohol, and drugs, which makes them less than ideal donors.

All of this explains the relatively low percentage of potentially useful organs that can be derived from death row “donors.” We have discussed how a poorly matched organ directly impacts the quality of the transplant surgery. If a high number of patients were to die on the operating table or have a short survival time after the surgery, it directly impacts the surgeon’s reputation and career. It stands to reason, then, that the transplant surgeon prefers not to use a randomly sourced organ in surgery. In summary, we consider a figure of 20-30% suitable organs derived from death row inmates a reasonable, if not optimistic, estimate, and in our calculations, we have settled on the 30% figure as the upper limit.

Due to these limitations on the use of death row prisoners’ organs, the annual number of organs from executed inmates is probably around 6,000. Yet, between 2003 and 2006, there was a massive growth in China’s organ transplant market. Clearly death row prisoners’ organs alone did not meet this skyrocketing demand.

References

[21] Wang Guoqi, “I have removed skins from the corpses of executed prisoners – testimony by Wang Guoqi, a surgeon at the Tianjin Armed Police Corps Hospital,” cited from The World Journal at http://www.chinamonitor.org/news/qiguang/wqgzb.htm

[22] Phoenix Weekly (number 21, 2005), “Investigation of Organ Donation from Death Row Inmates,” http://www.ifeng.com/phoenixtv/72951501286277120/20050823/617113.shtml

[23] Deng Fei, “Investigation of Organ Donation from Death Row Inmates,” Phoenix Weekly, http://health.sohu.com/20081120/n260760080.shtml