During the past few years there have been relentless
attacks by prominent, primarily Western bioethicists, against China’s
transplantation policies. The central claim is extreme: Thousands of prisoners
of conscience have been killed for their organs. For example, Wendy Rogers,
professor of bioethics at Macquarie University in Australia, recently claimed
that “Chinese prisoners of conscience, mainly Falun Gong practitioners,
Uyghurs, house Christians and Tibetans, are murdered for their organs …
<creating> a living organ bank where foreign patients and wealthy Chinese
citizens can be matched to potential donors, who are then killed on demand so
that their organs can be transplanted”. In a co-authored
article, Arthur Caplan, professor of bioethics at New York University, and
others claimed that “since 2006, mounting evidence suggests that
prisoners of conscience are killed for their organs in China with the brutally
persecuted Buddhist practice, Falun Gong, among others, being the primary
target.”
These criticisms of China are published in academic
bioethics journals by well-known scholars without any acknowledgment that reputable
individuals and organizations have repeatedly concluded that there is no
credible evidence for these claims. This has, unfortunately, led to the
establishment of a very biased view on transplantation policies in China among western bioethicists.
Most of what is presented in support of the claims made in
the bioethics literature originate from Falun Gong members. Many in the west
think that Falun Gong is simply a religious practice emphasizing meditation and
self-improvement, but that is not how it is viewed by those who have studied
the movement. It was started in China by Li Hongzhi in the early 1990s. It is
variously described as a religion, a spiritual practice or a cult. It is well
documented that its founder has propagated a high number of fringe ideas and
what are generally believed to be objectionable moral ideals. These include
such the views that human civilization is being invaded by aliens with the aim of
destroying it, that disease can be cured by spiritual practices, and that mixed
race marriages are evil. Many of its followers downplay these ideas and it is
not clear whether this is for strategic reasons or that they genuinely believe
that these are not central to the movement’s beliefs. Falun Gong runs a number
of news outlets, such as the Epoch Times,
also with a German version. The German Epochtimes has at least at times spread rumors associated with right wing
propaganda against immigrant groups. In spite of these shady associations Falun
Gong has been spectacularly successful at capturing the support of liberal and
progressive groups in the west, also among academics, who regard Falun Gong
members as suffering persecution in China because of genuine religious beliefs.
It helps, of course, that its followers see themselves as staunch enemies of China’s
Communist Party which is particularly useful if one wants to create a positive
image among politicians and the public in the US.
The Chinese government has cracked down on the activities of
the group in China, because of an understandable fear, based on a number of
such episodes in the past couple of hundred years, that a mass movement such as
Falun Gong can cause severe social instability. This has led to imprisonment of
a high number of Falun Gong followers, based on laws against “disturbing public
order”. While it may be legitimate to criticize such punitive measures as
over-reactions by the government, it would be wrong to claim that such actions
by the government are interference in “religious freedom”. Falun Gong is similar to western movements
such as Scientology which has also been seen as non-religious by authorities in
for example Germany. Or one may mention examples of the restrictions by Western
and other governments on certain muslim groups that also claim to be religious,
justified with reference to the need to national security. Interestingly enough
the Falun Gong movement was at first to a certain extent supported by the
Chinese authorities as a way to encourage local spiritual practices as opposed
to practices originating from outside of China. Once it became clear that the
group was anti-science and in particular propagated fringe ideas about medical
treatment, the authorities cracked down on the practice. This led to widespread
protests among the followers, and then to the subsequent arrests in order to
limit its influence. The authorities have been successful in limiting its
influence in China. The attention the group has received outside of China as a
persecuted religious group by communist China, and as victim of organ
harvesting, has greatly enhanced their standing in the west.
The claim about organ harvesting got the attention of
politicians and news outlets after a report published by David Kilgour (former
member of the Canadian Parliament) and David Matas (a human rights lawyer) in
2006. Ethan Gutman, a journalist, made similar claims a bit later, and they
jointly published an updated report in 2016. In these reports, they present
evidence that they think proves that there has been, and continues to be,
widespread killing of Falun Gong members for their organs in China.
There is no disagreement, and the Chinese government has
confirmed this, that the main source or organs in China until at least 2010 was
from executed prisoners. There is also no disagreement that unacceptable
practices have occurred in China, such as illegal trade in organs and
unacceptable transplant procedures in general. There is also no disagreement
that some of these practices continue today. In fact, the government of China
has attempted to crack down on low quality transplant centers and organ trafficking
, and have sanctioned and punished both institutions and individuals for
violating China’s transplantation laws and regulations. The controversial claim
is that a high number of Falun Gong practitioners, with a “best estimate” of 65000
in about a decade starting in 2000, have been kept in prisons and killed on
demand for their organs. According to these critics there are several pieces of
evidence for this claim, some of which are:
·
Interviews with detainees, security personnel
and others
·
Phone calls to institutions pretending to be
persons who seek an organ for transplantation and asking whether a “Falun Gong
organ” is available, with what is claimed to be affirmative answers
·
Short wait times for organs with a matched organ
being available a short time after a request has been made
·
A mismatch between the number of transplanted
organs and the number of judicial executions
All of this is at best circumstantial evidence. The interview
and phone call evidence are also clearly biased and open to other, more
plausible explanations. The short wait time is evidence for the use of organs
from executed prisoners in general, which has not been denied by Chinese
authorities. This leaves only the evidence that the number of transplanted
organs in the period between 2000 and 2010 exceed the number of organs
available from judicial executions (executions after a due process according to
Chinese law). This evidence is also problematic because there are no reliable,
generally available, figures for executions nor for the number of transplants in
China up until around 2010. All of the claims made on the basis of these
numbers are therefore to a large degree speculative. Although a number of
parliamentary declarations affirming the claims have been adopted both in
North-America and Europe, it is significant that independent attempts to
corroborate the evidence by official groups have failed. For example, the NewZealand Foreign Affairs, Defence and Trade Committee concluded in 2011
The New Zealand Government
investigated allegations made by Falun Gong of illegal organ harvesting from
Falun Gong practitioners after they surfaced in March 2006 in a report written
by Canadians David Kilgour and David Matas, and publicised through the Falun
Gong publication Epoch Times. Neither committee members nor the Government are
aware of any independent evidence verifying the Falun Gong claims on organ
harvesting. This conclusion is based on both New Zealand and foreign inquiries.
New Zealand officials discussed the allegations with Kilgour and Matas; the
office of the United Nations Special Rapporteur on torture; human rights
non-governmental organisations; and other countries interested in the human
rights situation in China. Other international organisations also attempted to
verify whether the claims on organ harvesting made in the Kilgour/Matas report
had substance. This included a significant US State Department investigation
that concluded that there was no evidence of the practice. Officials are not
aware of any independent assessment that supports the Falun Gong’s claims of
forced organ harvesting
Independent of what may or may not have happened in the
early 2000s, there is agreement that there have been substantial reforms in
China, both in terms of the number of executions and the system of organ
procurement and transplantation, that began in the late 2000s. Beginning in
2005 all death sentences needed to be reviewed by the Supreme People’s Court,
resulting in a gradual, but steady and significant, decline in the number of
executions. In 2007 a new regulation on
Human Organ Transplantation was enacted, and in 2010 “organ trafficking” was
made a crime. A nationwide organ donation program was introduced nationwide in
2013 with the Provisions on Human Organ
Procurement and Allocation coming into force. In 2015 the chair of China’s
National Organ Donation and Transplantation Committee, and a driving force
between the reform program that began in 2005, announced that organs for
executed prisoners should no longer be used. As a result of these developments registration
and quality controls of donation and transplantation programs have improved
dramatically in China, and there has been a crackdown on unacceptable practices
such as black market sale of organs and transplant tourism. Given the size of
the country nobody can claim that unacceptable practices do not still occur, as
they do in many other countries, also in the west.
Independent outside observers who are familiar with the
situation in China all confirm that there is now in place a transparent organ
procurement and distribution program in the country, and that there is no
government sanctioned black market in organs. This includes representatives from the World Health Organization and prominent transplant surgeons from theUS with extensive experience in China. A major piece recently published in the Washington Post also confirmed that the
policy change in China has been successful. In spite of this, the critics
continue to claim that the practice of killing Falun Gong followers for their
organs continues in China (as is evident in the present tense in the quotations
above). No new evidence is presented. One major piece of evidence presented in
the Washington Post piece is that
there is a close match between the official transplant numbers and the sale of
immunosuppression drugs used by patients who have received organs. This has
been contested by the critics, but the Washington
Post has in their reply maintained the accuracy of their original claim.
Not only do the prominent bioethicists make the outlandish claim
that thousands of people in China are being killed for their organs based on
little or no credible evidence, there have also been attempts to censor
articles written by Chinese bioethicists about issues related to
transplantation.
When a
short piece announcing the new policy ending use of death row prisoners as a
source of transplanted organs was published in the Journal of Medical Ethics in
2016, professor Rogers and coauthors demanded a retraction of the article
because of what they claimed were misleading statements about the situation in
China. The journal did not accept the demand for a retraction, but instead
required that the authors post a “correction” to their original piece, at the
same time they allowed a “rebuttal” by the criticizing authors. The main
correction required was a change from the claim that China had introduced a
“law” to prohibit death row organ donation to “a guideline”. This labeling
issue is completely beside the point, because it is difficult to translate
exactly what the status of a particular piece of Chinese government action is
using appropriate English terms for the corresponding Chinese ones. The piece
by Rogers and co-workers merely repeated the same exaggerated and
unsubstantiated claims made earlier.
When
other authors tried to publish a paper in 2014 on attitudes towards cadaveric organ donation among medical and non-medical students in China, the journal, Transplantation,
received a letter to the editor criticizing the article for failing to take
into account the political situation of organ donation in China, presumably
meaning failing to take into account what the authors of the letter think are
unethical transplantation practices. There is no particular reason why the
authors of a paper reporting the results of an empirical study of attitudes
towards cadaveric organ donation should also discuss the issue of use of organs
from death row prisoners. The authors refused to have their paper published
alongside such a letter to the editor, and therefore decided to retract the paper. Although the critical letter has not been published it is fair to assume
that it repeated the same unsubstantiated claims made earlier. The decision by
Zhang et al is therefore perfectly understandable, but it is sad to observe the
power of a small group of individuals to set the agenda for the debate in the
journal literature.
Given
the current climate of anti-China sentiment in the West there is little hope
that we will see a more balanced reporting of what happens in China. One can
still hope, though, that at least some Bioethics journals are willing to
consider articles that present a more balanced description of current
developments in China.
