A prominent Chinese transplant official made a rare admission in an interview with a state-run publication recently, saying that the authorities have for years used the organs of executed prisoners for transplant without gaining their consent.
Though that is already accepted as a reality among researchers of organ harvesting in China, the admission from a medical official was startling. The question of consent is a crucial one in medical ethics, since, in the case of organ extraction and transplantation, it is often seen as the dividing line between ethically acceptable practice and crime against humanity.
The remarks appeared in an Aug. 16 interview conducted by Global Times, a subsidiary to the Chinese Communist Party mouthpiece People’s Daily. Yang Chunhua, director of the Intensive Care Unit of the First Affiliated Hospital of Sun Yat-sen University in Guangdong Province, gave the admission while attempting to make a broader point about the reforms that the authorities say they are currently pushing through the Chinese transplantation system.
The newspaper said: “Previously, authorities used executed criminals’ organs without their consent, while permission has been required in recent years,” citing Yang. The harvesting of organs from prisoners would continue for the time being, however, because there are not enough voluntary donors in China to service the need.
Though it was not Yang’s intention, he also happened to give ammunition to critics of China’s transplantation system by admitting that their exposures of abuses in the system are propelling some of the reform efforts.
“China has been lambasted for violating human rights with organs from criminals,” Yang said in the Global Times interview. “Chinese doctors don’t even have the chance to publish their papers on organ transplants in international journals.”
Yang is an establishment figure in China’s organ medical and transplantation system. The hospital whose ICU he is director of was the alma mater of Huang Jiefu, who also served as president until 2001; Huang published scientific articles under the aegis of the institute until recently.
The reason for Yang’s admission is not clear, though it is part of a chain of admissions that began several years ago. “The official Chinese Communist Party line for many years was that all organs were donated, and this even when there was no donation system,” wrote David Matas, a Canadian lawyer and co-author of a report on organ harvesting from Falun Gong practitioners, in an email interview. “The criticism of those who said the contrary, that organs came from prisoners, was vociferous and indignant.”
Prior to 2006 the Chinese Communist Party, and the Chinese medical establishment, was adamant that all organ donations in China were voluntary.
After evidence came to light in 2006 of the large-scale harvesting of organs of prisoners of conscience, predominantly practitioners of Falun Gong, a traditional spiritual discipline that is persecuted in China, the authorities began to make piecemeal admissions. In 2008 Huang Jiefu admitted in the medical journal Lancet that the majority of transplant organs in China came from executed prisoners.
The question of consent is another matter. The international medical community takes the view that consent from death row prisoners is not meaningful because prisoners may be subject to coercion. Even allowing that, the notion that the organs were obtained with consent in China was maintained all along, until Yang’s admission, which came with the caveat that consent has been obtained “in recent years.” David Matas writes: “To see the Communist Party of China admit to the truth, when that truth puts them in a bad light, is a startling event.”
Matas added: “The admission we see today is surely not that the authorities just found out today that there was no consent in the past. It is an admission that they always knew that there was no consent. It is an admission of massive complicity in crimes against humanity.”
According to Arne Schwarz, an independent researcher based in Switzerland who has won an award for his examination of abuses related to the Chinese transplantation system, Yang has “admitted that the Chinese authorities have committed a heinous crime even according to their own dubious standards.”
The admission is problematic for international supporters of those identified as reformers in the Chinese medical establishment, according to Matas and Schwarz. The Transplantation Society, most notably, has been an open advocate for the work of Huang Jiefu, the former Vice Minister of Health, and currently the head of China’s Organ Transplantation Committee, a newly formed body tasked with overhauling the transplantation system built on harvesting the organs from prisoners (and in fact mostly prisoners of conscience, many allege.)
By saying that only until “recent years” has consent been obtained, Yang is also saying that Huang Jiefu himself must have therefore extracted the organs of nonconsenting prisoners, according to Schwarz.
“Huang Jiefu has been involved personally in organ harvesting from prisoners without consent and organ trade with foreigners, because he had been the leading liver transplant surgeon and responsible President at the Sun Yat-Sen Medical College” in 2000, Schwarz says.
According to a South China Morning Post article from January of that year, a doctor at the Sun Yat Sen University of Medical Sciences First Affiliated Hospital told a reporter that “a liver transplant could easily be arranged and that consent was not an issue. There was no provision in mainland law for prisoners to give consent to donate organs, he said.”
At the time the director of the hospital was Huang Jiefu.
In an interview with the state mouthpiece Xinhua in 2010, Huang says: “It’s Sun Yat Sen First Affiliated Hospital that nurtured me, it’s my experiences at that hospital that made me the man I am today.”
“This man, involved personally in all these crimes, also by more than 500 liver transplants he did himself, has been awarded by The Transplantation Society and the University of Sydney,” Schwarz said.
According to a book written by a businessman favored by the Communist Party, The Transplantation Society in 2008 gave Huang the President’s International Award for his work on “transplantation in China.” TTS did not respond to an email enquiry about the award.
The University of Sydney in 2008 awarded Huang an honorary professorship, and renewed it in 2011 over the strenuous objections of local and international experts. The university issued a defense of Huang in April, saying that “he has been an outspoken critic of organ retrieval from executed prisoners since 2005.”
Neither the University of Sydney nor Dr. Francis L. Delmonico, the president of The Transplantation Society, responded to multiple requests for comment on whether their position on Huang’s achievements and his role in the Chinese transplantation system had changed in light of Yang’s revelations.
“These awards and this cooperation should be revoked,” says Schwarz. “Otherwise they will damage the ethical credibility of transplant medicine worldwide.”