In China, state-run media have been promoting a job called “organ donation coordinators,” trumpeting how people in this line of work are making a difference in society. Their role is to convince families of dying patients to agree to donate their loved one’s organs—needed to supply China’s booming transplant industry.
The families that agree, in return, are paid for their consent.
Due to deeply-rooted cultural beliefs that hold that the human body must be kept intact even after death, Chinese people are generally reluctant to donate their organs. The creation of this role appears to be an attempt to lessen such a barrier to the country’s organ donation program.
But the job is less noble than it is depicted by the Chinese regime, according to an account by Liang Xin (a pseudonym), a former organ donation coordinator from northeast China. The work was more akin to being a salesperson, Liang told The Epoch Times, and much of it involves using money to manipulate the poor into agreeing to donate their dying relatives’ organs.
The coordinators’ methods are unethical and violate internationally recognized principles on transplantation that forbid the payment of money for an organ donor’s consent, according to an organ transplant expert.
Liang’s revelations further shine a light on abuses in China’s organ transplant system—which already attracts heavy scrutiny over the communist regime’s practice of forced organ harvesting from prisoners of conscience.
The former coordinator said he decided to speak out about his job in the hopes that more people will know the truth behind it.
Targeting the Poor
Organ donation coordinators mainly targeted poor families, in particular those of rural migrant workers, Liang said. These people often did not have enough money to pay for the expensive medical bills, and were therefore more susceptible to the coordinators’ monetary offers.
Liang recounted one case involving a very poor family. Their dying family member could still have been saved with proper medical treatment. But the family decided not to proceed with this—and cash out. So, the family’s doctor decided to starve the patient.
“After the person was deprived of food for a week, he was in the right condition for organ donation,” Liang said.
This case, according to Liang, was among many where patients were declared brain dead—a precondition to organ extraction—but did not strictly meet the criteria for it.
Liang and his colleagues were good salespeople. To the relatives, they sold organ donation as an act of “all-encompassing love” and “devotion to a greater cause.” But in reality, the coordinators thought of the donor’s organs as nothing more than “merchandise,” he said.
The coordinators, Liang said, had one specific strategy in their playbook that was particularly effective: They would target the most “greedy” family member. After these soft targets were converted to the cause, they could then be relied on to convince the other immediate family members who may have been less open to the idea of organ donation.
China’s official organ donation program requires the consent of the donor, or that of their immediate kin if the donor is already dead. While the Chinese regime claims all organs used for transplant are sourced from this donation system, mounting research and an independent people’s tribunal have found that Beijing has been killing prisoners of conscience for their organs on a “significant scale,” with detained Falun Gong practitioners being the main source of organs.
Liang didn’t have a medical background before taking up the role; the same as many of his colleagues. He got the job through his mother, who was already working at the hospital where Liang was hired. It is a major transplant hospital in a city in northeastern China’s Liaoning province.
Whenever a dying patient in the region was determined to be suitable for organ donation, Liang’s team would be contacted. They would then send Liang or another team member to the hospital to talk to the patient’s immediate family. If they managed to successfully convince the family to agree to the donation, then the doctor overseeing the patient would also be paid a small commission.
According to China’s state-run media, there were about 2,800 organ donation coordinators in the country as of the end of 2020. Like Liang, some of these worked for hospitals, while others worked for China’s Red Cross, which unlike its international counterparts is funded and operated by the Chinese regime.
China has in place a so-called humanitarian aid policy to support impoverished families of organ donors. According to China’s state-run media, the provincial Red Cross in central China’s Hubei province implemented a payment plan of between 50,000 yuan to 90,000 yuan ($7,720 to $13,880) per family in 2015.
In January 2020, Hubei’s Red Cross announced that it paid a total of 9.77 million yuan ($1.5 million) to 128 families in 2019.
Liang, who worked in the job for six months before quitting, likened his role to a sales representative—he earned about 2,000 to 3,000 yuan ($310 to $460) every time he was able to get a family to sign up to organ donation.
What the hospital paid Liang and what the families received accounted for only a tiny fraction of what hospitals charged for transplant surgeries. According to Liang, hospitals in China charged about 550,000 yuan ($84,870) for a liver transplant surgery, and 450,000 yuan ($69,440) for a kidney transplant surgery.
Therefore, a donor who gave up both of their kidneys and liver would generate an income of about 1.45 million yuan ($223,760) for a hospital. That amount, after accounting for the hospital’s medical expenses to procure the organs and carry out the surgeries, would leave the hospital with the tidy sum of 700,000 yuan ($108,010), according to Liang.
A small portion of this money would be used to pay the donor’s family, while the rest would go to the chief surgeon carrying out the transplants, Liang said.
The surgeon would also use some of this money to pay the local police. In return, the police would turn over the patient’s personal information, including their financial situation. The doctors would then pass this information on to the organ donation coordinators. The family’s financial details helped the coordinators find out if certain families were more susceptible to pressure.
China’s transplant industry is also rife with bribery. Liang said he knew that chief doctors at hospitals’ transplant centers would accept bribes to move people up the waiting list.
Liang recalled a specific incident in October 2020 involving a 28-year-old single man who had a brain hemorrhage. The man was admitted to the intensive care unit of a local hospital and was later declared brain dead.
The man’s organs were identified as very valuable, given his young age and his O blood type, according to Liang. People with O type blood can donate to every other group.
Liang’s coworker then got to work. The man’s older sister was identified as the soft target—she needed money as she had been footing her brother’s medical bill. The coworker was successful. In effect, they were able to convince the sister to “sell her younger brother for money to pay off her debt,” Liang said.
The sister then went on a mission, telling her parents that they should agree to donate their son’s organs since it was for the “greater good.” Despite their initial rejections, the parents eventually relented and agreed to donate their son’s two kidneys and liver.
In the end, the son’s heart was also donated, to the dismay of his mother who hadn’t agreed to it.
Sometimes organ donation coordinators and donors’ immediate families would haggle over the amount of the payment. In another incident around October 2020, Liang said that he and his colleague jointly worked on a case involving a prisoner from southwestern China’s Sichuan province. The prisoner was a member of China’s Yi ethnic minority.
Liang and his coworker located the prisoner at a hospital in Shenyang, the capital of northeast China’s Liaoning province. Liang had no idea how the prisoner ended up in hospital and where he was imprisoned, but suspected that the man was beaten while in detention.
The initial negotiation resulted in the coordinators agreeing to pay the prisoner’s family 50,000 yuan ($7,720) for their consent to donate the prisoner’s organs. However, the family then demanded more money, eventually being paid an additional 50,000 yuan.
While the negotiations were pending, doctors at the Shenyang hospital used medication to keep the prisoner alive for about five days. Eventually, his liver and two kidneys were retrieved and donated.
Dr. Torsten Trey, executive director of Washington-based medical ethics advocacy group Doctors Against Forced Organ Harvesting, said China’s organ donation system has for years relied on using monetary incentives to induce donations.
Liang’s account, according to Trey, shows that the Chinese regime continues to fail to abide by the World Health Organization’s (WHO) transplantation principles.
“In five out of the 11 guiding principles there is explicit mention that NO PAYMENTS should be made in exchange for organs,” Trey said in an email to The Epoch Times.
“The examples show that China pays for organs,” he added. “Even more so, they approach families in their greatest moments of sorrow, when a relative is about to die, that they offer money for his organs. That is unethical and ruthless.”
Trey also criticized the global health body for not holding the Chinese regime to account for these breaches.
“The WHO betrays its own ethical guidelines by failing to call out China for its breaking of WHO ethical guidelines,” Trey said. “The WHO would not hesitate to scold other countries if they would systematically pay money for organs.”
He urged the international community, and particularly the global transplant community, to demand the regime end the practice.
“We need to uphold ethical standards in medicine,” Trey said.
The lack of ethics in China’s transplant system extends far beyond using financial incentives to induce organ donations, Trey added, citing the regime’s state-sanctioned practice of harvesting organs from prisoners of conscience, in particular Falun Gong adherents.
Liang said he was never personally involved in any organ donation cases involving Falun Gong. However, he suspected that their organs continue to be a source for transplants since he’s seen Falun Gong mentioned in doctors’ reports.
Eva Fu contributed to this report.
A previous version of this article incorrectly described who chose to starve a dying patient after their family chose to not proceed with medical treatment. The family doctor decided to starve the patient. The Epoch Times regrets this error.