BEIJING -- After years of denial, China has acknowledged that
many of the human organs used in transplants here are taken from executed
prisoners and that many of the recipients are foreigners who pay hefty sums to
avoid a long wait.
Speaking at a conference of surgeons in the southern city of Guangzhou, Deputy Health Minister Huang Jiefu called for a strict code of conduct and better record keeping to stem China's thriving illegal-organ trade, state media reported.
"Apart from a small portion of traffic victims, most of the
organs from cadavers are from executed prisoners," Huang said, as reported by
the English-language China Daily newspaper Thursday. "The current organ donation
shortfall can't meet demand."
Acknowledgment of what had been an open secret on the Internet, in local magazines and among people waiting for transplanted organs came weeks after China announced tighter oversight of death-penalty cases. Legal experts say requiring the country's highest court to approve death sentences could reduce the number by a third.
While China doesn't disclose the number of people executed each year, Amnesty International reports that at least 1,770 people were put to death in 2005, based on a review of Chinese media reports. Some activists say the annual figure could be as high as 10,000.
Even the lower estimate represents more than 80 percent of the 2,148 executions reported to have taken place worldwide last year. The United States executed 60 prisoners in 2005.
In July, China ruled that all sales of organs were illegal. But enforcing such decrees can be a problem, especially when substantial profits are involved.
In September 2004, local media reported that well-known comedian Fu Biao spent more than $36,000 on a liver taken from an executed prisoner in Shandong Province. And starting in June 2005, reports surfaced on the Internet of retinas and kidneys taken from executed former gang members without their consent in Henan province near Beijing.
Americans are among the foreigners who have headed to China for transplants as the waiting time for kidneys and livers has grown in the United States. U.S. transplant doctors say the majority seem to be patients of Chinese ancestry who feel comfortable navigating the medical system there.
More than 11,000 organs
A Chinese transplant doctor, Dr. Zhonghua Chen, said at a conference in Boston in July that Chinese doctors had transplanted 8,102 kidneys, 3,741 livers and 80 hearts in 2005.
Some experts estimate that well over 90 percent of all organs transplanted in China come from executed prisoners, given the limited supply of other organs. China has no system of voluntary donor cards. Furthermore, experts say, because China defines death as a cessation in heart rather than brain-stem activity, there is little opportunity to recover organs from other sources.
A doctor at Beijing's prestigious Tongren Hospital, who gave only his family name of Wang, said Friday that until recently the hospital had numerous advertisements about buying and selling organs. Shortly after the new rules were announced, the hospital cleaned them up, he said.
Despite Beijing's record of denying the use of prisoners' organs, some Chinese defend the practice.
"It is understandable that China relies on organs of executed prisoners, given that voluntary organ donation is not well established in China," said the doctor at Tongren.
A patient agreed.
"There simply aren't enough organs to go around," said a woman in her 50s, who declined to be identified. "Saving someone's life using executed prisoners' organs is worth it. While it would be better not to, that's the reality in China."
Rules adopted in 1984 state that executed prisoners' organs can be used if the prisoner's relatives are unwilling to take the corpse or if the prisoner or his relatives agrees. But little is known about the distribution of such organs, how decisions are made and which patients get preference.
Mobile execution vans
Jurisdiction is a further complication. The new rules apply to hospitals answering to the Health Ministry. It is less clear that hospitals run by the military or police, which presumably have the best access to organs given their prominent role in executions, will comply.
China in recent years has introduced mobile execution vans and lethal injection, supplanting the traditional method of a bullet to the back of the head. While Beijing has touted these as more humane, critics say the changes facilitate rapid organ transfers.
China has faced a growing call for change from reform-minded lawyers and academics. It also has been embarrassed by a chorus of overseas criticism, including a campaign by Falun Gong, a spiritual movement banned in China that Beijing condemns as an "evil cult."
In July, a report by Canadian human-rights lawyer David Matas and David Kilgour, a former parliamentarian, concluded that hearts, kidneys, livers and corneas have been taken from Falun Gong practitioners and sold for large sums. The movement says its members are executed on trumped up charges to supply the organ trade. Beijing has denied the charges.
"Based on what we know, we have come to the regrettable conclusion that the allegations are true," the report said.
China also acknowledged this week the widespread practice of transplanting organs to foreigners arriving on tourist visas. Many foreigners can afford to pay more, and jump the long queue of those waiting for transplants. Some 2 million Chinese need transplants each year, according to state media, but only 20,000 receive them.
"China strictly forbids its medical institutions to lure foreign tourists to China for organ transplantation with the sole aim of profiting," the People's Daily said Thursday.