According to the dead donor rule, organ procurement must not commence until the donor is both dead and formally pronounced so, and procurement of organs must not cause the death of the donor
At least 71 death row inmates in China had their vital organs removed, to be used for transplants, before they were officially declared dead, according to a study published in the American Journal of Transplantation.
The authors of the study, Australian PhD scholar Matthew Robertson and Dr Jacob Lavee, an Israeli cardiac transplant surgeon, identified 71 Chinese medical journal publications dated between 1980 and 2015 describing cases in which the removal of the heart appeared to be the cause of the prisoner’s death.
This violates the principle of ‘do no harm,’ a core value in medical ethics, according to the Hippocratic Oath.
The dead donor rule is fundamental to transplant ethics. According to the rule, organ procurement must not commence until the donor is both dead and formally pronounced so, and procurement of organs must not cause the death of the donor.
The researchers originally began their study with a data set of 124,770 publications from 1951 to 2020, but whittled cases down to 2,838 reports after filtering for heart and lung transplants. They finished their research by manually reviewing a total of 310 papers. Cases were flagged by researchers if they contained a “problematic brain death declaration,” where doctors did not check whether a patient could survive on a ventilator, or patients were only partially ventilated with a mask and did not have a tube inserted into the throat.
“We find evidence in 71 of these reports, spread nationwide, that brain death could not have properly been declared. In these cases, the removal of the heart during organ procurement must have been the proximate cause of the donor’s death,” the study says. Fifty-six hospitals and more than 300 medical workers across China were found to be involved.
According to the study, China has developed one of the largest transplantation systems in the world, from the 1980s to the present, based primarily on organs from prisoners, supplied by the state’s security and judicial system. This practice has been condemned by international medical organizations. China regards both the number of judicial executions and the true number of transplants as official secrets. The identity of all prisoner donors is also unknown, and controversy has long centered on whether non-condemned political prisoners like Falun Gong practitioners and Uyghur Muslims have been used as an organ source.
“PRC hospitals continue to advertise transplant waiting times of weeks, whereas wait times in the United States are measured in months and years. Hospitals continue to advertise organs to transplant tourists with websites in English, Russian, and Arabic,” the authors of the study said.
According to Reuters, Beijing has repeatedly denied accusations by human rights researchers and scholars that it forcibly takes organs from prisoners of conscience and said it stopped using organs from executed prisoners in 2015.
“This abhorrent conduct is a grievous violation of medical ethics, human rights and basic human dignity,” said Arthur Caplan, head of the Division of Medical Ethics at New York University’s (NYU) Grossman School of Medicine, who reviewed the findings.
“Killing for parts cannot be accepted as a part of the field of transplantation by governments, NGOs, health care providers, scientific journals or the general public. The evidence is plain and I hope the requisite action will follow.”
With inputs from other agencies