Forced Organ Donations from Living Donors???!!!!

There is an acute shortage of organs for transplant in the US. However, in China they do not have shortages. Why not?

Forced Organ Donations from Living Donors???!!!!

Here in the US, there are long delays for organ transplants: for kidneys, its not unusual to wait 5 years as dialysis is an alternative. If you need a heart or liver transplant it is based on your overall condition as well as the severity of need - in other words, how quickly the organ is failing. However, in China the wait for a transplant might only be months, weeks or even days. Why????

This story comes out of China recently: "Official organ donations may come from people who voluntarily choose to donate their organs after death, or people who sell organs such as kidneys. But in June, the China Tribunal, an independent organization created to investigate the alleged crimes, found that some prisoners have their organs forcefully harvested—sometimes while they’re still alive. Human rights lawyers estimate 65,000 Falun Gong practitioners have been killed for their organs since 2001, and members of other religious and ethnic minorities, including Uyghurs, Tibetans, and some Christian sects, have suffered the same fate."

According to a recent NBC news story, "Some of the more than 1.5 million detainees in Chinese prison camps are being killed for their organs to serve a booming transplant trade that is worth some $1 billion a year, concluded the China Tribunal, an independent body tasked with investigating organ harvesting from prisoners of conscience in the authoritarian state."

The International Coalition to End Transplant Abuse in China made the above observation. There have been accusations over the years of unethical transplant practices in China. There are multiple academic and news reports of unwilling living donors mostly prisoners who were selected to be organ donors. See references for links. However, China continues to state that they stopped the practice of utilizing prisoners as unwilling organ donors in 2015.

So, what about the recipients of these organs? From the NY Post, "Experts estimate that between 60,000 and 100,000 organs are transplanted annually in China. Multiply that number times the cost of a liver transplant ($170,000) or a kidney transplant ($130,000), and the result is an eye-popping $10 billion to 20 billion." The article goes on to state that most "transplant tourists" don't ask or care to know where their organs come from, only that they get their transplant. Are some of these recipients from the US? Well, there are no published statistics of WHO receives these forced donations. China has faced scrutiny in the past few years for this practice. However, the transplant assembly line seems to continue.

Recently the UN has been urged to investigate this practice. "A senior lawyer called on Tuesday for the top United Nations human rights body to investigate evidence that China is murdering members of the Falun Gong spiritual group and harvesting their organs for transplant.

Hamid Sabi called for urgent action as he presented the findings of the China Tribunal, an independent panel set up to examine the issue, which concluded in June that China’s organ harvesting amounted to crimes against humanity."

In the US, we do utilize living donors for kidneys and partial liver transplants. However, transplantation from non-volunteer or incarcerated prisoners would be abhorrent to all. Ethically, in the US, we do not utilize prisoners for organ donations as they are considered an at-risk population in that they have limited ability to refuse. Intentionally executing people for their donors seems like something out of a horror movie for most of us.

What are your thoughts? What about the medical personnel who take part in these operations?

References:

Compliance with ethical standards in the reporting of donor sources and ethics review in peer-reviewed publications involving organ transplantation in China: a scoping review

Transplant Medicine in China: Need for Transparency and International Scrutiny Remains

Unethical Surgery

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traumaRUs

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2 hours ago, traumaRUs said:

What about the medical personnel who take part in these operations?

Sometimes in totalitarian regimes, HCPs don’t have choices. If you refuse to participate, they’ll go after innocent people like your family members.

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Specializes in Nephrology, Cardiology, ER, ICU.

Truth Daisy Joyce

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40 minutes ago, Daisy Joyce said:

Sometimes in totalitarian regimes, HCPs don’t have choices. If you refuse to participate, they’ll go after innocent people like your family members.

That is mostly a western construct, the whole communism bad...capitalism good thing.

Having personal experience dealing with Chinese healthcare on a professional level what I can tell you is that there are real cultural differences and values. It is hard to understand why some things are done as we view others through our ethnocentric lens but I can tell you they likely do not believe they are doing anything wrong. Criminals are criminals right? If they can harvest fresh organs from a criminal who forfeited their right to life and save someone's life then it was worth it, right?

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Specializes in Nephrology, Cardiology, ER, ICU.

I have lived in several other cultures due to military service (Korea, Spain, Japan, interior of Alaska) and the articles I cited, stated that "donors" were often governmental dissidents and organs were removed while they were alive.

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Specializes in Retired.

I had read years ago that organs were harvested from the victims of Tiananmen Square ...all those young student kidneys. And our president speaks highly of Xie. The Chinese have enough problems with extreme crowding and hot, polluted cities which contributes to the government's attitude that life is, indeed, cheap.

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Specializes in Infusion, Med/Surg/Tele, Outpatient.

This should bring the worst global sanctions against any country that operates this way, IF and only IF, proven. Not saying the authors research wasn’t done or is incorrect. The global populace needs to start taking up this cause, to stop forcing people to donate organs because they are a prisoner or a marginalized group.

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17 hours ago, Asystole RN said:

That is mostly a western construct, the whole communism bad...capitalism good thing.

Having personal experience dealing with Chinese healthcare on a professional level what I can tell you is that there are real cultural differences and values. It is hard to understand why some things are done as we view others through our ethnocentric lens but I can tell you they likely do not believe they are doing anything wrong. Criminals are criminals right? If they can harvest fresh organs from a criminal who forfeited their right to life and save someone's life then it was worth it, right?

I’m glad they value prisoners lives with ethics and integrity.

Free speech and right to protest not so much. It find it hard to believe that if a government would work that hard to stop a protest by shooting tear gas at people they value the lives of people who are deemed unfit for being in society.

this crackdown on these people had been going on for quite a while now.

https://www.nbcnews.com/news/world/hong-kong-protests-threaten-embarrass-china-s-communist-party-anniversary-n1060281

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16 hours ago, AggieNurse99 said:

This should bring the worst global sanctions against any country that operates this way, IF and only IF, proven. Not saying the authors research wasn’t done or is incorrect. The global populace needs to start taking up this cause, to stop forcing people to donate organs because they are a prisoner or a marginalized group.

Part of the challenge is that these human rights violations are exceeding difficult to 'prove' because the Chinese government has control of the records. The government obviously isn't going to divulge them to the UN or Amnesty International. Even if the UN requested the documents, they have no way to force China to cooperate since they have no legal jurisdiction over them; it's not like they can issue a subpoena. The only way for 'official proof' to make it's way to the necessary people would be via a whistle-blower disseminating classified documents, and given the horrible things that can happen to political dissidents (case and point, having your organs harvested) that seems highly unlikely.

21 hours ago, Asystole RN said:

It is hard to understand why some things are done as we view others through our ethnocentric lens but I can tell you they likely do not believe they are doing anything wrong. Criminals are criminals right? If they can harvest fresh organs from a criminal who forfeited their right to life and save someone's life then it was worth it, right?

I know this isn't what you're saying, but it makes me think of this ethics case scenario: If we had a serial killer who had been sentenced to death but was otherwise young and healthy--would it be ethical to harvest their organs? Would that allow some good to come from their life and death? Granted, there's an important distinction here: these people wouldn't be killed for their organs; rather, their organs would be harvested if they were going to be killed anyway. It makes me wonder, in the case of these Chinese prisoners: was the decision to harvest organs a deciding factor in their death, or would they have been sentenced to death regardless?

I'm all for cultural relativism and being cautious to judge the moral codes of other cultures. However, as an American, part of what I find so jarring is that many of the victims are only 'criminals' for speaking out against the government. I know that the US values freedom of speech more highly than just about any other country in the world, so we do judge from an ethnocentric lens. Still, it seems very troubling that a country would imprison or even kill it's citizens (and 'redistribute' their organs) just for voicing dissent. It's giving me major North Korea vibes.

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On 10/1/2019 at 9:07 AM, 0.5GPA said:

I’m glad they value prisoners lives with ethics and integrity.

Free speech and right to protest not so much. It find it hard to believe that if a government would work that hard to stop a protest by shooting tear gas at people they value the lives of people who are deemed unfit for being in society.

this crackdown on these people had been going on for quite a while now.

https://www.nbcnews.com/news/world/hong-kong-protests-threaten-embarrass-china-s-communist-party-anniversary-n1060281

The concept of "free speech" is largely a western, in particular, a construct of the United States. Most countries have some form of limited rights to speech and expression.

I personally do not subscribe to the concept of universal cultural tolerance but many do. For example, I think there are some cultures (not saying the people but specifically the culture) should be eradicated. I do however take great efforts to try to understand why a culture does what it does.

The Chinese as a culture simply do not value certain "human rights" the same as most Americans. Many Chinese think forced live organ harvesting from criminals and social rebels as just and right.

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On 10/1/2019 at 1:10 PM, adventure_rn said:

Part of the challenge is that these human rights violations are exceeding difficult to 'prove' because the Chinese government has control of the records. The government obviously isn't going to divulge them to the UN or Amnesty International. Even if the UN requested the documents, they have no way to force China to cooperate since they have no legal jurisdiction over them; it's not like they can issue a subpoena. The only way for 'official proof' to make it's way to the necessary people would be via a whistle-blower disseminating classified documents, and given the horrible things that can happen to political dissidents (case and point, having your organs harvested) that seems highly unlikely.

I know this isn't what you're saying, but it makes me think of this ethics case scenario: If we had a serial killer who had been sentenced to death but was otherwise young and healthy--would it be ethical to harvest their organs? Would that allow some good to come from their life and death? Granted, there's an important distinction here: these people wouldn't be killed for their organs; rather, their organs would be harvested if they were going to be killed anyway. It makes me wonder, in the case of these Chinese prisoners: was the decision to harvest organs a deciding factor in their death, or would they have been sentenced to death regardless? 

I'm all for cultural relativism and being cautious to judge the moral codes of other cultures. However, as an American, part of what I find so jarring is that many of the victims are only 'criminals' for speaking out against the government. I know that the US values freedom of speech more highly than just about any other country in the world, so we do judge from an ethnocentric lens. Still, it seems very troubling that a country would imprison or even kill it's citizens (and 'redistribute' their organs) just for voicing dissent. It's giving me major North Korea vibes.

I think concepts like cultural context and relativism are important for us to understand but I personally do not believe in universal cultural tolerance. I think it is more than just troubling but an indication of possible cultural incompatibility.

For a long time the United States has waged cultural war (not to be confused with physical war) throughout the world. We did it with Commodore Perry as he landed in Japan in 1853 and have continued this policy with varying degrees of formality throughout the years.

For a long time we have ignored China, with rare exceptions such as Nixon's visit in 72, but I think the recent events are evidence that we might need to step up the pressure.

Friedman in the 90's put forth the saying that "No two countries with a McDonald's will wage war." This is of course patently false but I think the general underlying concept is very wise. Instead of sending planes full of bombs, we send fast food workers with bags of fries. You wage a cultural war and destroy the undesirable cultural elements that you find hostile to "human rights." Elements of cultural warfare can be seen in the post Civil War Reconstruction program, and both post WWII Japanese and German reconstruction programs.

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On 9/30/2019 at 9:26 PM, AggieNurse99 said:

This should bring the worst global sanctions against any country that operates this way, IF and only IF, proven. Not saying the authors research wasn’t done or is incorrect. The global populace needs to start taking up this cause, to stop forcing people to donate organs because they are a prisoner or a marginalized group.

The Chinese organ harvesting program is just re-surging in the news due to their protests in Hong Kong but it is both well-known and well-documented. It is not a secret and has not been a secret for the last 30 years. There are entire documentaries and advertisements in China for organ transplants from involuntary "donors." This is a well-known industry that sits at their cornerstone of healthcare tourism.

People are afraid to upset China due to the size of their GDP and influence on the global markets, partly why people were/are upset with the U.S. "trade war" with China. China's government is not good, for values of good, and is not compatible with the world's values of "human rights."

The global community needs to put it's big boy/girl pants on and confront China's numerous human rights issues.

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