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