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For decades, China obtained human organs such as kidneys and livers from executed prisoners, a practice condemned by human rights activists and medical ethicists. China says they no longer do this and have built a new system for organ transplants that now relies on volunteers, not prisoners. Hari Sreenivasan reports.
Decades ago, China began a practice that human rights advocates and medical ethicists condemned: taking organs, such as kidneys and livers, from executed prisoners to transplant into people who needed them.
The Chinese government says it's reformed the practice. Now they say they only recover organs from volunteers. But some say the practice continues.
Hari Sreenivasan and producer Dan Sagalyn have the story.
One doctor's war against global organ trafficking
This is when a life is renewed. A transplant surgeon, seen here, removes a kidney from a volunteer donor and inserts it into someone whose kidneys are failing.
In most cases, patients who need a new organ have to wait months or years before one is available. But this man, who told us he had end-stage kidney disease 11 years ago, could wait no longer.
KIDNEY TRANSPLANT PATIENT (through interpreter):
I was on dialysis already two years, and I was constantly going downhill.
We met him in Vancouver, Canada. He asked that we conceal his identity by hiding his face and replacing his voice to protect his privacy.
KIDNEY TRANSPLANT PATIENT (through interpreter):
They called these people the living dead. You just haven't died yet, but you're gone.
Because of his age and rare blood type, he says he would have died before reaching the top of the waiting list for a new kidney. So, urged by family and friends, he went to China's capital, Beijing, in 2006. Within one week, he received a new kidney. He says he paid $10,000 for the transplant.
In Canada, it would have been free, since the government pays for health care. In the U.S., the average hospital charge for a kidney transplant is $150,000. Traveling to another country for this kind of surgery is called transplant tourism.
I went there dead. I came back alive.
On average, 22 people die every day in the United States waiting for a transplant. The median wait time for a lung here is four months, a heart almost a year, and a kidney two years. Transplant tourists understandably have been drawn to other countries by promises of little to no wait.
It's not just Canada that generates transplant tourists to China. On the other side of the world, at about the same time, an Israeli doctor had a patient who also needed a transplant.
DR. JACOB LAVEE, Transplant Surgeon:
Back in 2005, a patient of mine came to me one day and told me, doc, I'm fed up waiting here in Israel for a suitable heart donor to become available, and I was told — that's what he told me — by my insurance company that I should go to China because they have scheduled me to undergo heart transplantation. And he specified a specific date two weeks ahead of time.
Heart surgeon Dr. Jacob Lavee is president of the Israel Society of Transplantation. While kidney transplants can involve obtaining a kidney from a living donor, that is not the case with a heart transplant.
DR. JACOB LAVEE:
If a patient was promised to undergo a heart transplant on a specific date, this could only mean that the — those who promised that knew ahead of time when his potential donor would be dead.
Human rights investigator Ethan Gutmann and lawyer David Matas have testified before Congress about China's transplant system.
DAVID MATAS, Human Rights Lawyer:
It is unconscionable to kill a healthy, innocent person so that a sick person can live.
They say they know how organs in China become available with no wait time.
They have obviously got a lot of people sitting around waiting to be killed for a transplant. And they are just picking the right person to be killed depending on who the patient is.
Matas and Gutmann say Chinese doctors have coordinated with Chinese prison officials, and inmate executions take place when patients are in need of organs.
Medical professionals and human rights advocates say this practice violates the prisoner's human rights.
However, this is how one Chinese doctor justified the practice. This video was produced by the Chinese government.
DR. HE XIAOSHUN, First Affiliated Hospital of Sun Yat-Sen University (through interpreter): To apply the traditional Chinese way of thinking, the prisoners committed sins in their lives. If we let them donate their organs, well, in a sense, they are offering salvation. They can atone for their crime with that opportunity.
At a press conference in 2005, China's vice minister of health, Huang Jiefu, admitted the government took organs from executed prisoners.
But, in 2014, Huang Jiefu, who is now leading the reform efforts in China, declared that, starting in 2015, China would stop using organs from executed prisoners.
But Matas and Gutmann believe they have evidence that this practice still continues. They say inmates on death row include prisoners of conscience, such as practitioners of Falun Gong who become unwilling sources for organs. Falun Gong is a form of Chinese meditation and exercise with a spiritual underpinning.
Since 1999, the Chinese government has cracked down on Falun Gong, charging it with being an unregistered religion and cult that aims to subvert the state.
We interviewed Falun Gong who got out of prison, got out of China, systematically blood-tested, organ-examined, not for their health — they were being tortured — and only the types of examinations relevant to transplantation.
Wang Chunying and Yin Liping practice Falun Gong. Both say they were detained a number of times between 1999 and 2009.
WANG CHUNYING, Falun Gong Practitioner (through translator):
In 2008, I was forced to take a blood draw. The atmosphere was very tense and horrific. I thought this blood draw must be related to looking for matching organs.
The Chinese government might say, we just needed more blood. That is all. We didn't take her organs. We didn't do anything to her body. We just took blood to make sure there wasn't an infection in the yard.
How do you know that the government wanted your blood for any other reasons?
WANG CHUNYING (through interpreter):
Because the living conditions were terrible in the reeducation camp. They didn't care about whether we lived or died.
YIN LIPING, Falun Gong Practitioner (through interpreter):
Once, I was forced to take a blood draw. There were multiple times of other tests, such as MRI, ultrasound and chest X-ray.
Gutmann says he's interviewed ethnic minorities from Tibet and Xinjiang who all tell similar stories about medical examinations while in prison.
ETHAN GUTMANN, Human Rights Investigator:
When you start to hear the same description of an examination in a completely different language from a completely different group, but it's the same examination, this is one of the big tipoffs that this is really directed towards China's enemies, its political and religious enemies.
Matas and Gutmann say there's another possible motive driving this practice: profit. In the past, some Chinese hospitals even advertised the costs of new organs, $98,000 to $130,000 for a liver, $130,000 to $160,000 for a heart.
By reviewing Chinese medical publications, hospital Web site data, and making calls to hospitals, Gutmann and Matas estimate there could be 60,000 to 100,000 transplants still taking place each year in China. The Chinese government rejects these accusations.
In 2016, it says there were just over 13,000 transplants performed in the country. Compare that to the United States that had 33,000 transplants last year.
In an e-mail to the NewsHour, a spokesman from the Chinese Embassy in Washington, D.C., writes: "The Chinese government firmly abide by the internationally recognized ethical principles about organ transplantation, and adhere to the voluntary organ donation after the death of Chinese citizens."
We asked if political prisoners were singled out for execution for their organs. The embassy didn't respond to this question.
Chinese officials do say, since 2015, they no longer recover organs from prisoners.
Dr. Huang Jiefu, who is leading reform efforts, acknowledged in an interview with a Chinese newspaper progress has been slow.
"Our use of death row prisoner organs before the establishment of a citizen organ donation system was an act of desperation to save the lives of patients suffering organ failure. When the citizen donation system was set up, we abolished this source of organs as quickly as possible."
In February of this year, at a Vatican conference on organ trafficking, Chinese medical leaders agreed that using organs from executed prisoners is a crime and should be condemned worldwide. A number of American doctors who have been to China say they believe the country has taken major steps to stop the practice of taking organs from executed prisoners.
DR. FRANCIS DELMONICO, Adviser, World Health Organization:
The reports that we get from Canada or the United States or from the Middle East of individuals undergoing transplantation, that's markedly reduced, but it has not completely stopped.
Dr. Francis Delmonico is an adviser to the World Health Organization and former president of the Transplantation Society. He's leading the international effort to help China establish a new system of organ donation.
When did you first become aware that China might be executing people for their organs?
DR. FRANCIS DELMONICO:
I was invited to the Peking Union Medical College by Jiefu Huang, who was, at the time, vice minister of health.
And he was a liver transplant surgeon. And he said to me, "Frank, this is — we have got a horrendous problem, and I need your help."
Individuals in China were being executed. And those were the — they became the source of organs for many people from around the world going to China, as many as 11,000 transplants being performed, and this is in 2006.
While some doctors like Huang Jiefu wanted this practice stopped, others who were making money from organ trafficking didn't, according to Delmonico.
To put pressure on China, a number of medical associations and journals launched a boycott, beginning in 2006, banning Chinese research papers that relied on data from executed prisoners.
At the same time, Delmonico and other doctors helped China build a new and legitimate system for organ recovery, similar to the system in the U.S., requiring consent and only from live or deceased donors in hospitals.
Has China stopped harvesting organs from people that they have executed, that they are executing?
I don't know that for certain. So I can say to you that it's markedly reduced. But can I assure you or the rest of the world that it's completely stopped? I can't.
Delmonico says there's a new generation of doctors in China that want and embrace the reforms that are taking place in China's transplantation system.
But human rights investigator Ethan Gutmann says China is still killing prisoners and taking their organs.
Our report shows tremendous continuity over time, even while they're — the Chinese are making completely different statements about this.
Leading experts to call for inspections of Chinese hospitals.
What needs to be done now is an international committees of transplant experts that will be allowed to visit China and verify the source of these organs.
In his desperation, this man says he didn't think about where his new kidney came from, and, looking back, that he has no regrets.
It's given me a new outlook on life. I had an opportunity to see my children graduate from universities. I have a happy life with my wife.
For the PBS NewsHour, I'm Hari Sreenivasan.
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