Stolen Identity: China's Organ Trade and Policy Options for Canada

To the Chinese government, Falun Gong is a doomsday cult, capable of “disturbing the normal order of society by confusing the people’s moral and ethical concepts.”1 However, to the millions of Falun Gong members, their religious beliefs are peaceful, and definitely not a threat to state operations. In July 1999, the People’s Republic of China (PRC) banned all forms of Falun Gong practice thought to imperil social order and state stability. Subsequently, evidence surfaced attesting to the government’s role in torturing and killing incarcerated Falun Gong members. Does the plan of killing off every member sound implausible and extreme?

Not for the PRC, which views the Falun Gong faith as an incipient political competitor capable of bringing forth a revolution. So far, the ban has been unsuccessful in suppressing dissent, as Falun Gong devotees are relentless and the sect’s defiance has gained much attention from many human rights organizations and western governments. With the number of incarcerated people increasing precipitously under this worldwide religious movement China’s extermination plan has raised numerous human rights concerns. Topping the list of atrocities is China’s harvesting of organs from Falun Gong members after they are tortured through electrocution, sleep deprivation, sexual assault and hangings. In the midst of this plan organs of Falun Gong members are involuntarily seized for sale on the black market.

Given that harvested organs are sold on the international black market, could this mean that Canadians are directly supporting China’s intrusive extermination plan?

Evidence indicates that the bodies of executed prisoners are the source for many organ transplant operations performed in China, while Canadians frustrated with long organ wait lists are feeding the demand. China admitted in 2005 that it harvests and sells the organs of executed prisoners; and the British Transplantation Society has revealed that "an accumulating body of evidence suggests that the organs of executed prisoners are being removed for transplantation without the prior consent of either the prisoner or their family."2 In 2007, these allegations were further confirmed in a report entitled, “Bloody Harvest: Revised Report into the Allegations of Harvesting of Falun Gong Practitioners in China,” written by David Kilgour, Canada’s Secretary of State for the Asia Pacific region, and David Matas, a Canadian human rights lawyer. The report provides admissions from doctors, interviewed by telephone, that organs were harvested from Falun Gong members. These witness testimonies also reported that: after torture sessions, corpses were found to have had organs removed; Falun Gong members were tortured to death for menial convictions; detainees’ names were undisclosed; and family members were banned from seeing the corpses of those tortured to death. The testimonies also detailed how prisoners had their organs screened for harvesting while awaiting an involuntary seizure of their vital organs.

Matas and Kilgour further indicate that the sources of 41,500 transplants that occurred in China between 2000 and 2005 remain unexplained; the number of executed prisoners from which the government admits to extracting organs, together with the number of known willing donors, came nowhere close to the number of transplants that were performed. Not only were the sources of many transplants left unexplained, but this trend was matched by an astronomical increase in the number of organ transplantation procedures performed. In 1998, one facility, the Orient Organ Transplant Centre conducted only 9 liver transplants, compared to 2,248 in 2005. China’s surge in organ transplants has left many wondering how China is able to quickly replenish its organ supply while ensuring that recipients do not have to wait long for their organs.3  

In part, the frequency of organ transplant operations carried out in China is fueled by a foreign market. In 2006, patients in need of a liver transplant had to wait an average of two weeks in China, but the median waiting time for a kidney in Canada was 32.5 months in 2003. 4 Shorter wait times in China have encouraged many Canadian recipients to undergo organ transplant despite the risks and weak quality assurance systems in place. While there are no statistics available detailing who the recipients of organ transplants are, David Matas estimates that 100 Canadians have gone to China for transplants, unaware of the allegations that Chinese prisoners are killed for their organs.5 The “Bloody Harvest” report also confirms that hospitals in Toronto, Vancouver and Calgary have sent patients to China for organ transplants. Based on incomplete estimates, on average there is one case each month from Vancouver hospitals and 20 cases from Toronto hospitals. 6 In essence, China’s transplant economy collects huge profits from this foreign demand for organs.

In the midst of much controversy over health risks and human rights accusations, China’s booming organ transplantation business has proven to be remarkably sustainable. Using quotes from the China International Transplantation Network Assistance Centre , prices for transplantations can run up to $30,000 for a cornea, $62,000 for a kidney, $130,000 for a liver, and $160,000 for a heart (all prices US). These exorbitant costs have not at all hindered business. Before 1999, only 22 liver transplant centers operated across China; but by mid-April 2006, over 500 centers had been established. The number of kidney transplantation institutions also increased, from 106 in 2001 to 368 in 2005.7 The opportunity to make money has led to the establishment of numerous facilities specializing in organ transplantations: the Peking University Third Hospital Liver Transplantation Centre for example, as well as the Beijing Organ Transplantation Centre, the Organ Transplant Centre of the People's Liberation Army Number 309 Hospital, and the Oriental Organ Transplant Centre to name just a few.8 The creation of these centers offers permanency to China’s practice of harvesting organs from prisoners and performing organ transplantations for both domestic and foreign markets. The mounting evidence of clandestine, state-coordinated organ removal practices, combined with the number of unaccounted sources for organs and witness testimonies of Falun Gong prisoner atrocities by officials offers credence to China’s title as the second largest reigning organ transplants centre in the world following the United States.9 
 
Given that the use of executed prisoners' organs for transplant purposes creates an undesirable incentive for the authorities to refrain from either abolishing capital punishment or reducing the scope of its application, the issue then focuses on how the international community can eliminate the demand for these “dirty organs”. Canada has one of the worst organ donation rates in the western world, with only 13 donors per million people, compared to 20 per million in the United States. The problem is compounded by a low government effort to encourage donations. Demonstrating how critical the need for organs is, in January 2006 the demand for organs in Canada increased by 35% from 1995 levels.10 In addition, 283 patients died while waiting for an organ in 2005. Faced with long wait times, many candidates opt to undergo expensive and risky organ transplantations in China, as the alternative would mean dying on the organ waiting list. So far, the Canadian government has not issued any official warnings about the risks involved in undergoing organ transplants in China. Also, there is no mention of unethical organ transplants in the health section of the Department of Foreign Affairs’ travel advisory to China. More systemic communication can be done by Canadian officials to inform potential organ recipients of the source of organs in China, as well as the unethical ways in which these organs are harvested.

Enhancing this problem is Canada’s lax approach to improving its current organ donation system.  The current mechanisms in place are not largely ineffective. In Ontario, for example, individuals are encouraged to carry a donor card; however, once a patient arrives in a hospital and declared dead, a family member’s permission is still sought before removing an organ. The problem, as identified by Canada’s Standing Committee on Health , is that, although more than 90% of Canadians support organ donation, only 52% of donor's wishes are respected at the time of death. Forty-eight percent of the time, their wishes are over-ruled by loved ones. By contrast, in circumstances where the intended donors communicated their wishes directly to their family, those wishes were respected 92% of the time.

Adding to these missed opportunities, Frank Markel , chief executive officer of the Trillium Gift of Life Network, which runs the province's organ and tissue donation system, says: "We very seldom see a signed donor card. In cases where organ and tissue donation is possible, medical staff in emergency departments and intensive care units don't have the time to go rummaging around in search of donor cards. [As a result,] doctors will approach the family and ask consent for the donation.” Anne Lester , donor coordinator at Ottawa Hospital says: “Candidates are often involved in sudden, traumatic mishaps or illnesses. Sometimes they don't even have their wallets or purses with them. Unfortunately, the current system relies on Ontario citizens to speak to their families in detail about their wishes, in the event of death.” With many people not communicating their donor wishes to family members, many life-saving opportunities go unclaimed.

Perhaps the Canadian government should be exploring new frontiers in educating and creating awareness around this issue. A strong awareness campaign to advocate organ donation at the national level would encourage dialogue and bring urgency to the issue. After all, it was difficult to forget the black lung demonstration that toured Ontario schools under the anti-smoking campaign waged by the Canadian Lung Association , or the story of the paraplegic who was left paralyzed from a car accident, in the campaign spearheaded by Mother’s Against Drunk Driving (MADD). A strong awareness program like MADD Canada’s Youth Program is just what the organ donation campaign needs. This anti-drinking and driving campaign has been successful at raising awareness as it reaches 600,000 high school and 150,000 elementary students per year with the help of volunteer speakers sharing their experiences, and powerful multi-media assembly presentations. MADD Canada also uses the Internet, radio, TV ads, posters, national contests and bursaries to reach out to every age group. Organ donation requires a similar national advocacy and education plan in order to create awareness and enhance family dialogue.

On the front lines, more aggressive advocacy also needs to be carried out by healthcare workers. A 2006 study published in the American Journal of Transplantation by researchers in the Netherlands indicated that hospitals with initiatives to increase organ donation awareness among staff, so that potential donors are not overlooked, had higher organ procurement levels. The further presence of a transplant coordinator was also found to play a major role in higher consent rates from family members. Often, convincing the families of the benefits of organ donation is all that is needed. It has been proven that once hospital transplant coordinators talk to the family members, the chances of obtaining an organ are significantly higher. Changing the mentality of hospital workers to advocate organ donations within the hospital setting is essential.

Aside from an improved education system and aggressive advocacy within the hospital setting, the Canadian government could also seek out potential donors by using the national census. Currently, Canada’s Census is conducted every five years, and it is mandatory for all Canadians to fill it out under the Constitution and Statistics Act. Using the national census to get otherwise complacent people to detail their position on organ donation would cast the donor net even wider, as currently drivers license and donor cards leave out a large portion of potential donors.

Furthermore, the census data could be linked to a national electronic network which tracks available donors and offer front line workers the capacity to offer patients much needed information on the availability of organs. According to Dr. Francis Delmonico, medical director of The Transplantation society, "Rather than having Canadians travel abroad to buy their organs in the Philippines or China, Canada needs to do a better job of harvesting and distributing the organs of the deceased in its own country." However, the problem, as pointed out by Rene Bruemmer , a journalist for the Montreal Gazette, is that provinces have balked at the creation of a national network, fearing infringement on their health territory after spending decades establishing their systems. On one side, liver and heart transplant centers argue that they already have agreements to share organs on a priority basis nationwide; meanwhile, provinces like Ontario, British Columbia, Manitoba and New Brunswick have instituted similar measures, requiring hospitals to report potential donors. The problem is that there is no horizontal cohesive plan to track potential donors nationally. Therefore, Premier Dalton McGuinty’s recent $4million strategy to create a living donor database, as well as providing information to hospitals to identify people who wish to donate their organs after death, could be improved with the participation of other provinces as well. Calling for a national education plan to promote awareness, as well as an electronic registration which seeks out consent through the national census could be a step in the right direction.

Canada needs to take definite steps towards increasing the organ pool, as hundreds of patients die every year waiting for an organ. At a time when China’s institutions are replete with instances of subpar health standards, product recalls, weak inspection programs, as well as corrupt drug and food regulators, do we really want Canadians going to China to undergo organ transplants? By undergoing transplants in China, Canadians directly support a for-profit regime which deprives individuals of their personal and religious rights and physical identity. Under these circumstances, one can not ignore the perils which lie ahead for both our health care system and the long-term health of Canadians if this trend in black-market organ donation continues.

Comments (0)

Subscribe to this comment's feed

Write comment

Email Name		Title Comment smaller | bigger
		I have read and agree to the Terms of Usage. Write the displayed characters Add Comment