The Lancet, Volume 378, Issue 9798, Page 1218, 1 October 2011
doi:10.1016/S0140-6736(11)61536-5
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Time for a boycott of Chinese science and medicine pertaining to organ transplantation
AL Caplan a
, Gabriel Danovitch b, Michael Shapiro c, Jacob Lavee d, Miran Epstein e
, Gabriel Danovitch b, Michael Shapiro c, Jacob Lavee d, Miran Epstein e
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Organ transplantation in China has expanded rapidly in the past 20 years. According to official statistics, more than a million people in China need a transplant every year.1 Many transplants are being done. The China Liver Transplant Registry reports 20 048 recipients between January, 1993, and May 22, 2011. 1475 of these came from living donors. A representative of the Chinese Ministry of Health at the August, 2010, meeting in Vancouver, Canada, of the Transplantation Society reported similar figures.
Many residents of China might have benefited from kidney, liver, and other forms of transplantation. But the rapid expansion of the capacity to do transplantations has not been accompanied by the development of an ethical system for recovering organs from those who die in hospitals while on life support, as is international practice.2 And even though there is an inadequate supply of organs for its own citizens, there remains a brisk traffic to China to secure organ transplants. Transplant “tourists” find their way to China, frustrated by the long waiting times in their own countries and attracted by the competitive price.3
It is clear from the numbers provided by China that not all of the organs for Chinese citizens and transplant tourists are provided by voluntary consenting donors. The source of many of these organs is executed prisoners whose consent is either non-existent or ethically invalid and whose demise might be timed for the convenience of the waiting recipient. The Chinese Government has admitted as much on multiple occasions, although insists that it is trying to discourage the practice.
The use of executed prisoners as a source of organs is a morally reprehensible practice. Use of organs from executed prisoners violates basic human rights and also delays the development in China of ethical strategies for recovering organs.
Despite the continuation of organ donation by execution, the international medical and scientific community has done little to make its moral abhorrence of this state of affairs widely known. Presentations about transplantation in China continue to be made at international conferences, publications about the experience of transplantation in China appear in peer-reviewed journals, and pharmaceutical companies continue their marketing efforts and engage in sponsoring research involving various aspects of transplantation in China.
The time has come to bring normal scientific and medical interchange with China concerning transplantation to a halt. We call for a boycott on accepting papers at meetings, publishing papers in journals, and cooperating on research related to transplantation unless it can be verified that the organ source is not an executed prisoner. These steps are admittedly challenging. But the international biomedical community must firmly and boldly challenge the status quo—the barbarous practice of obtaining organs from executed prisoners.
We declare that we have no conflicts of interest.
References
1 Anon. China admits death row organ use. BBC News Online.http://news.bbc.co.uk/1/hi/8222732.stm. (accessed Aug 23, 2011).
2 Han M. Organ donor pilot a failure after one year. Beijing Today.http://www.beijingtoday.com.cn/feature/organ-donor-pilot-a-failure-after-one-year. (accessed Aug 17, 2011).
3 Anon. Oz kidney buyers giving China's ‘transplant tourism’ a boost. Sify News.http://www.sify.com/news/oz-kidney-buyers-giving-china-s-transplant-tourism-a-boost-news-international-lcgpOcbgcgj.html. (accessed Aug 17, 2011).
a Department of Medical Ethics, University of Pennsylvania, Philadelphia, PA 19104, USA
b David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
c Hackensack University Medical Center, Hackensack, NJ, USA
d Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
e Queen Mary University of London, London, UK
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