August 18, 2016
HONG KONG — An acrimonious debate over China’s use of prisoners’ organs for transplant — a practice Chinese officials say has ended — has flared anew as an international transplant conference gets underway in Hong Kong, with some doctors and ethicists saying the meeting should not be held in China given the controversy.
Chinese health officials say China stopped using organs from executed prisoners on Jan. 1, 2015, after decades of obtaining most of its organs from convicts. Officials say they are building a voluntary national donation system that does not include prisoners.
Hong Kong, a former British colony that returned to Chinese rule in 1997, has an organ donation system separate from the mainland’s.
But in an article published on Wednesday in the American Journal of Transplantation, a day before the 26th International Congress of the Transplantation Society was to open in Hong Kong, doctors and members of a nongovernmental medical organization criticized the decision to hold the meeting in China as premature.
“In the current context, it is not possible to verify the veracity of the announced changes and it thus remains premature to include China as an ethical partner in the international transplant community,” wrote the authors, who included Dr. Jacob Lavee, of the Sheba Medical Center in Israel, and Dr. Torsten Trey, the executive director of Doctors Against Forced Organ Harvesting, a nongovernmental group based in Washington.
“Until we have independent and objective evidence of a complete cessation of unethical organ procurement from prisoners, the medical community has a professional responsibility to maintain the academic embargo on Chinese transplant professionals,” they wrote.
International medical organizations like the World Medical Association and the Transplantation Society say the use of organs from prisoners in any country that has the death penalty violates medical ethical standards because the prisoners cannot give their consent freely. Hong Kong does not practice capital punishment, but the death penalty is widely used on the mainland.
There also are mixed messages about the issue in China. Prisoners can still donate organs, according to an entry dated May 5, 2016, on the website of the China Organ Transplantation Development Foundation, a group tasked with managing the transition.
Telephone calls to the foundation requesting clarification were not answered.
In an interview conducted on the messaging app WeChat, Huang Jiefu, a senior Chinese transplant official and a former deputy minister of health, appeared to defend the changes but simultaneously acknowledge they were far from perfect.
“We have finished walking the first step of a long march of 10,000 li, the task is heavy and the road far, but we are walking on a path of light,” he wrote. A li is a Chinese measure of distance equal to about a third of a mile.
But Dr. Lavee, who is also the president of the Israel Transplantation Society, said in an interview that by holding the meeting in Hong Kong and presenting papers from China, the society had “abandoned the only weapon against China it has in asking it to ethically source organs as it is supposed to” — a longstanding embargo intended to pressure China into changing.
Dr. Lavee, who is a member of the Transplantation Society’s ethics committee and the advisory board of Doctors Against Forced Organ Harvesting, said he would not attend the Hong Kong meeting as a protest.
Neither the society’s president, Dr. Philip O’Connell, nor two former presidents replied to an email requesting comment.
On its website, the society said that it opposed the unethical harvesting of organs and had requested three times in writing that the authors of papers from China disclose the source of the organs they cited.
“All submissions in which executed prisoner organs were used have been rejected, as have all submissions where there has been no response to any of our requests for declaration,” it said.
In the article in the American Journal of Transplantation, the authors said they had “ethical concerns” over 10 papers by Chinese doctors that were due to be presented in Hong Kong.
Dr. Lavee also expressed concerns mirroring those of a resolution passed by the United States House of Representatives in June over “persistent and credible reports” that organs were being taken from prisoners of conscience, principally detained practitioners of Falun Gong, a spiritual movement that is outlawed in China.
The article in the American Journal of Transplantation also addressed those concerns, saying: “It is noticeable that China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience.”
The Chinese government also has not changed the law to prohibit the use of prisoners’ organs.
Dr. Lavee, a heart surgeon, had a patient in 2005 who was told a new heart awaited him in China in two weeks — something only possible if there was a pool of living, blood-typed donors, the doctor said.
“I’m a simple Jewish heart transplant surgeon and the son of a Holocaust survivor, and the reason I spend so much time on this is that I can’t keep silent in the face of a new crime against humanity,” he said.
