As doctors, moreover, we do not have to be concerned, unlike politicians, about
jeopardizing our trading affiliations with China, so the onus is on us to call on our Chinese counterparts who stand guilty of ethically perverting the science of healing, to immediately and comprehensively explain their actions.
Medicine Weekly, Ireland: March 27, 2007 - Dr Declan Lyons and Dr Eileen Sweeney of St Patrick's Hospital, Dublin, examine the perversion of science in modern China that allows the sale of human organs from imprisoned Falun Gong practitioners.
A recent report investigating the possible organ harvesting of members of the Falun Gong movement in China has alleged that "the Chinese government has over the past half decade put to death a large but unknown number of Falun Gong prisoners of conscience" and "simultaneously seized their vital organs for sale at high prices".
The authors of the report, David Kilgour (a former Canadian Secretary of State for the Asia Pacific region) and David Matas (an international human rights lawyer), recently visited Ireland to discuss their concerns with the Oireachtas Joint Committee on Foreign Affairs.
This article will examine the backdrop against which these disturbing allegations have been raised and the implications for ethical medical practice.
Who are the Falun Gong and why are they being repressed?
Falun Gong (also known as Falun Dafa) is a popular spiritual movement in China that advocates channelling bodily energy through mental concentration and exercises. It is a meditative discipline that draws on Buddhism, Taoism and the traditional Chinese doctrine of Qigong and has been valued and promoted for its mental and physical health benefits.
Practitioners are encouraged to practice the exercises (which include slow moving, standing gestures, stretches and postures to sitting in meditation) privately or in groups and adhere to the core principles of truthfulness, compassion and forbearance.
Falun Gong practitioners are free to participate in any other religious observances and as a group has never made any demands for political reform or change in China.
Initial Chinese government reaction to the increasing popularization of the Falun Gong movement in the early 1990s was positive, and potential health benefits for older practitioners were cited by officials as a useful and cost beneficial spin-off effect.
Attitudes changed, however, when increasing official criticism aimed at the group's founder Li Hongzhi (now living in exile in the US) led to an unannounced peaceful protest in central Beijing in April 1999.
This public demonstration was the largest held in China since the Tiananmen
Square protests of May 1989 and apparently caught the government's security services completely by surprise.
By July of 1999, the Chinese government had announced that Falun Gong was a proscribed organization and that it should be "outlawed and extirpated throughout China".
Since then hundreds of thousands of practitioners nationwide have been detained, arrested, sent to jail or labour camps for periods of several weeks or years, or formally charged and sentenced to terms of up to 18 years' imprisonment. As of 2007, reports indicate that at least 3,000 detained practitioners have died as a result of torture or ill-treatment at the hands of the authorities.
The most distinctive aspect of the Chinese Communist Party's campaign to crush Falun Gong, aside from its sheer scope and brutality, has been reports indicating that large numbers of the group's detained practitioners were being forcibly sent to psychiatric hospitals by the security authorities. Leading members of Falun Gong appear to have been selectively targeted in this way.
In trying to discredit the movement as a whole by branding key members of the group as mentally ill, the Chinese authorities hope that Falun Gong will lose popularity generally. It is undoubtedly true that the Chinese authorities have devoted significant time and resources since 1999 to the destruction of Falun Gong, and some outside observers believe this protracted campaign, despite a change in political leadership in Beijing, is closely reminiscent of the kinds of extreme and unbridled political campaigns waged by the Communist Party during the cultural revolution, particularly the practice of political-psychiatric abuse that prevailed during that dark period in China's history.
The precise reasons for the persecution may never be known but clues begin to emerge from the state-sponsored survey undertaken by the authorities before the crackdown, which revealed that 70 million people regularly practised Falun Gong, a figure that exceeded the membership of the Communist Party in China.
Quite simply, Falun Gong had become too large to control and too popular, implicitly challenging the party's ideological power, in contrast to communism, which had lost appeal among a citizenry that looked to more traditional Chinese values as were being expressed in a number of different religious and spiritual value systems.
General human rights situation in China
Bodies such as Amnesty International and Human Rights Watch have long expressed concerns about the general human rights situation in China.
For the past 40 years, non-violent political and religious dissidents have run the risk of arbitrary arrest, detention and torture - a pattern of human rights abuse that continues even in today's economically more open society.
Thousands of people have been sentenced to death or executed and there have been recent renewed crackdowns on the media and internet controls have also been tightened.
Freedom of expression and religion continue to be severely restricted in Tibet and other Tibetan areas and members of churches not officially sanctioned by the central government face persecution elsewhere in Chinese-controlled territory.
The authorities continue to use the global 'war on terror' to justify harsh repression against the ethnic Uighur community. The death penalty continues to be used extensively and arbitrarily, often for non-violent crimes, at times as a result of political interference.
Based on public reports available, Amnesty reports that up to 2,000 people have been executed annually for many years, although the true figure is believed to be significantly higher.
Allegations of organ harvesting
It has been known for more than two decades that the Chinese authorities have been taking the organs of executed prisoners (a practice that has been officially admitted in 2005) and the past five years in particular has seen a huge increase in organ transplants in China and their sale at high prices, sometimes to foreigners who face long waits for voluntary donations in their home countries.
The independent report by Canadians David Kilgour and David Matas (neither of whom are practitioners of Falun Gong) helped shed light on fears that the Chinese government's campaign against Falun Gong was taking a new and alarming twist, with allegations that practitioners and other prisoners in China have unwillingly had their organs removed in a systematic way for resale to others awaiting transplants.
Their report is the result of a two-month investigation, including interviews with witnesses, research into websites of transplantation centers and transcripts of telephone inquiries.
According to public reports in China, there were approximately 18,500 transplants in China in the six-year period from 1994 to 1999 and according to the Chinese Medical Organ Transplant Association some 60,000 transplants were undertaken during the period 2000 to 2005 (coinciding with the start of the persecution against Falun Gong).
There appeared to be only 22 liver transplant centres operating across China before 1999, compared with over 500 by mid-April 2006. The number of liver transplant operations rose from 135 annually in 1988 to more than 4,000 in 2005. The numbers of renal transplant operations also nearly trebled in six years.
Central to the concerns of Kilgour and Matas is the fact that the source of 41,500 transplants from 2000 to 2005 is unexplained when 'predictable' sources such as executed prisoners, brain-dead persons or donated organs are taken into account.
As in Japan, the culture in China is such that people generally do not donate their organs and thus there is no organized system of organ donation yet established in China.
Other evidence to link the massive rise in availability of transplantation to the repression of Falun Gong has come from testimonies of escaped prisoners and from relatives of practitioners who died in detention and who described seeing the corpses of their loved ones with surgical incisions and unexplained mutilations.
The wife of a Chinese surgeon described in detail to Kilgour and Matas how her husband removed cornea from 2,000 anaesthetized Falun Gong prisoners in the North East of China from 2001 to 2003, asserting that none of the prisoners survived as other surgeons removed vital organs and the bodies of victims were subsequently incinerated.
Phone conversations with 30 hospitals and Chinese transplant centres are transcribed in the report by the two lawyers and a number of these centers openly admitted to using Falun Gong prisoners for organ harvesting, citing their good physical health as a prime factor in rendering them suitable.
The short waiting times advertised for organ availability further suggests the existence of both a computer matching system for transplants and a large bank of live prospective donors, according to the report. It is widely known that Falun Gong practitioners are routinely subjected to a 'blood work-up' on entering detention, a prerequisite for organ matching.
An unusual feature of many Falun Gong detentions is the fact that many who were of rural origin and who came to protest in Beijing in 2001 refused to identify themselves after arrest, for fear their families would be victimized.
They constitute a remarkably undefended and vulnerable group and frequently disappear within the labour camp system and may be the population providing an ever-increasing harvest of fresh organs, Kilgour and Matas emphasized in their report.
The authors acknowledge that the central tenets of their report are made inductively and that their allegations are not proven by their investigation, although this is in part due to the lack of verifiable information stemming from the Chinese authorities.
The somewhat alarming discrepancy between 41,500 recent transplants and the couple of thousand explicable organ donations raises questions and requires explanation, which will be difficult to then dismiss by falling into propaganda on one side or the other.
In the past, China has used the veil of sovereignty to evade responding to concerns about human rights, stating they were purely matters of national concern.
If, given its recent economic expansion, China hopes to have an ongoing dialogue with the West, it must allow an independent inspection of its facilities without notice to allay the concerns about the fate of Falun Gong prisoners of conscience.
The professional response cannot also disassociate itself from the suffering in China.
As doctors, moreover, we do not have to be concerned, unlike politicians, about jeopardizing our trading affiliations with China, so the onus is on us to call on our Chinese counterparts who stand guilty of ethically perverting the science of healing, to immediately and comprehensively explain their actions.
Dr Declan Lyons
St Patrick's Hospital
Dr Eileen Sweeney
Registrar in Psychiatry
St Patrick's Hospital