Sunday, November 19, 2006

Harvesting organs from the condemned

It is interesting how some news items have no real news content. Take the criticism, by a representative of Human Rights Watch, of the use of the organs of executed criminals in China for transplant purposes. The piece in Salon is an opportunity to review what is known about this practice and the ethical concerns it raises, but it does not offer any new information beyond an official acknowledgment by the Chinese government of what many knew, since Human Rights Watch outed the Chinese government document entitled 'Rules concerning the Utilization of Corpses or Organs from the Corpses of Executed Prisoners' back in 1984. What looks like a news item partly functions as an exercise in consciousness raising, which (especially in this case) is a good thing.

Capital punishment in China should trouble everyone, including those who support the death penalty. To the extent that the numbers are documented, China is by far the world leader in executions, and is by far the most 'liberal' in terms of what counts as a capital offense (68 crimes, including tax evasion). Serious problems in the Chinese legal system -- from the use of torture to obtain confessions to judges with major conflicts of interest -- draw into question whether the condemned received anything resembling a fair trial before being dispatched. It is within this dubious system of legal punishment that the Chinese practice of prisoner organ 'donation' finds itself. Although Chinese authorities insist that the condemned or their family members are required to give informed consent, it seems unlikely that the consent form will include a sentence like this: "Your organ may save the life of a fellow Chinese. However, your organ may also go to a rich foreigner, and the lucrative proceeds of this exchange will disappear into the pockets of unnamed officials." If that sounds far-fetched, read the first chapter of Trust is not enough: bringing human rights to medicine by David and Sheila Rothman. They recount the following story:

Several years ago a heart transplant surgeon told us that he had been invited to China to perform a transplant; accustomed to long waiting periods in America, he asked how he could be certain that a heart would be available when he arrived. His would-be hosts told him they would schedule an execution to fit his travel schedule. He turned down the invitation.

Officials willing to time their executions to meet the travel needs of foreigners are probably willing to do a whole lot else.

The current Chinese system allows for the worst case scenario: a man is innocent of any crime, but condemned to death; his kidney is removed under unsafe conditions; it is transplanted to a Japanese recipient who, after paying a hefty fee, dies of an infection. Could happen, probably already did, and if it manages to reach the light of day, it will be news.

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