Historical development and current status of organ procurement from death-row prisoners in China

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Abstract

Background

In December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners.

Discussion

In the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to “voluntarily donate” organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards.

Conclusions

Organ sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with “consent” are now simply labelled as “voluntarily donations from citizens”. The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain.

Electronic supplementary material

The online version of this article (doi:10.1186/s12910-015-0074-0) contains supplementary material, which is available to authorized users.

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Most cited references 20

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Voluntary organ donation system adapted to Chinese cultural values and social reality.

Jiefu Huang, J. Millis, Yilei Mao … (2015)

Organ donation and transplant systems have unique characteristics based on the local culture and socioeconomic context. China's transplant and organ donation systems developed without regulatory oversight until 2006 when regulation and policy were developed and then implemented over the next several years. Most recently, the pilot project of establishing a voluntary citizen-based deceased donor program was established. The pilot program addressed the legal, financial, and cultural barriers to organ donation in China. The pilot program has evolved into a national program. Significantly, it established a uniquely Chinese donor classification system. The Chinese donor classification system recognizes donation after brain death (category I), donation after circulatory death (category II), and donation after brain death followed by circulatory death (category III). Through August 2014, the system has identified 2326 donors and provided 6416 organs that have been allocated though a transparent organ allocation system. The estimated number of donors in 2014 is 1147. As China's attitudes toward organ donation have matured and evolved and as China, as a nation, is taking its place on the world stage, it is recognizing that its past practice of using organs from executed prisoners is not sustainable. It is time to recognize that the efforts to regulate transplantation and provide voluntary citizen-based deceased organ donation have been successful and that China should use this system to provide organs for all transplants in every province and hospital in China. At the national organ transplant congress on October 30, 2014, the Chairman of the China's national organ donation and transplantation committee, Jeifu Huang required all hospitals to stop using organs from executed prisoners immediately and the civilian organ donation will be sole source for organ transplant in China starting January 2015.

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WHO guiding principles on human cell, tissue and organ transplantation.

(2010)

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The national program for deceased organ donation in China.

F Huo, H. Zhao, Sheung Fan … (2013)

China has developed a new national program for deceased-organ donation to address the need for organ transplantation in the country. The program adheres to the World Health Organization (WHO) guiding principles, is compliant with the Declaration of Istanbul, and respects the cultural and social values of the Chinese people. The experience of pilot trials conducted between 2010 and 2012 was evaluated to generate a comprehensive design of a national program of organ donation and transplantation for implementation throughout China. The legal framework for this program was established from a series of legislative steps since 2007. Accountable national committees have been established to oversee activities of organ donation and transplantation across the nation. The Ministry of Health (MOH) has accredited 164 organ transplant hospitals in China, each of which has an organ procurement organization (OPO) to conduct organ donation and organ recovery. National protocols for deceased-organ donation in China include category I (organ donation after brain death), category II (organ donation after circulatory death), and category III (organ donation after brain death followed by circulatory death). The China Organ Transplant Response System (COTRS) has been developed to allocate organs equitably and transparently. Scientific registries have been established to evaluate the performance of transplant centers and OPOs. China is in the process of implementing a new national program for deceased-organ donation. The program includes a unique approach of organ donation, China category III, which will be promulgated throughout China and is intended to gain widespread acceptance of Chinese society.

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Author and article information

Contributors

Kirk C. Allison: alli0001@umn.edu

Arthur Caplan: Arthur.Caplan@nyumc.org

Michael E. Shapiro: mes362@njms.rutgers.edu

Charl Els: cels@ualberta.ca

Norbert W. Paul: norbert.paul@uni-mainz.de

Huige Li: huigeli@uni-mainz.de

Journal

Journal ID (nlm-ta): BMC Med Ethics

Journal ID (iso-abbrev): BMC Med Ethics

Title: BMC Medical Ethics

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6939

Publication date (Electronic): 3 December 2015

Publication date PMC-release: 3 December 2015

Publication date Collection: 2015

Volume: 16

Electronic Location Identifier: 85

Affiliations

[ ]Program in Human Rights and Health/Division of Health Policy and Management, University of Minnesota School of Public Health of Minnesota, Minneapolis, USA

[ ]Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, USA

[ ]Department of Surgery, New Jersey Medical School, Newark, USA

[ ]Department of Psychiatry, University of Alberta, Edmonton, Canada

[ ]Institute for History, Philosophy and Ethics of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany

[ ]Department of Pharmacology, Johannes Gutenberg University Medical Center, Obere Zahlbacher Strasse 67, 55131 Mainz, Germany

Article

Publisher ID: 74

DOI: 10.1186/s12910-015-0074-0

PMC ID: 4668660

PubMed ID: 26630929

SO-VID: 7978a342-936d-4a0b-b6ef-4ec42d8a1701

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 27 July 2015

Date accepted : 19 November 2015

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: organ sourcing,prisoners,medical ethics,china

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ScienceOpen disciplines: Medicine

Keywords: organ sourcing, prisoners, medical ethics, china

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Historical development and current status of organ procurement from death-row prisoners in China

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Abstract

Background

Discussion

Conclusions

Electronic supplementary material

Related collections

China Occupational Medicine

Most cited references 20

Voluntary organ donation system adapted to Chinese cultural values and social reality.

WHO guiding principles on human cell, tissue and organ transplantation.

The national program for deceased organ donation in China.

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Cited by 6

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