SPEAKERS CONTENTS INSERTS
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73–452PS
2001
ORGANS FOR SALE:
CHINA'S GROWING TRADE AND ULTIMATE VIOLATION OF PRISONERS' RIGHTS
HEARING
BEFORE THE
SUBCOMMITTEE ON
INTERNATIONAL OPERATIONS AND HUMAN RIGHTS
OF THE
COMMITTEE ON
INTERNATIONAL RELATIONS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTH CONGRESS
FIRST SESSION
JUNE 27, 2001
Serial No. 107–29
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Printed for the use of the Committee on International Relations
Available via the World Wide Web: http://www.house.gov/international—relations
For sale by the Superintendent of Documents, U.S. Government Printing Office
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COMMITTEE ON INTERNATIONAL RELATIONS
HENRY J. HYDE, Illinois, Chairman
BENJAMIN A. GILMAN, New York
JAMES A. LEACH, Iowa
DOUG BEREUTER, Nebraska
CHRISTOPHER H. SMITH, New Jersey
DAN BURTON, Indiana
ELTON GALLEGLY, California
ILEANA ROS-LEHTINEN, Florida
CASS BALLENGER, North Carolina
DANA ROHRABACHER, California
EDWARD R. ROYCE, California
PETER T. KING, New York
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STEVE CHABOT, Ohio
AMO HOUGHTON, New York
JOHN M. McHUGH, New York
RICHARD BURR, North Carolina
JOHN COOKSEY, Louisiana
THOMAS G. TANCREDO, Colorado
RON PAUL, Texas
NICK SMITH, Michigan
JOSEPH R. PITTS, Pennsylvania
DARRELL E. ISSA, California
ERIC CANTOR, Virginia
JEFF FLAKE, Arizona
BRIAN D. KERNS, Indiana
JO ANN DAVIS, Virginia
TOM LANTOS, California
HOWARD L. BERMAN, California
GARY L. ACKERMAN, New York
ENI F.H. FALEOMAVAEGA, American Samoa
DONALD M. PAYNE, New Jersey
ROBERT MENENDEZ, New Jersey
SHERROD BROWN, Ohio
CYNTHIA A. McKINNEY, Georgia
EARL F. HILLIARD, Alabama
BRAD SHERMAN, California
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ROBERT WEXLER, Florida
JIM DAVIS, Florida
ELIOT L. ENGEL, New York
WILLIAM D. DELAHUNT, Massachusetts
GREGORY W. MEEKS, New York
BARBARA LEE, California
JOSEPH CROWLEY, New York
JOSEPH M. HOEFFEL, Pennsylvania
EARL BLUMENAUER, Oregon
SHELLEY BERKLEY, Nevada
GRACE NAPOLITANO, California
ADAM B. SCHIFF, California
DIANE E. WATSON, California
THOMAS E. MOONEY, SR., Staff Director/General Counsel
ROBERT R. KING, Democratic Staff Director
Subcommittee on International Operations and Human Rights
ILEANA ROS-LEHTINEN, Florida, Chairwoman
CHRISTOPHER H. SMITH, New Jersey
RON PAUL, Texas
CASS BALLENGER, North Carolina
THOMAS G. TANCREDO, Colorado
JOSEPH R. PITTS, Pennsylvania
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CYNTHIA A. McKINNEY, Georgia
ROBERT MENENDEZ, New Jersey
GRACE NAPOLITANO, California
ADAM B. SCHIFF, California
MAURICIO TAMARGO, Subcommittee Staff Director
JEFFREY PILCH, Democratic Professional Staff Member
YLEEM POBLETE, Professional Staff Member
SANDY ACOSTA, Staff Associate
C O N T E N T S
WITNESSES
Michael E. Parmly, Principal Deputy Assistant Secretary of State, Bureau for Democracy, Human Rights and Labor, Department of State
Nancy Scheper-Hughes, Project Director, Organs Watch
Harry Wu, Executive Director, the Laogai Research Foundation
Wang Guoqi, former Doctor, Chinese People's Liberation Army Hospital
Thomas Diflo, M.D., Director, Renal Transplant Program, New York University Medical Center
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LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING
The Honorable Ileana Ros-Lehtinen, a Representative in Congress from the State of Florida, and Chairwoman, Subcommittee on International Operations and Human Rights: Prepared statement
Michael E. Parmly: Prepared statement
Nancy Scheper-Hughes: Prepared statement
Harry Wu: Prepared statement
Wang Guoqi: Prepared statement
Thomas Diflo: Prepared statement
ORGANS FOR SALE:
CHINA'S GROWING TRADE AND ULTIMATE VIOLATION OF PRISONERS' RIGHTS
WEDNESDAY, JUNE 27, 2001
House of Representatives,
Subcommittee on International
Operations and Human Rights,
Committee on International Relations,
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Washington, DC.
The Subcommittee met, pursuant to call, at 2 p.m. in Room 2172, Rayburn House Office Building, Hon. Ileana Ros-Lehtinen [Chairwoman of the Subcommittee] presiding.
Ms. ROS-LEHTINEN. The Subcommittee will please come to order.
When one first hears of China's gruesome practice of executing prisoners for the purpose of harvesting their organs and selling them to the highest bidder, the reaction is one of shock and disbelief. How can human beings do that to other human beings? How can there be such disdain for human life? How can avarice and greed reach such extremes? This cannot be true.
Unfortunately, the evidence gathered throughout the last two decades clearly shows that China's Communist regime is not just looking at traditional sectors of the economy to generate income for its military expansionist policies. It has found a lucrative industry in the field of organ transplantation which not only yields great financial rewards, but provides the regime with a powerful tool to coerce and intimidate the population into submission.
Governmental sanctioning of organ harvesting from prisoners reportedly began in 1979 with the issuance of a document from China's Public Health Ministry entitled Rules Concerning the Dissection of Corpses. This document asserted the legality of the practice and laid the foundation for future generations, such as the ones issued in 1984, the regulations entitled Provisions for Regulations on the Use of Dead Bodies or Organs from Condemned Criminals.
In this 1984 document, the Chinese regime provided detailed instructions on the conditions and the procedures for harvesting organs from executed prisoners, including the coordination between health personnel and prison and public security officials and the need for confidentiality in the entire process.
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This document states that those who are sentenced to death are to be executed immediately by means of shooting. We will hear testimony today about how this translates into a shot to the heart if corneas are needed and a shot to the back of the head for other organs. Family members of the executed prisoners are forced to pay for the bullets used.
This calculated method of execution helps ensure that there is no contamination of the organs, but the evil nature of this practice does not stop there. Although the official regulations issued in 1984 state that death must be confirmed before the extraction of organs, there are credible reports that the executions are sometimes deliberately botched to postpone brain stem death and help the retrieval of organs while the blood is still circulating.
Other reports refer to organ removal as the means of execution in and of itself. These methods are increasingly being used because living donor organs are in greater demand and, therefore, generate a higher price.
The official regulations also refer to consent from prisoners and/or family members and to the use of only bodies which have not been claimed by the family members. In the same text, however, it underscores that the use of the dead bodies or organs from condemned criminals must be kept strictly confidential, and once the bodies are used the crematory shall assist in the timely cremation.
In practice, this is what happens. I would like to summarize the events surrounding the execution of Mr. Qui in June of 2000, but which was reported in the U.S. and international publications in March of this year.
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Mr. Qiu was sentenced to death for tax evasion, was executed, and his body was sent to the crematory all within a little more than 1 hour. When his brother arrived to attempt to claim the body, he found blood all over Qiu's shirt. He pulled the shirt open and found that Mr. Qiu's stomach was cut open with his intestines spilling out. There was a foot long gash, and several organs had been extracted.
He drove back to the court to demand an explanation for the desecration of his brother's body. He argued that no family member had been asked whether his brother's organs could be removed. Court officials responded that the organ removal had been done according to regulations.
The prison authorities then said that Mr. Qiu had consented to donate his organs just prior to his execution. Mr. Qiu's brother asked for evidence, but the Chinese officials would not give him any. After complaining to the central government authorities, Mr. Qiu's brother was warned to keep silent or face retaliation against him and his family.
This case is possibly one of thousands taking place yearly in China. Amnesty International counted over 18,000 executions reported in China's official press during the 1990s. The number can be much higher since many executions remain a secret. Some observers estimate that the figures could approach 1,000 executions a year in individual cities.
Some will attempt to justify China's practice of harvesting organs by accepting the Chinese arguments that consent is given by the prisoners. Whether condemned prisoners donate their organs willingly is questionable, which is why the World Medical Association and the Transplantation Society both ban the use of organs from convicted criminals.
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In the case of Chinese prisoners, the issue of consent becomes even more contentious as Buddhist and Confucian beliefs dictate that the bodies are to be kept whole after death, meaning that voluntary donations are rare, if they occur at all.
Others seek to justify China's gruesome practice and to legitimize the trafficking of organs by emphasizing the number of lives being saved by these transplants. Presently, recipients of harvested organs from Chinese executed prisoners include increasing numbers of American residents and citizens. However, is one life more valuable than another? Do the ends justify the means?
It has been said that the only thing necessary for the triumph of evil is for good men and women to do nothing. This is why we are meeting here today to ensure that the U.S. Congress does not allow this horrific situation to go unchallenged; to ensure that the U.S. does not become an accomplice to the PRC in promoting this deplorable practice.
This is why I introduced H.R. 2030 on May 25 of this year. This bill responds to credible reports of Chinese doctors using medical training and exchange programs with the U.S. to perfect their organ transplantation techniques and to gain access to information on organ recipients.
H.R. 2030 seeks to prevent that U.S. government funding for these programs are assisting China's terrible practices. The bill prohibits the issuance of a visa or admission to the U.S. to any Chinese doctor who seeks to enter the U.S. for the purpose of training in organ or bodily tissue transplantation.
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We hope to move this legislation quickly through the Committee on International Relations and the House in order to send a strong message to Chinese health officials, officials such as the ones currently in the U.S. this very week for a conference at Harvard University, that the U.S. Congress will not sit idly by while their regime commits the most horrific human rights violations against its people.
We thank the witnesses for being here today and commend them for their courage to denounce publicly this gruesome practice.
I am proud to yield to the Ranking Member of this Subcommittee, my friend, Congresswoman McKinney of Georgia.
[The prepared statement of Ms. Ros-Lehtinen follows:]
PREPARED STATEMENT OF THE HONORABLE ILEANA ROS-LEHTINEN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF FLORIDA, AND CHAIRWOMAN, SUBCOMMITTEE ON INTERNATIONAL OPERATIONS AND HUMAN RIGHTS
When one first hears of China's gruesome practice of executing prisoners for the purpose of harvesting their organs and selling them to the highest bidder, the reaction is one of shock and disbelief. How can human beings do that to other human beings? How can there be such disdain for human life? How can avarice and greed reach such extremes? This cannot be true.
Unfortunately, the evidence gathered throughout the last two decades clearly shows that China's Communist regime is not just looking at traditional sectors of the economy to generate income for its military expansionist policies.
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It has found a lucrative industry in the field of organ transplantation which, not only yields great financial rewards, but provides the regime with a powerful tool to coerce and intimidate the population into submission.
Governmental sanctioning of organ harvesting from prisoners reportedly began in 1979 with the issuance of a document from China's Public Health Ministry entitled: ''Rules Concerning the Dissection of Corpses.'' This document asserted the legality of the practice and laid the foundation for future guidelines, such as the ones issued in 1984 entitled the: ''Provisions Regulations on the Use of Dead Bodies or Organs from Condemned Criminals.''
In this 1984 document, the Chinese regime provided detailed instructions on the conditions and procedures for harvesting organs from executed prisoners, including the coordination between health personnel and prison and public security officials, and the need for confidentiality in the entire process.
This document states that those who are sentenced to death are to be executed immediately by means of shooting. We will hear testimony about how this translates into a shot to the heart if corneas are needed, and a shot to the back of the head for other organs. Family members of the executed prisoners are forced to pay for the bullets used.
This calculated method of execution helps ensure that there is no contamination to the organs. But the evil nature of this practice does not stop there.
Although the official regulations issued in 1984 state that death must be confirmed before the extraction of organs, there are credible reports that executions are sometimes deliberately botched to postpone brain stem death and help the retrieval of organs while blood is still circulating. Other reports refer to organ removal as the means of execution in and of itself. These methods are increasingly being used because living-donor organs are in greater demand and therefore generate a higher price.
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The official regulations also refer to consent from prisoners and/or family members and to the use of only bodies which have not been claimed by the family members. In the same text, however, it underscores that the use of the dead bodies or organs from condemned criminals must be kept strictly confidential and, once the bodies are used, the crematory shall assist in timely cremation.
In practice, this is what happens. I would like to summarize the events surrounding the execution of Mr. Qiu in June of 2000 but which was reported in U.S. and international publications in March of this year.
Mr. Qiu was sentenced to death for tax evasion, was executed, and his body sent to the crematory all within a little more than one hour. When his brother arrived at the crematory to attempt to claim the body, he found blood all over Qiu's shirt. He pulled the shirt open and found that Mr. Qiu's stomach was cut open with his intestines spilling out. There was a foot-long gash and several organs had been extracted.
He drove back to the court to demand an explanation for the desecration of his brother's body. He argued that no family member had been asked whether his brother's organs could be removed. Court officials responded that the organ removal had been done according to regulations. The prison authorities then said that Mr. Qiu had consented to donate his organs just prior to his execution. Mr. Qiu's brother asked for evidence but the Chinese officials would not give him any.
After complaining to the central government authorities, Mr. Qiu's brother was warned to keep silent or face retaliation against him and his family.
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This case is one of possibly thousands taking place yearly in China. Amnesty International counted over 18,000 executions reported in China's official press during the 1990's. The number can be much higher since many executions remain a secret. Some observers estimate that the figures could approach 1,000 executions a year in individual cities.
Some will attempt to justify China's practice of harvesting organs by accepting the Chinese argument that consent is given by the prisoners. Whether condemned prisoners donate their organs willingly is questionable, which is why the World Medical Association and the Transplantation Society both ban the use of organs from convicted criminals.
In the case of Chinese prisoners, the issue of consent becomes even more contentious as Buddhist and Confucian beliefs dictate that the body be kept whole after death, meaning that voluntary donations are rare, if at all.
Others seek to justify China's gruesome practice and to legitimize the trafficking of organs by emphasizing the number of lives being saved by these transplants. Presently, recipients of harvested organs from Chinese executed prisoners include increasing numbers of American residents and citizens.
However, is one life more valuable than another? Do the ends justify the means?
It has been said that the only thing necessary for the triumph of evil is for good men and women to do nothing. This is why we are meeting here today to ensure that the Congress does not allow this horrific situation to go unchallenged; to ensure that the U.S. does not become an accomplice to the PRC in promoting this deplorable practice.
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This is why I introduced H.R. 2030 on May 25th of this year. This bill responds to credible reports of Chinese doctors using medical training and exchange programs with the U.S. to perfect their organ transplantation techniques and to gain access to information on organ recipients.
H.R. 2030 seeks to prevent that U.S. government funding for these programs are not assisting China's heinous practice. The bill prohibits the issuance of a visa or admission to the U.S. to any Chinese physician who seeks to enter the U.S. for the purpose of training in organ or bodily tissue transplantation.
We hope to move this legislation quickly through the Committee on International Relations and the House in order to send a strong message to Chinese health officials—officials such as the ones currently in the U.S. for a conference at Harvard University—that the U.S. Congress will not sit idly by while their regime commits the most horrific human rights violations against its people.
We thank the witnesses for being here today and commend them for their courage to denounce publicly this gruesome practice.
Ms. MCKINNEY. Thank you, Madam Chair, for calling a hearing on such an eerie subject. Who would have thought that Frankenstein could come true? The stories we are about to hear today suggest that we have entered into a world of Frankenstein medicine where body parts are snatched to fill empty body spaces.
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Would it were that the logic could be from each according to his ability to each according to her need, but that is not the case here. No. What we are discovering is that the traffic flows according to Adam Smith's invisible hand from those who have a spare body part to sell to those who have money and are in need.
The western version of this trade in human body parts operates no differently than the trade say in justice where innocent men who just happen to be poor over and over and over again find themselves on death row, in prison cells, forever on life's short stick.
But Old Testament justice is an eye for an eye and a tooth for a tooth. Could it be that Old Testament justice now is the modern practice of medicine? Our topic today is the Frankenstein world come true. Of course, state sponsored and sanctioned human organ harvesting of prisoners in China is repugnant, but is it not just as offensive when the invisible hand does it, transferring organs and human tissue from the rich to the poor, the commodification of our skin and kidneys?
This hearing could just as easily be entitled The Global Economy and the Commodification of the Body. The market for human body parts has become as sophisticated and pervasive as the spare parts business for cars. We have all been aware for quite some time that tissue banks and some organ banks here in the United States are increasingly soliciting tissue donations from the families of people who have just died. Frequently the families of tissue donors who may have been influenced by dramatic appeals that portray a dire need for their loved ones' bodies are not told of the profitable market for human body parts.
The Chicago Tribune reported last year that local tissue banks had paid money directly to medical examiners for each body they made available for tissue harvesting.
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In the May 29, 2001, edition of Canada's National Post appears an article entitled Canadians Urged to Back Organ Sales; U.S. Business Recruit; Experts Divided on Whether Offshore Scheme is Repugnant or Solution to Crisis.
It reports that Philip Slatin, an American businessman who wants to capitalize on the emerging underground market in human body parts, has been trying to persuade Canadians to sign onto his plan to open an offshore transplant clinic in the Caribbean that will offer patients kidneys purchased from eastern Europeans.
Mr. Slatin is quoted. ''This may sound crash and boorish, but there is a terrible shortage, and in North America there are plenty of people willing to pay for a new organ. I know 20 people right now who are willing to pay for organs.''
Mr. Slatin's business proposal is just one of a variety of schemes in the international organ trafficking market as patients from wealthy countries such as Israel, Canada and the United States travel to the Philippines, Iraq, Turkey and Moldova and pay for kidneys from those willing to sell them.
In a recent case in Thailand, relatives of a comatose patient alleged that the doctors removed the kidneys before the patient was even dead. In Brazil, allegations of child kidnapping, kidney theft and commerce of organs and body parts continue despite the passage of a 1997 universal donation law intended to prevent the growth of an illegal market in human organs.
Could these organs be winding up in the United States for sale? Could it be that even under the best of prevention within our justice system that the race and class based inequities that permeate our society also permeate who gets organs? Government studies confirm that blacks are less likely to get transplants than whites.
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I remember the 1970's movie Coma in which young, healthy patients admitted for minor surgery at a Boston Hospital end up on life support. In the movie, Dr. Susan Wheeler uncovers a horrifying deception. The conspiracy she discovers is that a select group of senior doctors at Memorial Hospital are taking patients into minor surgery who are then administered too much anesthesia. The patients are not dead. They are in a comatose state. Susan discovers they are harvesting the patients' body parts for a black market of wealthy recipients.
When it comes to organ transfers and tissue harvest, the exchanges tend to be from poor to rich, and too many countries fail to protect organ donors from exploitation. Is this what the globalization of medicine has come to?
I look forward to hearing the witnesses' testimony today. Thank you, Madam Chair.
Ms. ROS-LEHTINEN. Thank you so much, Ms. McKinney.
Mr. Smith?
Mr. SMITH. Madam Chair, I would ask that my full statement be made part of the record and just welcome——
Ms. ROS-LEHTINEN. Without objection.
Mr. SMITH [continuing]. Assistant Secretary Parmly and all of our witnesses.
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It is always good to see Harry Wu, who has been fighting on behalf of human rights in China. In previous times he has brought forward both himself and many witnesses who have given witness to the horrors of the Laogai. We had the first hearing, as you recall, in this Subcommittee on survivors of the Laogai and heard from six different survivors who spoke of the cruelty that they suffered.
Harry was also the one who brought forward a witness who spoke about forced abortion in China, a woman, Mrs. Gao, who ran a clinic in the Fuji Province and talked about how incarceration was commonplace for those women often in their ninth month of pregnancy because they would not give in to an abortion until they were coerced into having that abortion.
I will never forget her statement, and Harry was the one who made it possible for that witness to appear here. She said, ''By day I was a monster. At night I was a wife and mother.'' Monster was the way she self-described.
Of course, it was a couple of years ago—I think 3 years ago—that Harry again brought forth to this Subcommittee riveting and absolutely dismaying evidence of this use of execution to procure organs for transplantation to enrich members of the People's Liberation Army and others.
You know, more than 50 years ago horror, outrage and disgust met the news of Japan's gruesome experimentation on thousands of American, Chinese and Russian POWs during World War II. Amazingly, the spirit and the detestable legacy of Japanese Unit 731 lives on and thrives in the People's Republic of China.
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The Chinese leadership had made at times very strong statements against the Japan Unit 731. Today, their own army is doing that kind of outrage on their own people when they execute prisoners and often remove body parts without anesthesia, obviously without permission. These are crimes against humanity. They cry out for a cessation, for an ending and holding accountable those people who are part of that kind of regime. These are war crimes. These are crimes against humanity and again reminiscent of Japanese Unit 731.
This hearing and the information Dr. Wang brings to us just brings afresh just how terrible the situation is in China and that we need to reign in, and the world community needs to speak with one voice. These human rights abuses, gruesome as they are, must not be allowed to continue.
Thank you, Madam Chairman.
Ms. ROS-LEHTINEN. Thank you so much, Mr. Smith.
I will recognize Mr. Rohrabacher for his opening statement.
If I could ask Mr. Smith to briefly Chair the Subcommittee while we greet the new President of Peru? I will return quickly.
Mr. Rohrabacher?
Mr. ROHRABACHER. Thank you very much. Before you run off, let me applaud you, Ileana, for your leadership in this issue and other human rights issues.
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Today we send a message. We send a message to the clique that rules China and tyrannizes the Chinese people. What they are doing, their dirty deeds, are not going unnoticed. We will see that what they are doing to the Chinese people is known by the good people of the world, and those committing these crimes against the Chinese people will be held accountable.
I also salute Harry Wu, as my colleague has just done, for the tremendous service that he has provided to the good and decent people of this world in providing us the information we need to understand regarding what is going on in mainland China. We will in the end prevail. The good and decent people will prevail over tyrants and gangsters, and it will have a lot to do with the fact that Harry Wu provided us the information we needed to see the light.
One of the most ghoulish aspects of the Communist dictatorship in China is the harvesting of human organs from executed prisoners. This travesty that is going on in China today is a crime against humanity. Many of those people who are being executed would not be executed in any western country. Many of those executed are not even criminals by anyone's definition. Some of them have committed crimes that they would not be executed for in the USA. Some of them would not be even criminals at all. They are just people who are against the system.
Who will be held accountable? Who is at fault? Well, first of all, the people who run that system, the gangsters that run the government in Beijing and the hoodlums that take their orders and keep them in power.
In this case, those who are responsible also include the medical doctors in China who are participating in this crime against humanity and this horrible deed against their own people. These doctors must know that we see what they are doing. We know that they are taking part in something that is a criminal act, which is a horrific and indefensible act against their own people. They will be held accountable.
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I applaud Ms. Ros-Lehtinen's legislation that suggests that access to the United States will be denied to any Chinese doctor who is involved in the harvesting of organs of executed prisoners. This puts the responsibility right square in the lap of those doctors who are participating. They cannot simply say, as the Germans said during World War II when they were involved in crimes against humanity, ''I was simply following orders.'' That is not good enough.
I am very pleased to be here today. Although I am not a Member of this Subcommittee, I am very pleased to be here to lend my voice and my concern to this very important issue. As we proclaim to the world, yes even to those Chinese who are being executed in the far reaches of China, many of whom are nameless, we are concerned about them because they are part of humanity.
Thank you very much.
Mr. SMITH [presiding]. Mr. Rohrabacher, thank you very much.
The Chair recognizes the distinguished gentleman, Mr. Brown.
Mr. BROWN. I am also not a Member of this Subcommittee. I am in the middle of another hearing, but wanted to stop in and thank Mr. Wu for the great courage and the great work that he has done on human rights.
I read his book some time ago and have met with him about this incredible issue. I hope that Congress will pursue this issue of organ harvesting, will pursue other issues of human rights in China.
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I am amazed, as I know the other people sitting in this Committee, Mr. Chairman, Mr. Rohrabacher and Ms. McKinney, of the hypocracy sometimes in this Congress when we deal with issues on China where corporate interests always override human rights, and dollar signs and profits always override the treatment of workers in China and human rights overall in China.
I hope that this Congress will pursue this issue on organ donation to a point that those people that have participated in that come to some justice in terms of here in our country and in other ways.
I yield back my time and thank the Chairman for allowing me to say a few words.
Mr. SMITH. Thank you, Mr. Brown. Thank you for your ongoing concern about human rights in China and for being here today.
I would like to now introduce to the Committee a very familiar face, Mr. Michael Parmly, the Principal Deputy Secretary of State for the Bureau of Democracy, Human Rights and Labor, since April 3 of this year, of 2000. Mr. Parmly served as the Acting Secretary of State for the Bureau up until late May.
A career member of the Senior Foreign Service, he has served as the Minister/Consular for Political Affairs in the American Embassy in Paris, as well as Deputy Chief of Mission Affairs at the American Embassy in Sarajevo, Bosnia and Herzegovina. He has also worked as the political counselor at the U.N. Mission of the European Communities in Brussels and American Embassies in Luxembourg, Bucharest, Robat and Madrid.
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He is accompanied by Mr. Jim Keith, who is Director of the Office of Chinese and Mongolian Affairs, who will also be available to the Members for any questions they might have.
Mr. Secretary, please proceed.
STATEMENT OF MICHAEL E. PARMLY, PRINCIPAL DEPUTY ASSISTANT SECRETARY OF STATE, BUREAU FOR DEMOCRACY, HUMAN RIGHTS AND LABOR, DEPARTMENT OF STATE
Secretary PARMLY. Thank you, Mr. Chairman. I want to thank the Committee and especially the Chairwoman for organizing this Committee. All of your words have been very inspirational, and I thank you for them.
This is an important hearing because of the subject matter. The removal of organs from executed prisoners without proper permission from family members, along with the trafficking of these organs, is a serious, deeply disturbing subject raising a number of profoundly important human rights issues. The State Department welcomes the opportunity to update the Committee on our assessment of the problem and to brief you on what the Department is doing to encourage China to put an end to this abhorrent practice.
As you know, reports of Chinese authorities removing organs from executed prisoners in China without the consent of the prisoners or their families are not new. Our concern about such practices is also not new. We have repeatedly raised this issue with high level Chinese officials throughout the 1990s, pressing for changes in Chinese policy and practice and urging changes in China's legal and medical systems to ensure the protection of individual rights and the guarantee of due process.
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We have covered the issue of organ harvest in our annual human rights report on China to put the spotlight of international attention on this issue. We consider organ harvesting from executed prisoners without permission from family members to be an egregious human rights abuse that violates not only international human rights law, but also international medical ethical standards.
Unfortunately, despite our efforts, as well as those of human rights activists like Harry Wu, who is here with us today, human rights organizations and concerned medical professionals such as Dr. Diflo, who has written so eloquently about this subject, the practice of harvesting organs from executed prisoners continues in China.
The lack of transparency in the Chinese criminal justice system and the secrecy that surrounds prison executions and the removal of organs makes actual documentation of the practice impossible. However, the anecdotal and circumstantial evidence regarding the practice of removing organs from executed prisoners for sale to foreigners and wealthy Chinese is substantial, credible and growing. It cannot be ignored.
Credible sources include public statements by patients who have had transplants in China, doctors who have provided post transplant care to those patients in the United States and elsewhere, and testimony by Chinese doctors and former officials who claim to have witnessed or taken part in such practices or to have seen incriminating evidence.
In the past, according to available evidence, the majority of patients receiving transplants in China came from other parts of Asia, including Malaysia, Singapore, Taiwan and Thailand. A leading kidney specialist in Malaysia has estimated that over 1,000 Malaysians alone have had kidney transplants in China.
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More recently, deeply troubling reports of Americans receiving transplants in China have been made public. American doctors, including Dr. Diflo, who will also be testifying to this panel, have reported seeing transplant patients from China in need of follow up care. I will leave it to Dr. Diflo and others to elaborate on their views.
The Department of State is also aware of reports, which it cannot independently confirm, of other even more egregious practices, such as removing organs from still living prisoners and scheduling executions to accommodate the need for a particular organ. I have to tell you that that is the thing that is absolutely the most revolting act as I prepared for this hearing.
There are compelling firsthand reports that doctors, in violation of medical ethics codes, have performed medical procedures to prepare condemned prisoners for execution and organ removal. Our concern about the abhorrent practice of removing organs from executed prisoners without consent is compounded by our concerns about the lack of due process.
According to Amnesty International, there were 1,263 confirmed executions in 1999. According to another report, 800 prisoners were executed in May, 2001, alone as the government conducted another Strike Hard campaign against crime.
A high court nominally reviews all death sentences, but, as our Country Report on Human Rights Practices points out and as a recent New York Times article graphically described, the time between arrest and execution is often days and even hours, as was highlighted by some of the Members. Some prisoners, again as was stated, are taken directly from the courtroom directly to the execution grounds. Appeals of sentences consistently result in confirmation of sentence.
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Many have expressed the view that condemned prisoners and their families cannot make free and fully voluntary decisions on organ donations because of the very nature of incarceration. Recent reports indicate that the phenomenon of organ trafficking has expanded beyond trafficking in the organs of executed prisoners.
Our posts have reported increased numbers of Chinese media reports of organ harvesting from hospital cadavers by corrupt medical and hospital personnel and the sale of organs by poor people for cash. This trade in human organs takes place openly, including on the internet. Chinese Web bulletin boards have reports of organs for sale and discussion of corruption in the ''organ business,'' and I put that in quotes.
We are monitoring this trade closely and are raising our concerns with the Chinese Government. I want to get to that. The lack of due process and consent, coupled with credible evidence of harvesting organs from executed prisoners and from hospital cadavers, raises serious human rights concerns.
We, like Congress, are committed to press the Chinese authorities to take strong action to address human rights abuses wherever they occur. Despite the lack of transparency in China's legal system, we are making every effort to determine the magnitude of the problem and how effectively Chinese authorities have implemented Article 3 of China's Provisional Regulations on the Use of Executed Prisoners' Corpses or Organs, a 1984 piece of legislation that the Chairwoman referred to, and other pertinent regulations governing the practice of organ donations, sale and transplants. I will talk about that in a second.
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In the weeks and months ahead, we will step up our efforts to work with countries in the region, with allies and with other like minded countries to put an end to organ trafficking. Finally, we are committed to investigating and prosecuting to the fullest extent of our own law any criminal acts over which the United States has jurisdiction.
While we continue to press the Chinese on this issue, we recognize the enormous challenge we face. The complex social issues in China involving severe rural poverty, along with corruption among poorly paid prison and hospital administrators who harvest organs from prisoners and patients without their consent, play a large role in this issue. We will not be deterred by any of those factors. We will press ahead.
Let me come back to what we are doing now. During the course of the 1990s and in response to repeated inquiries and demarches by the State Department, by our Ambassadors to China and by other Embassy and State Department officials, the Chinese have provided information on their official policy, including two documents on regulations promulgated on April 6, 1996, governing organ donation. However, the Chinese have not responded to our inquiries about the extent and scope of harvesting and trafficking human organs and, most importantly in my eyes, about Chinese authorities' efforts to implement their own regulations.
We most recently discussed the issue of organ harvesting in Washington with the Ministry of Foreign Affairs International Organization Director and with senior Chinese Embassy officials on June 26, just yesterday. I participated in the meeting yesterday and specifically told my interlocutors that I would be testifying before this Committee today and would have to say that the United States was appalled by the highly credible reports coming out of China about the removal of organs from executed prisoners and about trafficking in those organs.
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I noted to my interlocutors that enforcement of Chinese regulations governing organ donations appeared to be woefully inadequate. Our interlocutors responded that such practices are illegal in China and that those who are found to engage in such practices are brought to justice. I responded by asking that Chinese authorities provide us with evidence of such prosecutions, which I have not seen yet.
We also raised the issue on June 14 in Beijing with the MFA with the Foreign Ministry Human Rights Division Director and here in Washington with the Chinese Embassy. We informed Chinese Embassy officials of the increasing level of attention being focused on this issue in the United States and urged China to work intensively to ensure that its organ transplant policies are consistent with international standards.
We also urged China to take steps to combat the actions of those who engage in such unconscionable acts, pointing out that they are a perversion of medical ethics and state power, as well as an egregious human rights violation.
Assistant Foreign Minister Zhou Wenzhong was in Washington last week, and we comminuted to him the strong bipartisan support, and I am pleased to see such bipartisan presence on this Committee, that the issue of human rights has in the United States.
In the months ahead, we will continue to make clear our strong opposition to the repugnant practice of coercive organ harvesting, and we will press the government of China to ensure its organ transplant policies and practices are in compliance with international human rights norms, as well as international medical practices. We will urge them to enforce all regulations governing organ transplants, to prosecute those who violate existing regulations and to pass and implement new legislation.
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We also will share the testimonies delivered here today with our Embassy in China and instruct our Embassy to raise the allegations made in them with the appropriate officials in China. My colleagues will be asking Chinese authorities for evidence that those who engage in the practices discussed here today are brought to justice.
In the United States, we will investigate and prosecute all violators over whom the United States has jurisdiction to the fullest extent of the law.
Thank you.
[The prepared statement of Secretary Parmly follows:]
PREPARED STATEMENT OF MICHAEL E. PARMLY, PRINCIPAL DEPUTY ASSISTANT SECRETARY OF STATE, BUREAU FOR DEMOCRACY, HUMAN RIGHTS AND LABOR, DEPARTMENT OF STATE
Chairwoman Ros-Lehtinen and Members of the Committee, thank you for the opportunity to appear at this important hearing to address the issue of the sale of human organs in China. The removal of organs from executed prisoners without proper permission from family members along with the trafficking in these organs is a serious, deeply disturbing subject that raises a number of profoundly important human rights issues. The State Department welcomes the opportunity to update the committee on our assessment of the problem and what the Department is doing to encourage China to put an end to this abhorrent practice.
As you know, reports of Chinese authorities removing organs from executed prisoners in China, without the consent of the prisoners or their families, are not new. The Hong Kong and London press carried the numerous reports as early as the mid-1980s, when the introduction of the drug Cyclosoporine-A made transplants a newly viable option for patients.
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Our concern about such practices is also not new. We repeatedly raised this issue with high-level Chinese officials throughout the 1990s, pressing for changes in Chinese policy and practice, and urging changes in China's legal and medical systems to ensure the protection of individual rights and the guarantee of due process. We have also covered the issue of organ harvesting in our annual human rights report on China to put the spotlight of international attention on this issue. We consider organ harvesting from executed prisoners, without permission from family members, to be an egregious human rights abuse that violates not only international human rights law, but also international medical ethical standards.
Unfortunately, despite our efforts, as well as those of human rights activists like Harry Wu, human rights organizations, and concerned medical professionals, the practice of harvesting organs from executed prisoners continues in China. The lack of transparency in the Chinese criminal justice system and the secrecy that surrounds prison executions and the removal of organs makes actual documentation of the practice impossible. However, the anecdotal and circumstantial evidence regarding the practice of removing organs from executed prisoners for sale to foreigners and wealthy Chinese is substantial, credible, and growing. It cannot be ignored. Credible sources include public statements by patients who have had transplants in China, doctors who have provided post-transplant care to these patients in the United States and elsewhere, and testimony by Chinese doctors and former officials who claim to have witnessed or taken part in such practices or to have seen incriminating evidence.
In the past, according to available evidence, the majority of patients receiving transplants in China came from other parts of Asia, including Malaysia, Singapore, Taiwan, and Thailand. A leading kidney specialist in Malaysia has estimated that over 1000 Malaysians alone have had kidney transplants in China. More recently, deeply troubling reports of Americans receiving transplants in China have been made public. American doctors, including Dr. Thomas Diflo, who will be testifying in a later panel, have reported seeing transplant patients from China in need of follow-up care. These patients have stated that they were informed by hospital personnel in China that the organs that they received came from executed prisoners.
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The Department of State is also aware of reports that it cannot independently confirm, of other, even more egregious practices, such as removing organs from still-living prisoners, and scheduling executions to accommodate the need for particular organs. In addition, there are compelling first-hand reports that doctors, in violation of medical ethics codes, have performed medical procedures to prepare condemned prisoners for execution and organ removal. As former Assistant Secretary John Shattuck testified before this committee in 1998, our concern about the abhorrent practice of removing organs from executed prisoners without consent is compounded by our concerns about the lack of due process. According to Amnesty International there were 1,263 confirmed executions in 1999; according to another report 800 prisoners were executed in May 2001 alone as the government conducted another ''strike hard'' campaign against crime. A high court nominally reviews all death sentences, but as our Country Report on Human Rights Practices points out, and as a recent New York Times article graphically described, the time between arrest and execution is often days or even hours. Some prisoners are taken directly from the courtroom to the execution grounds. Appeals of sentences consistently result in confirmation of sentence.
The lack of meaningful consent further compounds our concerns about this practice. According to Article 3 of China's Provisional Regulations on the Use of Executed Prisoners' Corpses or Organs (1984), a corpse may be used for medical purposes if: nobody claims the body or the family refuses to bury it; the prisoner voluntarily donates the body for use by medical facilities; or the inmate's family consents to its use after death. The first category opens the door to abuse because families are often not notified of impending executions or are too far away or unable financially to make the trip to claim a relative's body. Also, bodies are routinely cremated immediately after a sentence is carried out, making it impossible even for those families who are able to claim a family member's remains to determine whether or not the body has been used for medical purposes.
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Many have expressed the view that condemned prisoners and their families cannot make free and fully-voluntary decisions on organ donations because of the very nature of incarceration. In the United States, Federal Bureau of Prisons regulations do not allow organ donation by federal prisoners, unless the donation is to an immediate family member. Other countries have similarly strict laws and regulations regarding organ donations by prisoners.
Recent reports indicate that the phenomenon of organ trafficking has expanded beyond trafficking in the organs of executed prisoners. Our posts have reported increased numbers of Chinese media reports of organ harvesting from hospital cadavers by corrupt medical and hospital personnel, and the sale of organs by poor people for cash. This trade in human organs takes place openly, including on the Internet. Chinese web bulletin boards have reports of organs for sale and discussion of corruption in the ''organ business.'' We are monitoring this trade closely and are raising our concerns with the Chinese government.
The lack of due process and consent, coupled with credible evidence of harvesting organs from executed prisoners and from hospital cadavers, raises serious human rights concerns. We, like Congress, are committed to press the Chinese authorities to take strong action to address human rights abuses wherever they occur. Despite the lack of transparency in China's legal system, we are making every effort to determine the magnitude of the problem and how effectively Chinese authorities have implemented Article 3 of China's Provisional Regulations on the Use of Executed Prisoners' Corpses or Organs (1984) and other pertinent regulations governing the practice of organ donations, sale and transplants. We are also pressing the Chinese to enact and implement legislation or regulations that prohibit removing organs from executed prisoners. In the weeks and months ahead, we will step up our efforts to work with countries in the region, with allies, and other like-minded countries to put an end to organ trafficking. And, finally, we are committed to investigating and prosecuting to the fullest extent of our own law any criminal acts over which the United States has jurisdiction. While we will continue to press the Chinese on this issue, we recognize the enormous challenge we face. The complex social issues in China involving severe rural poverty, along with corruption among poorly paid prison and hospital administrators who harvest organs from prisoners and patients without their consent, play a large role in this issue.
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During the course of the 1990s, in response to repeated inquiries and demarches by the State Department, our ambassadors to China and other Embassy and State Department officials, the Chinese have provided information on their official policy, including two documents on regulations promulgated on April 6, 1996, governing organ donation. The regulations provide that ''the buying or selling of human tissues and organs is not allowed. The donation or exchange of human tissue and organs with organizations or individuals outside national borders is not allowed.'' However, the Chinese have not responded to our inquiries about the extent and scope of harvesting and trafficking in human organs and about Chinese authorities' efforts to implement their own regulations.
We most recently discussed the issue of organ harvesting in Washington with the Ministry of Foreign Affairs (MFA) International Organization Director and senior Chinese Embassy officials on June 26. I participated in the meeting and specifically mentioned that I would be testifying before this committee today and would have to say that the United States was appalled by the number of highly credible reports coming out of China about the removal of organs from executed prisoners and about trafficking in those organs. I noted that enforcement of Chinese regulations governing organ donations appeared to be woefully inadequate. Our interlocutors responded that such practices are illegal in China and that those who are found to engage in such practices are brought to justice. I responded by asking that Chinese authorities provide us with evidence of such prosecutions. We also raised the issue on June 14 in Beijing with the MFA Human Rights Division Director and here in Washington with the Chinese Embassy. We informed Chinese Embassy officials of the increased level of attention being focused on this issue in the United States and urged China to work intensively to ensure that its organ transplant policies are consistent with international standards. We also urged China to take steps to combat the actions of those who engage in such unconscionable acts, pointing out that they are a perversion of medical ethics and state power as well as an egregious human rights violation.
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Assistant Foreign Minister Zhou Wenzhong was in Washington last week and we communicated to him the strong bipartisan support that the issue of human rights has in the United States. In the months ahead, we will continue to make clear our strong opposition to the repugnant practice of coercive organ harvesting and will press the Government of China to ensure its organ transplant policies and practices are in compliance with international human rights norms as well as international medical practices. We will urge them to enforce all regulations governing organ transplants, to prosecute those who violate existing regulations, and to pass and implement new legislation. We also will share the testimonies delivered here today with our Embassy in China and instruct our Embassy to raise the allegations made in them with the appropriate officials in China. They will be asking Chinese authorities for evidence that those who engage in the practices discussed here today are brought to justice. In the United States we will investigate and prosecute all violators over whom the United States has jurisdiction to the fullest extent of the law.
Thank you.
Mr. SMITH. Mr. Secretary, thank you very much for your very strong statement and for the good work that you are doing.
For the purposes of an opening statement, Chairman Gilman would like to offer some remarks.
Mr. GILMAN. Thank you very much, Mr. Chairman. I want to thank you and Chairwoman Ileana Ros-Lehtinen for conducting this very important hearing on the Chinese government's harvesting, trading and transplanting of prisoners' organs for money, and I want to also thank Harry Wu for his courage and tenacity in bringing this issue to light once again. We welcome him before the Committee. I want to thank Michael Parmly for his testimony.
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News documentaries and testimony before this Committee have disclosed that the majority of the resources generated by organ extraction and transplants in China goes into the coffers of the People's Liberation Army. The PLA runs the majority of the hospitals, which are undertaking the sale of organs and which is doing the operations.
The close relationship that the PLA has with the prisons and the justice system ensures that a great number of the victims will be individuals who are condemned for their political and religious beliefs, but convicted under other pretenses.
The enormous amount of money that changes hands in that corrupt society with every operation ensures that many people are going to be killed and their organs harvested for all the money that it generates. What is going on in China today is the ultimate human rights abuse. It is a well oiled machine that sentences, condemns and executes humans so that their organs can be extracted, sold and transplanted by government officials for personal gain and to continue a repressive totalitarian system.
Today, once more as a result of this Committee's work, the American public and the world will be able to learn the details of these gruesome facts. The question now remains what will we do about this ultimate affront to human rights and the sanctity of life.
The doctors from the People's Republic of China who come to the United States for training in organ transplants should be prohibited from undergoing any training here, and it is for that reason I am pleased to support this measure. We should also prevent them from being granted visas in the days ahead.
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I thank you, Mr. Chairman. I regret I have to go on to another meeting, and I hope I can have time to return before the hearing is completed. Thank you.
Mr. SMITH. Thank you very much, Chairman Gilman.
We are also joined by the distinguished gentleman, Mr. Wu.
I would like to ask a few opening questions. I have been summoned to the White House, along with a few others, for a meeting, but I will come back as soon as that meeting is over to join the remainder of the hearing. I do have a couple of questions.
Mr. Secretary, in your statement you talk about we consider organ harvesting from executed prisoners without permission from family members to be an egregious human rights abuse. I was wondering if I could, and I would like to just throw out a few questions and then get your response.
Without permission from the family members. It would seem to me that if they give permission there is a very high likelihood that there is some kind of coercion, some kind of threat that would be put upon them. My hope would be that regardless of how those organs are stolen or extracted, permission or not, that family members are really not in a position, it would seem to me, to provide that permission.
Secondly, given that the evidence indicates that 90 percent of all transplants performed in China use organs taken from executed prisoners, does the Department of State have in place a mechanism to evaluate and scrutinize visa requests from the Chinese officials or Chinese physicians to safeguard against trafficking visas for those engaged in harvesting, transplantation or trafficking of organs of executed prisoners? Is there such a thing in place?
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Secondly, how many visas are granted yearly to Chinese physicians or medical students for the purpose of participating in programs or conferences providing training and medical information about organ transplantation?
Mr. Secretary?
Secretary PARMLY. Thank you, Mr. Chairman. Let me start with your last question first of how many. I will have to take that question and get back to you with the answer.
We do have regulations for reviewing visa requests. I will have to talk to our colleagues in the Consular Division to make sure that those procedures apply all the scrutiny that is necessary to make a proper determination regarding visa requests.
Mr. SMITH. On the question of whether or not family members are suffering coercion in order to give permission, I do not want to say we have the right answer for everything, but it seems to me the Federal Bureau of Prisons have very strict regulations regarding these matters.
I would like to see at least the philosophy, if not the specific aspect of those regulations, applied in the case of China. They seem to me to be the most civilized and the most humane in terms of only accepting the donation of organs from condemned prisoners for immediate family members.
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I am not an expert in all the ins and outs of the Federal Bureau of Prisons' regulations, but in preparing for this testimony I and my colleagues did look into what we do, and I know that similar regulations are in place in a number of countries. I would like to see those applied.
Mr. ROHRABACHER [presiding]. Let me get this straight. If we pass some legislation that requires that doctors who are engaged in this type of human rights abuse or crime against humanity be sanctioned, will the State Department be able to identify those doctors who have been engaged? Will we have the answer to that?
Secretary PARMLY. We will make every effort to provide to the fullest extent whatever legislation is passed.
Mr. ROHRABACHER. Well, let us then put on notice and let us make sure that every doctor in China that is listening to these words understands that the Executive Branch is now agreeing with the Legislative Branch that we are going to work together to make sure that any doctor in China who is engaged in the harvesting of organs from executed prisoners will face dire consequences because of his or her actions.
Any doctor who has been engaged in this type of criminal behavior in China who tries to come to the United States, and we consider this criminal behavior, will be denied access to the United States. They will pay a price. That word has to get out and has to be understood. That is the purpose of this hearing, and that is the purpose of Ms. Ros-Lehtinen's legislation.
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We are talking about a crime against humanity that we consider to be of the scale of any other crime that Mr. Milosevic committed or that were committed in the Second World War or crimes that were committed by the Japanese against the Chinese people.
Those Chinese medical professionals engaged in this behavior will find that there will be a price to pay, and that they should opt out of this official activity. Whether they are ordered or not to be involved in it is irrelevant.
We will work together with you and the Administration to make sure that this is enforced. I take it by your answer that the Administration is willing to work with us on that account.
Secretary PARMLY. Mr. Chairman, the Administration is looking forward to working with this Committee and with the Congress on this piece of legislation.
We do not have a position on the piece of legislation itself. We certainly share all the concerns that inspire this piece of legislation, and that is why we want to work with this Committee.
Mr. ROHRABACHER. I would hope that the President, when meeting with his counterparts in China, brings this issue up, as well as several other important humanitarian and human rights issues.
Ms. McKinney, you may proceed.
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Ms. MCKINNEY. Thank you, Mr. Chairman.
I have just a few questions, Mr. Parmly. The first question pertains to page one of your testimony where you say the lack of transparency in the Chinese criminal justice system and the secrecy that surrounds prison executions and the removal of organs makes actual documentation of the practice impossible.
Could it be that we are having a hearing here today, and we are having a whole lot of discussion about something that does not even exist?
Secretary PARMLY. I do not believe so. I believe the evidence is overwhelming and growing. I believe the sources that have reported this are credible. They are numerous. No, I do not believe so.
Ms. MCKINNEY. Do you know what kind of evidence you have?
Secretary PARMLY. I do. In some cases, as I stated in my testimony, it is statements by people who have been involved. In some cases it is recipients of transplants.
In some case it is statements by doctors themselves who have had changes of conscience, changes of heart. I believe you will be hearing from one of those later in the hearing today.
Ms. MCKINNEY. Further, you state that reports of Americans receiving transplants in China have been made public. We have a proposal for legislation that penalizes the Chinese and not the American transplant tourist. What do you think about the fairness of that?
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Secretary PARMLY. Excellent question, Madam McKinney. We want to see the practice stopped. We want to stop the source and stop the practice there. We are open to a number of ideas as to how we can stop this practice so long as they are in conformity with the law.
I think it was sensitive to the human drama of people who are seeking transplants for loved ones or even for themselves, and we can be compassionate with them, but it is where you are getting the organ that concerns us the most.
Ms. MCKINNEY. So how is it that you are going to be compassionate with those folks if they are getting the organ from an illegal source?
Secretary PARMLY. I am not an expert on organ transplanting. I have had relatives who have had organ transplants themselves. There is a legal way to do this.
What I am concerned about here and what this hearing is all about is mainly the trafficking in organs from executed prisoners who do not have free exercise of their free will.
Ms. MCKINNEY. But this hearing is also about the legislation that the congresswoman has introduced, and it just seems to me it already has a number on it, so it has been introduced. I am just interested in knowing how you or the Administration feel about the unfairness of the legislation that tackles only half of the problem. This is a trade.
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Secretary PARMLY. We want to work with the Committee and with the Chairwoman and those responsible for this legislation on the legislation.
Ms. MCKINNEY. Thank you. I have just a couple more questions based on your testimony.
You say that you spoke with the Ministry of Foreign Affairs, and they responded that they prosecute the offenders. I traveled to China several years ago, and my issue was forced abortions. They kind of told me the same thing. They also said that they could provide evidence of prosecutions.
Have they provided evidence of prosecutions since your conversation with them I guess as late as yesterday?
Secretary PARMLY. That was yesterday. No, they have not gotten back to me since then.
Ms. MCKINNEY. Do you expect that they will?
Secretary PARMLY. I intend to pursue it with them.
Ms. MCKINNEY. Good show. I guess my final——
Secretary PARMLY. I should say I and my colleagues, the Embassy in Beijing, the Consulate. We all intend to. That is why I said we were talking this morning about getting the instruction cable out to make sure that they pursued the conversations that we had yesterday in Washington.
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Ms. MCKINNEY. Great. My final question would be do the Chinese acknowledge that this is a problem?
Secretary PARMLY. Yes, they do. They recognize it is a problem. They point to the legislation and the regulation as evidence of the fact that they, too, are concerned about this problem.
What I want to see is results. What I want is prosecutions. What I want to see—what I think we all want to see—is a halt to this practice, so in my conversations with them yesterday that is what I said I was looking for. Now we will see. It is tough to verify.
Ms. MCKINNEY. Yes. Even though Reagan said it, I do it, too, in my life.
Thank you, Mr. Chairman.
Mr. ROHRABACHER. Thank you. Ms. McKinney and I work together very often on human rights issues, even though we are on opposite ends of the spectrum.
Ms. MCKINNEY. Honey, we are on way opposite ends of the spectrum.
Secretary PARMLY. I will not comment on that one.
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Mr. ROHRABACHER. I might add that it is already illegal for U.S. citizens to purchase organs like this if any part of the transaction happens in the United States. Of course, we cannot criminally make that illegal if it is done in some other country, but it is illegal.
Also, I think that we can be proud that in the United States we have bent over backwards to make sure that American prisoners do not get undue pressure put on them because it is illegal for a prisoner about to be executed to donate organs except for family members, his or her own family members.
I think it is important for us to maintain that safeguard so that the United States would not slip into this same sort of pattern where somebody needs an organ, and you are maybe overlooking some appeal on the part of somebody on death row simply because you want their kidney or something like that. It would be horrible.
Ms. MCKINNEY. Mr. Chairman, if I may?
Mr. ROHRABACHER. Absolutely.
Ms. MCKINNEY. I would just like to say, though, that the fact is that in the Assistant Secretary's testimony he states that Americans are traveling to China for the purpose of receiving these transplants. Then there is a problem with whatever the law is. The reach of this bill does not extend to those folks.
This is just like in the so-called criminal justice system that we have in this country where we lock up the guy that is standing on the street corner selling the drugs and fill the prisons with them, and the guys, the rich guys who are laundering the money in the banks and on Wall Street get away scott free.
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Here we have the same situation where we are going to let some folks who are engaging in criminal activity get away scott free. I just do not want to see that happen.
Thank you, Mr. Chairman.
Mr. ROHRABACHER. I think you make some good points. I see that the Chairman is back,
Secretary PARMLY. Mr. Chairman, if I could just comment on the——
Ms. ROS-LEHTINEN [presiding]. Yes, Mr. Parmly?
Secretary PARMLY. Thank you, Madam Chairwoman.
Mr. Rohrabacher was making some observations about the safeguards of the American prison system regarding the use of organs from prisoners. My colleagues and I did some checking. It has been a rather ghoulish few days in DRL, but we did some checking just to see what the practices were at least at the Federal level.
I was assured by our contacts with the Federal Bureau of Prisons that from a non-expert eye that we have been very attentive to the kind of phenomenon at play here to ensure that if there is the transplant of an organ it is under the strictest of safeguards.
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Ms. ROS-LEHTINEN. Thank you.
Now I would like to recognize Mr. Wu for his questions. We are honored to have you with us.
Mr. WU OF OREGON. Thank you, Madam Chairwoman. I only have one inquiry of Mr. Parmly. I would like to associate myself with the previous Chairman's remarks about putting physicians on notice who participate in the harvesting of human organs for commercial sale after execution.
I would like to expand on that perhaps in the spirit that Ms. McKinney mentioned in that I would like to inquire of you, sir, what the Administration's position would be to prosecute before an appropriate international tribunal the personnel involved in this process and all governmental officials who know or should have known about these processes and having these people prosecuted for crimes against humanity in an appropriate international tribunal.
Secretary PARMLY. Mr. Wu, that is an excellent question. My goal, as stated in response to some of the other questions, is to bring about a halt to this sort of practice.
The first authority that is responsible for bringing that about is the Chinese Government and officials of the Chinese Government. That is where we are going to focus our attention. It is where we have focused our attention in past months and even years.
I regret to say that we have not produced the kind of results we would like to see. We still intend to pursue that effort. It cannot be in the interest of China to allow this to continue.
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One will get all sorts of explanations back to the extent of the local level, the national authorities, that it is hard to get a handle on, that the poor people are willing to sell body parts in order to keep their families alive. The practice has to stop.
Mr. WU OF OREGON. If I can interrupt at this point?
Secretary PARMLY. Sure.
Mr. WU OF OREGON. I find your efforts to stop this commendable, but there are two parts of this going beyond associated with stopping this.
One is that there is nothing quite so effective in stopping things as either criminal prosecution or the prospect of criminal prosecution, and the other thing that we have to keep in mind is that if you have a series of crimes occur and your effort is to stop those crimes from occurring even after you successfully stop those crimes from occurring do you not think there is a social obligation to prosecute the crimes that have been uncovered?
Secretary PARMLY. Absolutely. I think there is an obligation to prosecute the crimes that have been uncovered. That is what we are pressing the Chinese authorities to do when those activities are uncovered.
Mr. WU OF OREGON. And if they fail will the Executive Branch recommend action by an international tribunal?
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Secretary PARMLY. I will have to save that question.
Mr. WU OF OREGON. I look forward to a written answer.
Secretary PARMLY. All right.
Mr. WU OF OREGON. I would venture a personal response. Having served in Bosnia and seen the extraordinary effort that goes into the ITTY—I visited the Hague and have spoken with prosecutors there. It is an extraordinarily huge and, I would add, an extremely expensive undertaking to launch an international tribunal. Frankly, I do not want to have to wait for the creation of an international tribunal to try this sort of a crime.
I am not asking you to wait. I am asking you to get back to me with an answer about whether this government will pursue that course or not. If it was worth pursuing in Bosnia and if we are talking about 1,000, 2,000 or 3,000 organs then it is certainly worth pursuing in this instance in my view.
If the government, if the Executive Branch, does not share that view, I would like to hear about it.
Secretary PARMLY. Okay. I take your point, and I will get back to you. We will get back to you with a written answer.
Mr. WU OF OREGON. Thank you.
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Ms. ROS-LEHTINEN. Thank you, Mr. Wu.
Following up on that, could you tell us how many U.S. citizens or residents travel to China each year? How many do you suspect would be doing so for the purpose of organ transplantation or are involved in brokering sales of organs from executed Chinese prisoners?
Secretary PARMLY. I do not know if we have it broken out in subcategories how many go to China to participate or to benefit from an organ transplant. I will have to get back to you, unless my colleague, Mr. Keith, has the information on how many Americans visit China every year. Mr. Keith
Mr. KEITH. We do not have that. We do not have that information, but we can certainly provide it very quickly to you.
Ms. ROS-LEHTINEN. Thank you. Do you believe that there is sufficient evidence to support an active and vigorous investigation by the State Department?
Would the Department press for access to Chinese prisoners, to interview the guards and death row inmates, to call on the Chinese Government to provide access to human rights organizations to do the same?
Secretary PARMLY. We can try all of those ideas, and they are very good suggestions, Madam Chairwoman. One of the difficulties we have had over the years in pursuing this issue is precisely that the prison system is so opaque.
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It is so difficult to get a handle on and often decentralized, so even if you get an answer from Beijing it may not be the right answer. It might be the right answer for that official in Beijing, but it may not necessarily be the accurate one on a prison in some far-flung province. We will certainly pursue it.
Ms. ROS-LEHTINEN. Has the Department previously conducted any investigations similar to that or have been asked and been denied? What has been the response of the Chinese authorities of any previous attempts from our Department.
Secretary PARMLY. We have, but I would ask Mr. Keith, who has worked on China for a number of years, to address that question.
Mr. KEITH. We have throughout the country as our officers travel outside of the capitol or outside of the provincial capitols raised questions about this issue. We have talked to hospital administrators. We have talked to local officials. We have talked to central government officials.
In general, the response is as described in Secretary Parmly's testimony. That is, we are assured that this action is illegal. We were not provided with a record of prosecutions or of specific cases that the Chinese Government has uncovered, but we will continue to press for that.
Ms. ROS-LEHTINEN. Okay. How closely does the Department work with the U.N. Working Group on Arbitrary Detention and with the U.N. Commissioner for Human Rights on these issues? What efforts does the U.S. already undertake and will undertake through international channels to help put a halt to the continuing efforts of the Chinese to see harvested organs?
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How well do we work with the U.N. Working Group on Arbitrary Detention, and what will we be undertaking?
Secretary PARMLY. Thank you, Madam Chairwoman. Actually a good question because the multilateral route is one of the points of pressure that we most want to pursue.
We have the met with the various U.N. bodies, also with another one which is even perhaps more critical in all of this, the ICRC, and we have pursued our concerns with them.
It is when China hears the refrain coming not just from the United States and not just from government officials, but from other governments, from international organizations such as the High Commissioner for Human Rights and the ICRC, that perhaps they will begin to wake up and get the message that this practice has to stop and that they need to do something about it.
Ms. ROS-LEHTINEN. Thank you. I would like to ask you a question about one of our next panelists, Dr. Wang. Is the Department aware of the persecution that Dr. Wang's family was being subjected to because of Dr. Wang's work to help bring attention to this gruesome practice?
Could we get a commitment that the Department will look into this matter and assist Dr. Wang's wife and son in the possible persecution that they are already facing?
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Secretary PARMLY. Thank you, Madam Chairwoman. For someone like me who has worked in human rights for much of my career, you have asked the key question. What about the effect on the individuals involved?
The courage of Dr. Wang is extraordinary. I think of all of the attempts that I have read, his has been the one that moved me the most. I can tell you that my boss, Norm Craynor, who was recently confirmed, shared the revulsion when he read Dr. Wang's stories.
We did discuss the issue that we raised among us and are taking action to see what we can do to ensure that Dr. Wang's family receives as much protection as we can possibly provide.
Ms. ROS-LEHTINEN. Thank you so much. We would like to thank the panelists for being here today. We thank the Department for being vigilant on this issue. We will anticipate getting those written questions in response.
Thank you so much. It is always a pleasure to have both of you here; especially you, Michael. Thank you so much.
I would like to introduce the second panel. Testifying before us today is an exceptional panel of experts on the condition of human rights protection in China and firsthand witnesses of the gruesome organ trade bribing in China.
We begin with the testimony of a gentleman whose encouraging story we are all familiar with, Mr. Harry Wu. Imprisoned in 1960 for his critical views of the Soviet and Chinese Communist system, he served 19 years condemned at the most extensive forced labor and reform camp in the world. After his release, he has become a true human rights activist who has worked tirelessly to expose the cruelties of the Chinese regime.
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He was imprisoned in China once again in 1995 and released quickly thereafter when the world cried out in support of Harry Wu, and China was forced to release its critical foe.
Mr. Wu continues his work as the executive director of the research foundation and is a research fellow at the Houve Institution of Stanford University. It gives me great pleasure to see you, Mr. Wu, once again testify before this Subcommittee on a topic that is very close to you. We welcome you once again.
Secondly, we will hear the eyewitness account of Dr. Wang Guoqi. He joined the People's Liberation Army in 1981 and soon thereafter began studying medicine. He became a doctor at the burn/surgery department at the hospital and is a specialist in storing and preserving human tissue for operations on burn victims. He assisted in constructing the first low temperature and tissue storehouse in China.
He found that much of the skin and tissue was removed from execution grounds and crematoriums. Dr. Wang estimates that he assisted in removing skin from over 100 executed prisoners. When he sought a different position at the hospital and refused to partake in the occupational outings to execution grounds, the hospital responded by threatening him and forbade him from disclosing information about these practices.
Dr. Wang fled China in April, 2001, under a pseudonym and traveled to the United States where he remains intent on bringing the abuses of organ harvesting to international attention. Thank you for your bravery and sharing your experiences with us here today. We welcome you to our Subcommittee.
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Following Dr. Wang, we will hear from Dr. Thomas Diflo. Currently at NYU, he is a principal investigator in several medication studies. One of his specialties is in transplantation surgery.
In 1993, Dr. Diflo became the director of the Renal Transplant Program, and, according to NYU reports, kidney transplants have quadrupled and his department has yielded a 97 percent survival rate amongst kidney graft transplants under his guidance.
Due to his extensive work in this field, Dr. Diflo increasingly became concerned over numerous Chinese-American patients coming to his department for follow up care after receiving organs that had been harvested from executed Chinese prisoners. He contacted the Village Voice and held a shining light on the insidious organ trade thriving in China, and we are welcome to discuss with him this atrocious practice. We welcome you, Dr. Diflo.
Lastly, we are joined by Dr. Nancy Scheper-Hughes. She is a professor of Anthropology at the University of California at Berkeley where she also directs a doctorate program in critical studies of medicine, science and the body.
She has received many awards for her publications, including the Margaret Meade Award. She is currently writing a book entitled Who Is The Killer: Violence and Democracy in the New South Africa. She now serves as the director of Organs Watch, a small, independent medical human rights research and documentation center located at the University of California-Berkeley.
Thanks to all of you for coming and participating in this hearing. We look forward to your testimony.
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Dr. Scheper-Hughes must leave at 3:30 for her flight back to California. Because of that, we would like to have her testify first, followed by Mr. Wu and the others. Professor, thank you for your patience. We would like to recognize you first.
Your full statement will be made a part of the record. Please feel free to limit your remarks to 5 minutes. Thank you.
STATEMENT OF NANCY SCHEPER-HUGHES, PROJECT DIRECTOR, ORGANS WATCH
Ms. SCHEPER-HUGHES. Actually, I am on my way to Brazil and Argentina to continue the study of global trafficking in organs, but thank you, Madam Chair and Ranking Member McKinney, for the opportunity to speak before you and the Members of this Committee.
For the last 5 years, I have been involved in active field research on the global traffic in human organs following the movement of bodies, body parts, transplant doctors, patients, brokers, kidney sellers and the practices of organ and tissue harvesting in several countries from South America to the Middle East to Southeast Asia, South Asia, to Africa and to the United States.
As a member of the Bellagio Task Force on International Trafficking of Organs and a co-founder of Organs Watch, which is funded by the Soros Foundation and works with interns in medicine and medical anthropology in various countries of the world and with a reliance on them, as well as on our own field work, in trying to unmask the spread of commerce in organs and tissue.
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I think that my role here as Director of Organs Watch is to put the specific Chinese case, as egregious as it is, into a larger global perspective because, as I said, this trafficking of organs transcends national boundaries, and it involves doctors, patients, brokers and impoverished organ sellers from both third and first world contexts.
Despite the many obvious benefits of global capitalism, it has also released a voracious appetite for foreign bodies to do the shadow work of production and also to provide fresh bodies for medical consumption. What we are witnessing today is the confluence in the flows of immigrant workers and itinerant kidney sellers who fall into the hands of unscrupulous, highly sophisticated transnational organ brokers.
The problem is that markets are inclined to reduce everything, including human beings, their labor, their reproductive capacity, to the status of commodities, things that can be bought, sold, traded and stolen.
We found that the growth of medical tourism for transplant surgery has exacerbated older divisions between north and south, haves and have nots. In general the flow of organs, tissues and body parts follows the modern routes of capital from south to north, from third to first world, poor to rich, from black and brown to white and from female to male bodies.
In the worst instance, the market has resulted in theft and coercion, as in the case of China, to a self-serving belief in the rights of the more affluent to the spare parts of the poor, as in the case of many of the transplant junkets that are arranged to carry patients from Saudi Arabia, Israel, North America and elsewhere to Turkey, India, Romania, the Philippines, where kidney sellers are recruited from prisons, from unemployment offices, in shopping malls and in urban transit towns.
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While China supplies the largest supply of organs that are available to transplant tourists today, China does not stand alone in this practice. Illicit and illegal practices of organ harvesting recognize no specific political or ideological boundaries and can be found in capitalist and communist countries, in secular and in religious cultures, in Christian, Muslim and Jewish states alike.
For example, Dr. Chung Jean Lee, chief transplant surgeon at National Taiwan University Medical Center, reported to the Bellagio Task Force that until human rights organizations put pressure on his own country, transplant units in Taiwan also used executed prisoners to supply the organs they needed.
China held out, Chung Jean Lee suggested, because of the desperate need for foreign dollars and because in general there is less concern throughout Asia for issues of informed consent, and in some Asian cultures the use of prisoners' organs is seen as a social good and as an opportunity to redeem a family's honor.
Not only the executed prisoners, but also the profoundly mentally retarded are at risk of illegal organs and tissue harvesting. In January, 2000, I visited the grounds of Montes de Oca state mental asylum a few hours drive from Buenos Aires to verify specific reports of blood, tissue, cornea and kidney harvesting from the bodies of the profoundly mentally retarded, but otherwise physically healthy, inmates of the asylum. This practice began during the war in Argentina.
I visited with the patients and interviewed staff. A night nurse and ward supervisor explained to me off the grounds that the regime of blood letting and cornea removal from inmates, both living and dead, without consent was a pay back for their care at the state's expense. ''Is that not the way it is done everywhere?'' the nurse asked me.
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Meanwhile, transplant doctors in Sao Paulo and Rio de Janeiro told me that during the military period in Brazil during 1964 through 1984 with some spill over into the democratic era, doctors were given quotas by the military to produce a specific number of organs, which were delivered to military hospitals, organs they said they got by any means possible, including, I was told by one guilt-ridden and high ranking practitioner now retired, by chemically inducing the signs of brain death in some of the very, very sick, but certainly not near brain dead patients in his hospital, a large, prestigious, public hospital in Sao Paulo.
By far the largest practice of elicit organ harvesting concerns the almost now routine and every day trafficking from the bodies of desperately poor living donors. In the Middle East, residents of the Gulf States have for many years traveled to India, the Philippines and now more recently to Eastern Europe to purchase kidneys made scarce locally due to local fundamentalist Islamic teachings that allow organ transplants to save a life, but prohibit organ harvesting from brain dead bodies.
At the same time, hundreds of kidney patients from Israel, which has its own well-developed transplant centers, but low rates of donation due to certain ultra Orthodox reservations about brain death, travel in transplant junkets to Turkey, Moldova, Romania, where desperate kidney sellers can be found, and to Russia where an excess of cadaveric organs are produced due to lax standards for designation brain death, and to South Africa where the amenities in private transplantation clinics can resemble four star hotels. We at Organs Watch have visited all of these sites except Russia.
Dr. Zaki Shapira, head of transplant services at Bellinson Medical Center near Tel Aviv and, ironically, a former member of the Bellagio Task Force with me, has been operating as a transplant outlaw since the early 1990s when he first used intermediaries and Arab brokers to locate kidney sellers amongst strapped Palestinian workers in Gaza and the West Bank.
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When Shapira's hand was slapped by an ethics board, the Cotev Commission, and I interviewed the head of the Commission, in the late 1990s, Shapira simply moved his illicit practice overseas to Turkey and to countries in Eastern Europe where the considerable economic chaos of the past decade has created parallel markets in bodies for sex and bodies for kidneys.
Affluent Palestinians from the West Bank also travel in search of transplants with purchased kidneys, and they go to Baghdad, Iraq, where several medical centers cater to transplant tourists from elsewhere in the Arab world. The kidney sellers, in Iraq are mostly young men, foreign workers from Jordan and poor Iraqis who are housed in a special wing of hospitals in dorms that could be called kidney motels. We found these kidney motels also in India where very desperate, hopeless people wait for the blood and cross matching tests that will turn them into the day's winner of the kidney lottery.
These transplant packages cost as low as $12,000 to as high as $180,000. In Israel, I interviewed more than 50 transplant professionals, patients, organ buyers and sellers involved in commercialized transplants. The passivity of the Ministry of Health in refusing to intervene and crack down on this multi-million dollar business, which is making Israel into something of a pariah in the international transplant world, requires some explanation, as does the passivity of the governments of the Philippines, Iraq, Turkey, Romania, Moldova and Jordan where specialized kidney belts have sprung up.
We in the United States cannot claim any high moral ground, given the number of U.S. transplant centers, public and private, with the idea of donated organs as a national and community resource. Dr. Michael Friedlander, chief nephrologist at Hadassah Hospital in Jerusalem, tired of reports about commercialization of kidneys in Israel, decided, like Dr. Diflo, to speak out, and he says that among his recovering international transplant patients are several Israelis who have recently returned this year and last from the United States with kidneys purchased here from living donors.
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The U.S. doctors in charge of the identified kidney units where these transplants have taken place, some of whom I have interviewed by telephone, claim ignorance on their part, saying that they believed that the donors and recipients were biologically or strongly emotionally related.
I have met a great many kidney experts. The understanding is that commerce in kidneys between strangers is everywhere practiced and is protected in the United States by a policy of ask, but please do not tell me anything I do not want to hear.
In March of 2001, I interviewed in Israel two men, one a young student and the other a retired civil servant, who had both returned to Jerusalem from transplant units in Baltimore and New York City, each with a brand new purchased kidney.
The student preferred not to think about his donor and was told by his own doctor to consider the trip to the United States as an extended vacation. The older transplant patient described the payment he made to an acquaintance that he brought with him for her kidney as a bonus—vacation money for her to recuperate while having a good time far away from home.
I think that one of the problems is the participation of medicine and transplant surgeons in perpetuating a kind of a myth that a living kidney donation is necessarily altruistic.
Ms. ROS-LEHTINEN. Professor, if you could wrap it up? I see our red light is on.
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Ms. SCHEPER-HUGHES. Okay. I am sorry. If I can, I will answer questions later. Thank you.
[The prepared statement of Ms. Scheper-Hughes follows:]
PREPARED STATEMENT OF NANCY SCHEPER-HUGHES, PROJECT DIRECTOR, ORGANS WATCH
Today's important Congressional Hearing owes in large part to the courage of physicians like Dr. Thomas Diflo, director of the renal transplant program at the New York University Medical Center and to human rights activists, like Harry Wu of the Laogai research Foundation, and it is an honor to be in their presence. Dr. Diflo was moved to report to his hospital's medical center's ethics committee that several of his post transplant patients had returned from China with ''freshly'' transplanted kidneys that had been obtained from China's death row where prisoners are killed—sometimes for minor offenses like tax evasion—and their organs harvested to supply a lucrative, state sponsored, business. Other transplant specialists in Canada, Europe, and Israel are also beginning to speak, not only about the Chinese practice of organs harvesting but about other aspects of the growing international traffic in human organs to meet the needs of transplant surgery and other advanced medical procedures.
I am here representing Organs Watch, a small, independent, medical human rights, research and documentation center, now located at the University of California, Berkeley, with funding from the Open Society Institute (Soros Foundation), the Center for Human Rights and the Institute for International Studies at Berkeley. My role here is to put the specific Chinese case, as egregious as it is, into a larger global and social perspective. For the traffic in human organs, tissues, and body parts today transcends specific national boundaries and involves transplant doctors, nephrologists, their patients, organs brokers, and impoverished organ sellers from both third world and first world contexts (see Scheper-Hughes 1998a and b; 2000).
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ORGAN TRANSPLANTS IN THE GLOBAL MARKET
Over the past 30 years, organ transplantation—but especially kidney transplant—has developed from an experimental procedure, performed in a few advanced medical centers, to a fairly common therapeutic one, carried out in hospitals and clinics throughout the world. Today, kidney transplantation is widely practiced in North and South America, Europe, throughout Asia, in the Middle East, and in four countries in Africa. Survival rates for kidney transplant have increased markedly over the past decade, although these still vary by country, region, the quality and type of organ (living or cadaveric), and access to the anti-rejection drug, cyclosporine.
A triumphant global capitalism, despite its many obvious benefits, has also released a voracious appetite for foreign bodies to do the shadow work/dirty work of production and for ''fresh'' bodies for medical consumption. Global markets, together with advanced medical and bio-technologies, have incited new tastes and desires for the skin, bones, blood, organs, tissues, marrow, and reproductive and generic material of the other. And we are witnessing, today, a confluence in the flows of immigrant workers and itinerant kidney sellers who fall into the hands of unscrupulous and highly sophisticated transnational organs brokers
As George Soros (1998) the billionaire financier turned human rights advocate has recently noted, one of the dangers of the spread of global capitalism is the erosion of social values and social cohesion in the face of anti-social market values. Markets are by nature indiscriminate and inclined to reduce everything—including human beings, their labor and their reproductive capacity—to the status of commodities, things that can be bought, sold, traded, and stolen.
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Again, nowhere is this more dramatically illustrated than in the current markets for human organs and tissues to supply a medical business driven by ''supply and demand''. The rapid and recent transfer of organ transplant technologies to countries in the East (China, Taiwan, Philippines), to India, and to the South (especially Argentina, Chile, and Brazil) has created a global scarcity of viable organs that has initiated a movement of sick bodies in one direction and of ''healthy'' organs and tissues—some transported by commercial airlines in Styrofoam picnic coolers—in the opposite direction. Some organs travel ''inside their package'', a phrase some transplant specialists use to describe those kidney sellers who travel in special chartered flights to meet with pre-matched kidney patients and their surgeons in the host country. Sometimes both kidney buyers and sellers, each from different countries, arrive in a third country for an illicit transplant, making this a very difficult business to track. In all these transactions, a new profession of organized ''body Mafia'' or independent ''organs brokers''—like the notorious, but not terribly successful, Jim Cohan who operates by fax, telephone, and e-mail out of a home office in southern California—are the essential actors.
In these new transplant contexts the human body, as we knew it, is radically transformed. Notions of bodily holism and integrity have given way to notions of a divisible body in which individual organs and tissues can be detached, alienated, bartered, and sold. This points to the demise of classical humanism and to the rise of what my Organs watch colleague, Lawrence Cohen, refers to as ''an ethics of parts''—divisible bodies from which detached organs emerge as market commodities, and as fetishized objects of desire and of consumption. I refer to this as neo- or postmodern cannibalism.
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Amidst the neo-liberal readjustments of the new global economy, there has been a rapid depletion of social values. New relations between capital and work, citizenship and social and medical inclusion or exclusion are emerging. The growth of ''medical tourism'' for transplant surgery and other advanced procedures has exacerbated older divisions between North and South, between haves and have-nots, spawning a grotesque market for sold organs, tissues, and other body parts.
In general, the flow of organs, tissues, and body parts follows the modern routes of capital: from South to North, from third to first world, from poor to rich, from black and brown to white, and from female to male bodies. In the very worst instance, this market has resulted in theft and coercion ranging from kidney theft, as in the case of China and to a self-serving belief in rights over the—spare parts—of the poor, as in the case of the transplant junkets arranged through Dr. Zaki Shapira and his brokers operating today out of Bellinson Hospital in Tel Aviv.
Illicit and exploitative organs and tissue procurement practices are protected by the invisibility and social exclusion of the world's population of organ suppliers and organ sellers—living and dead—most of them poor and socially marginal, but especially prisoners, mental patients, foreign guest workers, people in debt, soldiers, undocumented immigrants, and displaced rural workers (especially in Russia and the former Soviet countries of Eastern Europe).
China's Killing Machine
In 1994 Human Rights Watch/Asia (1994) and the Laogai Research Foundation (January 1995) published reports documenting through available statistics, Chinese informants, some of them doctors and prison guards, that the Chinese state systematically takes kidneys, cornea, liver tissue and heart valves from its executed prisoners. While some of these organs are given to reward politically well-connected Chinese, others are sold to ''transplant tourists'' from Japan, Hong Kong, and other Asian countries who were willing to pay as much as $30,000 for an organ. Human Rights Watch reported that with the discovery of this lucrative market, the kinds of crimes punishable by death—even some forms of tax evasion—have increased. In 1996 at least 6,100 death sentences were handed out and at least 4,367 confirmed executions took place.
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Public officials in China have denied the allegations, but they refuse to allow independent observers to be present at executions or to review transplant medical records. David Rothman (1998) medical historian of Columbia University reported at an ''Organs Watch'' Conference in Berkeley on his visits in 1995 to several major hospitals in Beijing and Shanghai where he interviewed transplant surgeons and other medical officers about the technical and the social dimensions of transplant surgery as practiced at their units. While the surgeons and hospital administrators readily answered technical questions, they refused to respond to questions regarding the sources of transplant organs, the costs for organs and surgery, or the numbers of foreign patients who receive transplants at Chinese medical institutions. Rothman returned from China convinced that what lies behind the Chinese anti-crime campaign is a ''thriving medical business that relies on prisoners' organs for raw materials.''
Tsuyoshi Awaya (1996, 1998) a Japanese medical sociologist and law professor was more aggressive in his investigations. He has made five research trips to China since 1995, the most recent one in 1997, when Awaya accompanied a Japanese organs broker and several of his patients, all of whom returned to Japan with a new kidney within two weeks. All the patients knew that their kidneys were taken without consent from executed prisoners but this did not influence their decision. The organs from executed prisoners were simply part of the ''package'' of hospital services for a transplant operation.
More recently, there are reports (Jain 2001) of Canadian patients, desperately seeking kidney transplants, traveling to China, as well as to India the Philippines to get organs and transplant operations for which they pay between $50,000 and $145,000 depending on the circumstances. Dr. Jeffrey Zeltzman, a Toronto-based kidney specialist and director of St. Michael Hospital's renal transplant program, likened the new medical tourism to a ''black-market underground economy. We've had lots of patients who have gone. Some tell us and some don't tell us—they just come back with the kidneys.'' Canadian citizens were not deterred by the illegality of buying and selling organs which in Canada is, not a criminal offence, and is subject to a maximum $1,000 (Canadian dollar) fine and six months in jail. No one has ever been prosecuted for this offense. Nor are they dissuaded by the unseemly manner in which the organs are procured.
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The complicity of Chinese doctors in these highly medicalized executions whereby the condemned prisoner is carefully examined, intubated, and ''prepped'' for organs harvesting minutes before he is executed by a bullet to his head, is reminiscent of Nazi Medicine as practiced in the death camps. Since executed prisoners are not asked for their consent the harvesting of their organs can be seen as a form of body theft. The feelings of revulsion toward the practice that some medical human rights activists express are understandable.
But while China provides the largest supply of organs that are available to transplant tourists today, it is important to note that China does not stand alone in this practice. Illicit practices of organs harvesting recognize no specific political or ideological boundaries, and can be found in both capitalist and communist countries. Dr. Chun Jean Lee, chief transplant surgeon at the National Taiwan University Medical Center, reported to the international Bellagio Task Force on organs trafficking (of which I was a member, along with the notorious Dr. Zaki Shapira) that until international human rights organizations put pressure on his own country, transplant units in Taiwan also used executed prisoners to supply the organs they needed. China held out, Lee suggested, because of the desperate need for foreign dollars, and because there is less concern throughout Asia for issues of ''informed consent.'' And, in some Asian societies and cultures the use of prisoner's organs is seen as a social good, a form of public service, and an opportunity to redeem the family's honor.
That there are no fixed political, ideological, or religious boundaries with respect to illicit transplant practices is clear in the case of the Middle East. Residents of the Gulf States (Kuwait, Saudi Arabia, Oman) have for many years traveled to India and to countries in Eastern Europe to purchase kidneys made scarce locally due to local fundamentalist Islamic teachings that allow organ transplantation (to save a life), but prohibit organ harvesting from brain-dead bodies. Meanwhile, hundreds of kidney patients from Israel, which has its own well-developed, but under-used transplantation centers (due to lingering orthodox Jewish reservations about brain death) travel in privately brokered ''transplant tourist'' junkets to Turkey, Moldova, Romania where desperate kidney sellers can be found, to Russia where an excess of lucrative cadaveric organs result from lax standards for designating brain death, and to South Africa where the amenities in transplantation clinics in private hospitals can resemble four star hotels.
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The infamous Zaki Shapira, head of kidney transplant services at Bellinson Medical Center, near Tel Aviv (and, ironically, former member of the Bellagio Task Force on global transplant ethics) has been operating as a transplant outlaw since the early 1990s when he used local Arab brokers to locate willing kidney sellers among strapped Palestinian workers in the Gaza and the West Bank. When Shapira's hand was slapped by an ethics review board (the Cotev Commission) in the mid 1990s, Shapira simply moved his illicit practice overseas—to Turkey and to countries in Eastern Europe where the considerable economic chaos of the past decade has created parallel markets in bodies for sex and for kidneys.
But affluent Palestinians from the West Bank also travel in search of transplants with purchased kidneys to Baghdad, Iraq, where several medical centers cater to transplant tourists from elsewhere in the Arab world. The kidney sellers, I was told by one Palestinian transplant patient whom I interviewed in March 2001, are mostly young men, foreign workers from Jordan, and poor Iraqis who are housed in a special wing of each hospital in dorms that could be called ''kidney motels'', while they wait for the blood and cross-matching tests that will turn them into the day's ''winner'' of the kidney lottery. In Iraq the transplant package, complete with pre- and post-operative care and with fully equipped modern apartments provided in the hospital complex for accompanying relatives, is only $20,000, up, we were told, from only $10,000 several years ago. In fact, it was the appearance of these successful transplanted Palestinians in the after care clinic of Hadassah hospital (See Friedlander 2000) that prompted Jewish patients to pursue alternative transplant options for themselves.
While in Israel for Organs Watch in the summer of 2000 and, again in March 20001, when I accompanied Mike Finical, of The New York Times (see Finical 2001), I interviewed more than 50 transplants professionals, transplant patients, and organs buyers and sellers involved in commercialized transplants. Most surgeons, while worried about the risk to their patients and the potential for exploitation of both organs sellers and buyers on the part of