Practice must be stopped

EDITOR—On 27 June 2001 Thomas Diflo, a New York transplant surgeon, Wang Guoqui, a Chinese doctor who had taken kidneys and skin from recently executed prisoners, and Harry Wu of the Laogai Association gave evidence to the committee on international relations of the United States House of Representatives in Washington, DC. They noted that in China, organs are taken from recently executed prisoners, to be transplanted into recipients from the United States, Taiwan, Malaysia, Japan, and other countries. The recipients pay $17 000–40 000 each. It was not known whether the executed prisoners had given their consent.

In China prisoners can be executed for crimes such as rape, robbery, drug dealing, and black market activities, in addition to murder. It is extremely rare for those accused not to be found guilty. As soon as the prisoners are sentenced, blood samples are taken for grouping. The prisoners' appeals are hardly ever upheld. They find this out only when they are taken to be shot. Ambulances wait at the site of the executions, and the fresh organs from healthy young persons are harvested, to be transplanted into recipients from abroad.

The World Medical Association made declarations condemning these practices at Brussels in 1985 (on the grounds that this was commercial exploitation of human organs), at Madrid in 1987 (on the grounds that doctors should not participate and that it was not known if the executed prisoners had given consent to the use of their organs), and at Stockholm in 1994, when the BMA had rejoined the World Medical Association (on the same grounds as the 1987 declaration).

In Beijing, in 1998, Delon Humann, the secretary of the World Medical Association, Anders Milton, its chairman, and Dr T J Moon of the Korean Medical Association, reached an agreement with the Chinese Medical Association that these practices were undesirable and that they would investigate them jointly, with a view to stopping them. Nevertheless, in 2000, the Chinese reneged on these undertakings and refused to cooperate. This lucrative and immoral trade continues unabated. One is entitled to ask whether any British patients have visited China to receive transplant from executed prisoners, and what the international medical community can do to stop these practices?

Opportunities to offer support to members from the China Medical Association have been limited

EDITOR—Hillman makes some important points on the use of the death penalty in China and its relation to the procurement of organs for transplantation.

When the China Medical Association rejoined the members of the World Medical Association at the general assembly, voting on that application was in the hope that membership of the World Medical Association would help the China Medical Association to oppose unethical practices and encourage the teaching of medical ethics and human rights. At an early meeting with the China Medical Association its leaders produced a statement with the World Medical Association, condemning harvesting of organs from executed prisoners. Other activities were planned; one of the first was to be a seminar on teaching human rights for doctors and medical students. The requirements of the World Medical Association—including freedom to set the agenda for the meeting and a guarantee that invited guests and speakers would get visas—were not met, and the meeting was cancelled.

Since rejoining the World Medical Association, members from the China Medical Association have rarely attended meetings, and the opportunities to offer them support have been limited. All members of the World Medical Association share Hillman's concern to effect change. We continue to hope that such contacts as we have with Chinese colleagues will encourage them to share our views, and to use our help in opposing this practice. Our human rights working group will continue to press this agenda.