Beijing Mulls New Law on Transplants of Deathrow Inmate Organs    

  Nov 28 2005 Caijing Magazine/Issue:147                          

  By staff correspondent Ji Minhua in Manila and staff reporter    

  Zhang Yingguang in Beijing                                        




  The Chinese government has admitted that most human organs used   

  for transplants in China are those of executed prisoners, and has 

  promised to expedite new legislation that would regulate the      

  market for those organs.                                          


  Vice Minister of Health Huang Jiefu acknowledged the use of       

  prisoners' organs in his remarks at the International Conference  

  on Liver Transplants in July. He reiterated both the problem and  

  the government's commitment to improving oversight at another     

  international conference in Manila earlier this month. China has  

  finished its first draft of the regulations, Huang said, which    

  will be submitted to the State Council for review. He told Caijing

  in an exclusive interview that he hopes the new regulations will  

  help improve China's image in the organ transplant field.         


  Geneva-based WHO representative Luc Noel said China's "unequivocal

  commitment" was a hopeful sign. It will come not a moment too     

  soon, as the number of organ transplants in China has soared over 

  the last decade. China is now second only to the US, with         

  approximately 60,000 kidney transplants, 6,000 liver transplants  

  and 250 heart transplants since 1993.                             


  But because Chinese medical scholars seldom publish about those   

  transplants in internationally-recognized peer-review             

  publications, the international community generally does not      

  recognize China's role in organ transplants despite the growing   

  demand here. That is primarily because researchers cannot identify

  the source of the organs used in transplant procedures, because   

  the practice of using executed prisoners' organs is ethically     

  questionable. But Huang argued that the Chinese protocol does in  

  fact meet international standards of medical ethics, and that no  

  organs are harvested without consent from either the condemned     

  prisoners themselves or from their families.                      


  Noel expressed concern about the issue as a whole, and said that  

  use of prisoners' organs must comply with strict regulations if it

  is to occur at all. Huang concurred, and said that the government 

  has promised to consider initiatives that would encourage more    

  donations from living donors. But making good on that promise will

  prove a significant challenge, as only five percent of the current

  supply of human organs come from living donors.                   


  China has tried to draft legislation to regulate organ transplants

  for many years, but the involvement of many local and regional    

  interest groups complicates the process. The only existing        

  regulation for transplanting organs from prisoners' cadavers is a 

  draft government document from 1984. It stipulates that such      

  organs can be used only if families consent to donate a prisoner's

  organs, or if a cadaver goes unclaimed. But in several cases,     

  local courts have sold organs from prisoners' cadavers without    

  informing their families. Legal experts argue that the process is 

  in dire need of more transparency and third-party oversight.      



  Academic experts remain divided over the merits of using such     

  organs in transplants. Some believe that refusing on principle to 

  use those organs would be a waste of scarce resources; others     

  argue that the organs should be used, but only under strict       

  regulation. Most agree on the need to eliminate that possibility 

  of judges ordering prisoners executed simply in order to harvest  

  their organs.                                                     


  Good regulation would deal not only with the issue of prisoners'  

  organs, but would also define explicitly the circumstances in     

  which all human organs may be harvested and used, Huang said. That

  regulation would go a long way toward eliminating the controversy 

  that surrounds the issue, for example, by preventing unqualified  

  hospitals from conducting operations that might endanger their    

  patients. It will also give condemned prisoners a transparent     

  process by which to donate their organs, should they so choose.   


  Some people in the organ transplant field claim that cash-strapped

  domestic hospitals are quick to rush into transplant operations to

  cash in on rising demand, despite inadequate facilities,          

  equipment, and specific expertise. About half of these operations 

  produce unsatisfactory results, according to Shen Zhongyang,      

  director of the Tianjin Oriental Organ Transplant Center, in no   

  small part because of those sub-par procedures. Official          

  statistics show that in China, the one-year survival rate for a   

  liver transplant is about fifty percent; in the US, it is         

  eighty-one percent.                                               


  Good regulation would address the issue of how to set fees for    

  transplants. Because the industry currently lacks guidelines for  

  fees for each procedure, charges can vary greatly from one        

  hospital to another. It would also create a national donor and    

  recipient registration system to coordinate collection and        

  distribution of organs throughout the country, a mechanism China  

  currently lacks. Without such a system, China cannot allocate its 

  organs efficiently, and some hospitals watch organs go to waste    

  while others wait desperately for donors. That disconnect creates 

  the perfect environment for cross-border trafficking in human     

  organs, which Noel warns occurs frequently under the radar in     

  China and often goes unpunished.                                   


  The Ministry of Health is considering establishing a national     

  committee to manage human organ transplants. It would be led by   

  the Ministry, and composed of organ transplant experts, ethicists,

  and local supervisors.                                            


  English version by Xin Zhiming and Lauren