Study: China Conducting ‘Execution by Heart Removal’ for Lucrative Organ Trade

Suspects sit as Chinese police officials stand guard before boarding a plane at the Phnom
STR/AFP via Getty Images

Researchers at the Australian National University (ANU) published a study on Tuesday concluding that years of Chinese government data indicate government surgeons have killed prison inmates by tearing out their organs for transplants.

The ANU study pored through years of descriptive documents on the executions of death row inmates and found inconsistencies that indicated the inmates were not brain dead when surgeons tore out their vital organs, to be used in transplant surgeries. The researchers concluded that, in many of the cases they identified in Chinese government reports, tearing out organs was the “proximate cause” of death for the inmates.

“Might the transplant surgeon become the de facto executioner? Evidence suggestive of such behavior has emerged over many years from the People’s Republic of China (PRC),” the report stated.

The researchers concluded that China had likely breached a medical ethics standard known as the “dead donor rule,” which asserts that doctors should not kill people to transplant their organs into another person. The report follows years of mounting evidence – organized similarly by medical researchers, human rights activists, journalists, and attorneys – suggesting that China has systematically killed political dissidents and members of religious and spiritual communities it disapproves of to sell their organs to wealthy buyers.

Members of the Falun Gong spiritual community, Uyghur ethnic group, dissident Christians, and Tibetan Buddhists are among the groups prior reports identified as being at particularly high risk for illicit government organ harvesting. A Uyghur surgeon, Enver Tohti, has repeatedly testified publicly to being forced to harvest the organs of a live political prisoner in the immediate aftermath of his execution, while he had reason to believe the prisoner was still alive, in 1995.

The ANU report found 71 reports from the Chinese government with documented evidence of “problematic declarations of brain death,” predicting that the number of such incidents – where prisoners were likely alive and the removal of their organs killed them – occurred.

“The data we rely on in this paper involves transplant surgeries from 1980 to 2015. During this period, there was no voluntary donation system and very few voluntary donors,” the researchers write. “According to three official sources … the number of voluntary (i.e., non-prisoner) organ donors in China cumulatively as of 2009 was either 120 or 130, representing only about 0.3% of the 120,000 organs officially reported to be transplanted during the same period (on the assumption that each voluntary donor gave three organs).”

“The leader of China’s transplant sector wrote in 2007 that effectively 95% of all organ transplants were from prisoners,” the researchers observed. In the dozens of examples of “problematic” removal of organs, the study found that, “given that the donors could not have been brain dead before organ procurement, the declaration of brain death could not have been medically sound.”

“It follows that in these cases death must have been caused by the surgeons procuring the organ,” the researchers declared. “If the reports we examine are accurate, they indicate that heart and lung procurement by the surgeon was the proximate cause of the prisoner’s death, thus directly implicating the surgeon in the execution.”

The ANU report also quotes a senior Chinese transplant doctor, Huang Jiefu, specifically thanking the penal system publically for donating so many organs, suggesting that these abuses occurred against prisoners. As China is a communist, totalitarian government, it regularly imprisons individuals for “crimes” like “picking quarrels and provoking trouble,” typically used when someone is perceived to express disagreement with the government, and “illegal” religious beliefs.

“We are deeply grateful to the many cadres in the judicial system, because without their cooperation, without organs donated from death row prisoners, China’s transplantation system would not be as technologically advanced and mature as it is today,” Huang reportedly said.

Matthew Robertson, one of the co-authors of the study, said in comments following its publication that the researchers believe the reason for these executions is that organ harvesting surgeries are “highly profitable for the doctors and hospitals that engage in them.”

“We found that the physicians became the executioners on behalf of the state, and that the method of execution was heart removal,” Robertson said.

The ANU study’s findings are in line with Enver Tohti’s testimonies, which have proven to be one-of-a-kind and describe events Tohti claims are within the timeframe that the report studied. In 2019, Tohti told the China Tribunal – an independent organization created to research evidence of international law crimes by the Communist Party – that he was personally rushed into extracting the organs from a still-alive death row patient in East Turkistan, where the majority of the world’s ethnic Uyghur people live, in 1995.

“There were many corpses, 10? 20? Do not know how many, looking through the windscreen and the driver side window, I was seating next to him, 5 or 6 corpses were visible to me to the left, on the slop[e] of the hill. Shaved heads with prison uniform, the foreheads were blown up,” Tohti recalled at the time. “A police officer shouted at us: to the right, far right, the last one is yours. Confused, why is ours? Not [sic] time for that, moved to the location, our surgeons hold me and told me: hurry up, extract the liver and two kidneys.”

“The man seems already dead anyway, so I started my insertion, the cut designed as upside-down ‘T’ shape, to expose internal organs as wide and possible,” Tohti continued. “My scalpel finds its way cutting his skin, blood could be seen, it implies that his heart was still pumping blood, he was alive! My chief surgeon whispered to me: hurry up!”

The China Tribunal published a report following its investigation accusing the Chinese state of committing crimes against humanity by systematically killing people for their organs, particularly Falun Gong practitioners, Uyghurs, and “some Tibetan Buddhists and House Church Christians.”

In addition to Tohti’s evidence, the Tribunal noted a fact also present in the ANU report: “there is a mismatch between the number of donors who become ‘eligible’ each year by dying and the number of actual transplants performed each year. There are more transplants than could possibly come from the number of registered or ‘eligible’ donors.”

China’s Global Times newspaper celebrated in June 2021 that it had 100 times more “volunteer” organ donors that year than in 2015, the last year the ANU study noted it could find available government data.

“More than 1.77 million people have been registered as an organ donation volunteer as of Friday at China Organ Transportation Development Foundation (COTDF), an institute supported by China’s National Health Commission,” the state newspaper reported. “The number shows an increase of about 46.5 percent compared with the number at the end of 2019, despite the impact of the epidemic, according to a report released by COTDF at a Friday conference held in Yan’an, Northwest China’s Shaanxi Province.”

“It is also 100 times higher than at the beginning of 2015, when citizens’ voluntary organ donation after death officially became the only legal channel for organ transplantation in China,” the Global Times concluded.

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