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Testimony of Harry Wu, Executive Director of the Laogai Research Foundation, before the Subcommittee of International Operations and Human Rights of the Committee on International Relations in the Unites States House of Representatives
Madam Chairwoman, members of the committee, it is an honor to appear before you in this hearing to discuss this important topic. I would first like to thank the Chairwoman for calling this hearing, for it has been more than three years now since the House of Representatives has heard testimony on the topic of organ harvesting from the executed prisoners of the People's Republic of China and during this time evidence continues to mount concerning this practice and its brutality. Because this Committee and others in both the House and the Senate have held hearings on this subject in the past, you have all heard of the existence of the practice of organ harvesting in China before. Today, I wish that my testimony and the testimonies of the other witnesses on this panel will not only confirm to you the persistence of this practice, but also reveal the dreadfulness of this practice and ruthlessness of its perpetrators.
When I first heard about organ harvesting in China it was 1985 and I was preparing to depart China for the United States. Revelation of this practice brought a sense of dread to my soul. I had spent nineteen years in the Chinese Laogai camps, a place where the space between life and death is often paper thin. I knew that if I had died in the camps, my family would never be told of my fate. Besides, the communists had forced them to completely disown me so even if they knew of my execution they would never claim my body or even inquire about whether I was buried or cremated. Such was the cruel reality of prisoners of my era. My organs would have been harvested for transplantation into the body of someone else, and then the rest of me tossed into a furnace as waste to be disposed of quickly. No one would remember me as an "organ donor" - a term that connotes a caring person in the West, not a nameless, faceless prisoner as in China.
Now that I am an American citizen, I also have become a voluntary organ donor as evidenced by the red heart on my driver's license. That is my right, my dignity, the way I identify myself with my civilized community. My decision, like thousands of others in America, is voluntary.
From examination of Chinese government documents, we know that Chinese governmental involvement in the practice of organ harvesting began more than twenty years ago with the promulgation of the "Rules Concerning the Dissection of Corpses" in 1979 from China's Public Health Ministry. This document asserts the legality of using corpses and organs of executed prisoners in experimental research procedures. In the 1981 "Reply Concerning the Question of the Utilization of Corpses of Criminals Sentenced to Death" the Chinese Ministry of Justice made clear their approval of the practice. This document describes organ harvesting as "very necessary from the standpoint of medical treatment and scientific research." These earlier rulings were soon followed by China's first national directive on executed prisoners and organs for transplant. This document, the Provisional Regulations on the Use of Dead Bodies or Organs from Condemned Criminals, was signed in 1984 and has been discussed before this Committee and others in previous years. This document stipulates the conditions under which health personnel may harvest organs from executed prisoners, the procedures for coordination of prison and public security officials with transplant doctors, and the confidentiality of the process. Although it was promulgated at the national level, it is noteworthy that even this document is simply a directive. It is not law. It was never passed through the Chinese Peoples Congress. It provides a basis, establishes a practice and so the orders are carried out to the benefit of the Chinese Communist Party. Is this not what we have seen in other examples of Chinese legal process that violate the rights of its citizens?
But this document, as shocking and significant as it may be, is only a piece of paper and the Committee has seen it before. Today I wish to examine the practice that lies behind this piece of paper and to discuss the details of what has developed and what persists in China today as a gross violation of human rights, medical ethics and human dignity.
The entire system of organ harvesting in China would not be possible were it not for the Chinese government's policy involving capital punishment. Since Amnesty International began publication of records for worldwide executions in 1993, China has continuously held the distinction of conducting more executions every year than the rest of the world combined. This figure remains constant despite that fact that Amnesty's recorded executions are limited to those published in China's open source press materials. They represent only a fraction of the true number, which in China is considered a state secret.
One cannot mention China's system of execution without also noting the role of the Strike Hard campaign, another tool of China's Communist government that enforces control throughout the Chinese population. The Strike Hard Campaign is based upon regulations drawn up in 1983 that allow for rapid administration of justice and call for heavy sentences to crackdown on targets of the campaign. During China's last implementation of the Strike Hard Campaign in 1996, the execution rate soared to a record of 4,367. On April 11, 2001, Chairman Jiang Zemin initiated another Strike Hard Campaign and according to reports from Agence France Presse, more than 1,000 were executed within the first six weeks. According to certain reports in both Chinese and Western press, one specific target of this campaign was Uighur nationalists in the Xinjiang Autonomous Region.
In times of political tension, Strike Hard Campaigns offer the government a tool to manipulate the public and increase governmental control. Since its inception, the Chinese Communist Party has used public sentencing rallies and public executions to instill fear in the hearts of all its citizens, linking executions and violence as a tool to increase political power. Even outside of the Strike Hard Campaign, China's system of criminal justice stands in infamy for extracting confessions through torture and for blatant disregard of rights to due process.
Through this system, the Chinese government orchestrates large-scale execution and then continues to further dehumanize the victims of this policy through its system of organ harvesting. In China, the harvesting of organs from executed prisoners proceeds as an entirely government owned and controlled operation. It is completely different from black-market organ sales that are conducted between poverty stricken farmers and rich buyers in other developing nations. In China there is no chance that an individual donor may profit from selling his or her organ or even for a donor to offer consent for the use of their body in such procedures. In China such buying and selling between individuals is forbidden according to notices passed through the Ministry of Health in 1996. What is legal is encoded in the 1984 Provisional Regulations on the Use of Organs or Dead Bodies from Condemned Criminals. The Chinese government controls and operates a system to harvest organs from executed prisoners and ensures its secrecy.
It is additionally striking that no other established system of organ donation exists in China. There is no national public registry for people to voluntarily register their consent to donate their organs after their death. Only this year small-scale experiments commenced in Shanghai to open a city-wide registry. That's as far as it goes outside of the source of thousands of executed prisoners.
Government officials play integral roles in every step of the organ harvesting procedure from the sentencing of prisoners to death to the extraction and transplantation of their organs. This begins in the courtroom as judges and other court officials provide for speedy adjudication of cases and rapid turn over of appeals to the death sentence so as to ensure that a prisoner will be executed at the optimal time to harvest an organ for the waiting patient. Court officials also often inform doctors when they pass down death sentences, alerting them to contact the prison to make a match for transplant patients. The pattern continues as guards and other officials at detention centers allow doctors into the prison to administer tests to determine donors for their patients. They also set execution dates and ensure that the family will not be notified to prevent them from possibly disturbing the harvesting procedure. Finally, doctors at government owned hospitals carry out laboratory tests to match prisoners with patients prior to the execution. They also administer shots of anti-coagulents to prisoners on their way to the execution sites to provide for easier extraction of organs. Most horrifically, doctors are brought into intimate contact with the execution system as they perform organ extraction and transplantation often directly on the site and within seconds after the victim is shot.
As for the patients who receive transplants of organs extracted from the bodies of executed Chinese prisoners, one theme remains common - all recipients are among society's economic or political elite. As documented in several sources, in China an unwritten priority list states the following order for transplant recipients: 1) high ranking government officials or members of the military 2) wealthy overseas Chinese and other foreigners 3) members of the military and 4) the common citizen. Recent press reports from newspapers in the US, Hong Kong and the nations of South East Asia have printed stories describing the journeys of patients who travel from Thailand, Malaysia, Hong Kong and other nations to receive a kidney transplant paying prices that generally total to $30,000. This process generally begins in the patients' home country where brokers work as go-betweens to arrange for transportation and logistics. Once a patient arrives in China they will be immediately hospitalized and started on dialysis while awaiting the next execution. The hospital will receive notification from a prison official and will immediately begin administration of immuno-suppressant drugs to prepare the patient for the transplant operation.
Certain press reports have also included shocking estimates of the numbers of patients in each nation that travel to China every year in desperate search for a kidney. According to an Associated Press article in 1998, through 1997 at least 360 Taiwanese made the journey. During the same period, the Straits Times of Singapore states that at least forty-seven had come from Thailand. Later, another Straits Times article reported that at one military hospital in Chongqing, officials stated that of the 100 transplants performed at the hospital annually, most patients were from South East Asia. Finally, in one report from the International Herald Tribune, a Malaysian doctor estimates that approximately 1,000 Malaysians have received a kidney transplant in China.
Even as doctors perform the life-saving transplant operation, profit remains a primary motive. Former patients state that as they see doctors, they expect to hand out 'red envelopes' to every physician they see. Their money also works its way up the chain as doctors pay prison officials for access to prisoners in matching of donors to recipients, and then for access to the execution site where organs are harvested. Court officials also receive payment for their role in delivering prompt verdicts in death penalty cases and for informing the hospital at the proper time.
As the drive for profit holds highest priority, doctors demonstrate clear disregard for medical ethics. According to reports in the International Herald Tribune about Malaysian patients traveling to China in June of 2000, patients stated that one woman ran out of money shortly after she had received her transplant. She was still in recovery and required large amounts of immuno-suppressant medication to prevent rejection of her new kidney. When doctors found out she could not pay, they cut off her medication and the woman died. Reports in the South China Morning Post reveal stories of patients receiving liver transplants even though they are already into advanced stages of liver cancer. Not surprisingly two patients died soon after their transplant operations. Their disease was already too advanced for the procedure to offer a cure. In other nations these organs would go to healthier patients observing medical ethics of the principle of justice. In China, these patients were willing to pay for a transplant and that was all that mattered.
Returning to the document, the Provisional Regulations on the Use of Dead Bodies or Organs from Condemned Criminals, it is also important to note the stipulations of the document providing for and indeed requiring secrecy throughout the procedure of organ harvesting. The Chinese government states the following instructions for officials in harvesting the organs of executed prisoners:
"Use of dead bodies and organs from condemned criminals must be kept strictly confidential, ¡vehicles with the logo of medical institutions are not to be used and white clinic garments are not to be worn. The execution ground should be guarded against before the operation is completed. After the dead bodies are used, the crematorium shall assist the units in timely cremation."
Through this provision, the government opens wide the door for abuse and closes the door to oversight. Eye-witness accounts of organ harvesting attest to strict adherence to these regulations. In one case recorded by private investigator Cheng Weimin in May, 1999 in Xinyang City, Henan Province, the witness stated the following:
"Two of the corpses were loaded onto a white car, one onto an ambulance. The white car and the ambulance's license plates were covered and the windows tinted and the doors sealed."
Such provisions virtually give those involved in the organ harvesting process license to trample the rights of the prisoner. Officials from courts, prisons and hospitals are guaranteed there will be no independent oversight of their procedures; the law protects them with clauses providing for their secrecy. As for the prisoners and their families, they have no rights and no protections. Neither in this law nor in any other of the Chinese government are provisions included regarding punishment of officials who abuse the rights of prisoners and their families in the process of organ harvesting.
Some may protest that provisions regarding consent of prisoners and their families offer some degree of protection. I must state several objections to this argument. First of all, in the past two decades of history of this practice, never has any official of the Chinese government produced any piece of paper or other evidence to demonstrate confirmation of consent from a prisoner who willingly donated his or her organs. Additionally, according to several reputable organizations of medical ethicists, even if such evidence were produced it would be meaningless. China's death row, where prisoners are shackled to the ground twenty-four hours a day while they await execution hardly produces an environment conducive to informed and voluntary consent for organ donation. On the contrary, the environment produces a situation of duress where prisoners are easily manipulated and their rights ignored. The testimony of one Chinese doctor by the name of Yang Jun demonstrates the manipulation of prisoners in obtaining consent to harvest their organs. I quote from Dr. Yang's testimony as he describes the situation in a Chinese prison where a prisoner has been matched with a potential kidney transplant patient:
"In Hailin Prison we saw him lying naked on the cement floor of a solitary confinement cell with his face up, his limbs stretched out and his wrists, ankles, and neck locked by iron rings fixed to the floor. Prisoners appointed by the prison police fed him one meal a day. After the prisoner told the administration that he was willing to donate his organs and he had signed his consent, the ground shackle was unlocked and he gained relative freedom with only handcuffs and leg irons. Nourishment was improved to enhance his physical condition and to ensure top performance of his organs".
The World Medical Association, an organization where both China and America hold membership, states the following regarding free and voluntary consent relevant to procedures of organ harvesting in China:
1. No physician may therefore assume responsibility in organ transplantation unless the rights of the donor and the recipient are fully protected
2. The fullest possible discussion of the proposed procedure with the donor and the recipient is mandatory. Free and informed consent must always be obtained
3. The purchase and sale of human organs for transplantation is condemned
So now we stand with a question before us, a question that has been presented at other hearings on this topic in previous years: What can the United States government do about this egregious violation of human rights that occurs in China? Despite the fact that the Chinese government carries out this procedure fully within its own system of governance, I believe there are several options of response that are available and are certainly warranted in the US.
There is a measure that stands before this committee today that I believe is highly relevant to the US stance on the practice of organ harvesting in China. Today at Harvard University there is a Conference underway entitled Health Care East and West.At least two of the Chinese doctors attending this conference are renowned in Chinese organ transplant journals as experts of organ transplantation. The first of these is Dr. Huang Jiefu, a liver transplant specialist at Sun Yatsen University First Affiliated Hospital in Guangzhou. This same hospital was highlighted in a series of articles in the South China Morning Post in March, 2000 for their sale of liver transplants using organs from executed prisoners for patients from Hong Kong. The other doctor, Dr. Wu Jieping, a leading kidney specialist, is published in several articles of the China's most renowned journal on organ transplantation. So now, the very same doctors that participate in human rights violations in China are participating in medical conferences in the United States to enlighten our doctors on their medical practices and also to benefit from our advances in medical care. When I discussed this with the honorable chairwoman of this Subcommittee, she proposed the resolution H.R. 2030 to prohibit issuance of a visa or admission to the United States of any physician who is a citizen of the People's Republic of China and who seeks to enter for the purpose of training in organ or bodily tissue transplantation. Many of you have already offered your support for this measure. I hope this resolution will pass through this body and through the United States Senate to confirm legislation that prevents US institutions from knowingly or unknowingly supporting Chinese doctors who participate in this egregious practice.
As I recount this horrible practice to you, I cannot help but recall my visit to Auschwitz. Suppose I had been a physician in 1943 or 1944 who loathed the Nazi policy of exterminating the Jews and other inferior races. However, I was a medical researcher specializing in the rescue of sailors from icy water. I have used animals in my research, but here are thousands upon thousands of people being herded into the gas chambers every day. I think, why not use them for experiments, they are going to die anyway. With the consent of camp officials I solicit volunteers for my experiments by saying: You won't necessarily escape death, but at least you won't be gassed right away, and there is the possibility you will survive. I am certain I would find volunteers.
When the Nazi regime was defeated, all twenty-three physicians put on trial at Nuremberg defended themselves with the argument that all prisoners joined their experiments voluntarily, and they were conducting experiments to benefit human beings.
These arguments fell on deaf ears and the physicians were convicted. The judges stated clearly that prisoners, deprived of their freedom and threatened by fear and violence cannot make a "voluntary" decision.
The use of executed prisoners' organ is obviously not the same as Nazi experiments on live human beings, but the inclination of physicians to rationalize the good that comes from an evil they cannot affect is similar. Many of the physicians I have spoken with quickly seize on the fact that the condemned prisoner has 'voluntarily consented' to donate their organs. Even if it were true, it is a sham. In my view, the physicians are violating basic medical ethics. They are directly involved in violating a person's basic human rights. They are witting participants in a unique atrocity. They must be denounced.
Perhaps even more importantly, the US government must recognize the existence of this practice and state its firm opposition to its continuation. Currently, in the State Department's yearly Human Rights Report on China, the following is included regarding the practice of organ harvesting:
"In recent years credible reports have alleged that organs from some executed prisoners were removed, sold and transplanted. Officials have confirmed that executed prisoners were among the sources of organs for transplant but maintain that consent is required from prisoners or their relatives before organs are removed. There is no national law governing organ donations, but a Ministy of Health directive explicitly states that buying and selling human organs and tissues is not allowed. In February 1998, two Chinese nationals were charged in a foreign court with attempting to sell human organs allegedly taken from the bodies of executed prisoner; the charges were dropped in November. At least one Western country has asked repeatedly for information on government investigations of alleged organ trafficking, but to date no information has been released. There have been credible reports in the past that patients from abroad had undergone organ transplant operations on the mainland, using organs removed from criminals".
What would it take for the State Department to simply recognize that the organs are harvested from executed prisoners in China, to say that the practice exists as opposed to saying that credible reports allege it exists? In their report the State Department has mentioned one Western country that has sought information from government investigations. Has the Chinese government ever released any investigation offering information on human rights abuses against its people? Would we ever expect the Chinese government to release information on a practice that according to their own law is explicitly classified as a state secret?
Three years ago I stood before this committee with a bibliography listing ninety-five items mentioning the practice of organ harvesting in some capacity. Today, I stand before you again with a comprehensive report on organ harvesting from the executed prisoners of China. This report includes information from ninety-four sources, less than twenty of which were included in my bibliography of sources presented in 1998. How many more newspapers must print stories on foreigners traveling to China to receive transplants of organs harvested from executed prisoners? How many more Chinese transplant doctors must I interview and bring before you to testify of their experiences? How many more patients from Thailand, Malaysia, Japan or Hong Kong must tell their stories of receiving transplants in China and knowing that they were receiving organs from an executed prisoner?
I present this report to the Committee and to all present at this hearing today and submit it to the public record as one hundred and thirty pages of evidence to confirm the practice of organ harvesting among executed prisoners in China. This report is not scattered allegations, this report along with all others that have come before it represent more than 'credible evidence'. They represent confirmation that organs are harvested from executed prisoners in the People's Republic of China, that the government does condone and indeed participate in this practice and that it persists as a profit generating internationally marketed enterprise. In 1995, after the first hearing on this topic in the US Senate, Secretary of State Warren Christopher stated that if such allegations of organ harvesting are true, that it would comprise one of the grossest of human rights violations. These words were repeated before this committee by Assistant Secretary John Shattuck at the hearing in June of 1998. This report represents the truth, and that is what should be said in the human rights report from the US State Department.
Ultimately, the Chinese government has created a system to make it possible for officials to harvest organs from any prisoner that they so desire. The entire process from execution to transplantation is regarded as state secrets. Families are often not notified of the date of the execution until after it is already carried out, making it impossible for them to offer consent for the harvesting of organs. Prisoners are manipulated and victimized to the point that any consent they could offer is rendered meaningless. If there is a paying patient, once a prisoner is found to supply an organ, the organ will be obtained. In the end, once doctors determine that a prisoner's organs are fit for transplant into a waiting patient, the prisoner becomes nothing more than a walking incubator holding a kidney that is destined for someone else, a tool to generate profit for the Chinese prison system, Chinese military and civilian hospitals, and the Chinese Communist government.
The Chinese regime executes more prisoners every year than the rest of the world combined. This produces a huge number of organs to harvest. It is unprecedented that a government has profited from this harvesting on the scale that is evident in China and for as long as this practice has ensued.
Now as I close my testimony, I urge you to ask yourselves, Can we remain silent any longer about such atrocities that reject human dignity and morality and tarnish civilization?
I thank the honorable Chairwoman and the Committee for their time and will be happy to answer any questions.
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