Spare the bullet
Officials try to curb the use of organs from executed prisoners
TRANSPLANT operations in China have long relied on organs taken from executed prisoners, a practice that has led to such abuses as the timing of executions to meet organ demand, with no notification of relatives. As by far the world's biggest user of the death penalty, China could count on an abundant—if still far from adequate—supply. But in recent years, stung by international criticism, it has been trying both to reduce executions and to end the harvesting of organs from executed prisoners without their, or their families', consent. Since January 1st the government has insisted that no such organs be used for transplants. Ensuring compliance, however, will be difficult.
The number of executions is almost certainly falling, even if it remains far higher than in the rest of the world. The government does not release data, but the Dui Hua Foundation, an American NGO, reckons there were around 2,400 executions in 2013, down from 6,500 in 2007. In spite of the impact this has had on organ supply, the government still seems keen to sever the grim link between hospitals and courts that allows wealthy (or well-connected) patients to use organs from condemned prisoners. In theory, the rules mean that hospitals will be able to obtain only organs donated by volunteers to a national organ-bank.
The bank was set up in 2010, partly to fight corruption in the organ-allocation system by making it less haphazard. It was slow to get going: by the end of 2014 it had received only about 8,000 organs from deceased volunteer-donors (it is not clear if this includes organs from executed prisoners; there is little incentive for court officials to force death-row inmates to give assent if the organs are given to a bank rather than to somebody willing to pay). But in January and February alone nearly 1,000 were donated, thanks to the linking of more provinces to the bank's network. The head of the government's organ-donation committee, Huang Jiefu, believes the bank will receive more than 10,000 organs this year. That is about as many as the number of transplants carried out annually, but a fraction of the 300,000 needed.
Persuading the public to donate remains a problem. Many Chinese adhere to a traditional belief that the body has to be kept intact to show respect for ancestors. A senior official at a provincial branch of the Red Cross Society of China, the agency responsible for the donor scheme, says that a lucrative backdoor trade in executed prisoners' organs will be hard to stop. He says hospitals, middlemen and court officials all benefit from it. They have often ignored a regulation passed in 2007 that requires consent from a deceased donor's family.
The government now appears to be suggesting it will get serious about a rule issued in 2013 which threatens hospitals with cancellation of their licences if they use organs other than those from the bank. One doctor says a small number of transplants performed at his hospital last year still involved prisoners' organs from outside the network. Mr Huang of the organ-donation committee admits that much work remains to be done.
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