Americans are using Chinese prisoners as spare parts
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March 13 2003 | By Hamish McDonald, Beijing
China is equipping its courts with mobile execution vans as it shifts away from the communist system's traditional bullet in the head, towards a more "civilized" use of lethal injection.
Intermediate Courts of the southern province of Yunnan were issued with 18 new execution vans on February 28 and a court official said some have already been used.
"We cannot tell you how many executions so far, otherwise you could work out from the daily rate how many we carry out," the official said.
Chinese authorities keep execution numbers a secret, but Western human rights monitors believe it is about 15,000 a year, more than the rest of the world's judicial executions combined.
The death penalty can apply for serious crimes against the person, armed robbery, drug trafficking, major cases of corruption and political violence.
Many public executions have been held in football stadiums so traditional execution methods are no secret. The condemned criminal is taken by open truck to the execution ground and made to kneel with hands cuffed and head bowed, before being shot in the head. Families who want to reclaim the body are charged for the bullet.
China's legal system allows only one appeal and lawyers say that less than 20 per cent of defendants have professional legal representation. When appeals against the death penalty are rejected, the sentence is carried out immediately, sometimes within hours.
In Yunnan, as well as in the cities of Harbin and Shanghai, death on the road has replaced death row. The execution vans are converted 24-seater buses. The windowless execution chamber at the back contains a metal bed on which the prisoner is strapped down. A police officer presses a button and an automatic syringe plunges a lethal drug into the prisoner's vein. The execution can be watched on a video monitor next to the driver's seat and be recorded if required. Court officials say the lethal drug was devised by researchers at the Chinese Academy of Medical Sciences to meet two criteria: that it causes no sharp pain or emotional upset for the prisoner and that it works within 30 to 60 seconds.
Although the vans cost about 500,000 yuan ($A100,000) each, officials say the method is cheaper and requires less manpower than traditional executions, because land for traditional execution grounds is not cheap. But the main impetus was a law passed in 1995, making lethal injection an alternative to the bullet.
Yunnan officials say most prisoners and their families prefer the injection.
"When they know they can't be pardoned, they accept this method calmly, and have less fear," one official told the Chinese Life Weekly.
Americans are using Chinese prisoners as spare parts!
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by Erik Baard and Rebeccah Cooney
Three years ago, Dr. Thomas Diflo's moral nightmare walked into his examination room: a patient freshly implanted with a kidney bought from China's death row, where prisoners are killed sometimes for minor offenses and their organs harvested.
Since then, Dr. Diflo, director of the renal transplant program at the New York University Medical Center, has seen half a dozen such people, typically young Chinese American women. The surgeon says his patients weren't distressed about snatching organs from the condemned, but he was overwhelmed by the implications.
Unable to shoulder the burden alone, on January 11, Diflo took his "horror at a real ethical quagmire" to the medical center's Ethics Committee.
Diflo is the first American doctor to talk publicly about this experience. The gruesome practice has been documented among ethnic Chinese communities throughout Asia, but so far every attempt to prove that people were leaving U.S. soil to buy organs from China's massive death row has failed.
"To tell you the truth, the original rationale for bringing this situation to the Ethics Committee was my own discomfort in taking care of these patients. I was outraged at the way in which they obtained their organs, and I had a great deal of difficulty separating that fact from the care of the patient," Diflo told New York City's Village Voice.
"Several patients were very up-front and candid about it, that they bought an organ taken from an executed convict for about $10,000," Diflo recalls. "Most of the patients are ecstatic to be off of dialysis, and none has seemed particularly perturbed regarding the source of the organs."
There's no telling how many kidney buyers returning to the U.S. have gone for follow-up care at a less elite institution or stayed within secretive medical channels recommended by their brokers. Diflo gets his patients on referral from recognized hospitals. "Patients sort of arrive on their doorstep and they don't know what to do. Not everybody who's had a transplant is cared for by a transplant specialist. I tend to see the more complicated ones," Diflo says.
Of all medical disciplines, organ transplantation is perhaps the most bittersweet. Transplants are gifts that coax life from death, that close the door for one person while opening the future for another. But the outright sale of organs is abhorrent to nearly all surgeons in the field. Selling organs is a felony under a 1984 federal law that was spearheaded by then senator Al Gore, and is punishable by up to five years in prison and a fine of up to $50,000. Live or executed prisoners in the U.S. are forbidden to donate an organ, even for free, except to family members under special circumstances.
In China, human rights groups say citizens have been executed for nonviolent offenses like taking bribes, credit card theft, small-scale tax evasion, and stealing truckloads of vegetables. Political dissidents have also been sentenced to death. Chinese embassy officials did not respond to requests for comment, but in the past the government has denied promoting the for-profit organ trade.
Diflo says he and his colleagues wrestled with the issue in a debate that was "quite lively and revealing, but the bottom line was that we take care of patients who come to us, regardless of their situation moral, ethical, financial, or social. Although I might find what they had done reprehensible, I was still nonetheless obligated to care for them in the best way that I knew how, and that is what I do."
But Diflo refuses to let it end at that. "Because it is not really appropriate for me to take my outrage out on the patients who come to me, I began to think that I would be better off addressing the root problem, the pilfering of organs from prisoners in China. That is what pushed me to pursue this further," he says. And so he's going public.
America-based human rights activists have sought this break for years.
The trafficking of human organs from Chinese executions to American residents is "something we've always known was going on but something we've never been able to document," says an American investigator working for the Laogai Research Foundation, a group founded by renowned human rights crusader Harry Wu and named for the gulags of China.
The Federal Bureau of Investigation partnered with Wu in 1998 in a sting operation aimed at netting two suspected organ brokers who resided in Queens. Wu posed as a board member of a renal clinic in Aruba and got the men, Wang Cheng Yong and Fu Xingqi, to not only arrange for patients to fly to China for kidneys but to also smuggle corneas, which can keep for weeks when frozen, for sale abroad. The case was dismissed when a key witness fled the U.S. and refused to return to testify. The Laogai Research Foundation also discovered a doctor advertising himself as an organ broker in a Chinese-language newspaper published in the U.S. but no physical evidence was ever uncovered. In 1998, the FBI raided the Los Angeles offices of a man the feds said had presented himself as an organ broker, but it's unclear whether the scheme led to any transplants.
When told that an American doctor was revealing his experiences, the laogai investigator, who asked that she not be identified because it would make her work in China impossible, pointed out that the opening comes at a critical time. Executions in China have surged to 400 in April alone as the Communist government conducts another of its periodic "strike hard" crackdowns on crime. During the most recent campaign, in 1996, more than 4,000 prisoners were killed, she said.
Even in a normal year China executes more inmates than in all other nations combined, reports Amnesty International. In 1999, the confirmed toll reached 1,263, according to the organization, which gathers its statistics from tallies published, for propaganda purposes, in government-run newspapers.
"It's for scaring criminals and scaring controlling society," the investigator says. The approach is known as "killing the chicken to scare the monkey."
Executions often come in floods, usually around the holidays, according to the investigator. This month, with Labor Day celebrations that started May 1, is viewed by Chinese doctors as a particularly good time to get an organ, but there's no better time than the Lunar New Year, she added. Most perhaps 70 percent of the hospitals performing the procedures are run by the military, which has the best connections to the penal system and can be present at executions, she explains. Money from patients purchasing organs is dispersed among those who provide access to the prisoner's body. Hospitals even pay judges to tip them off when they sentence a suitable donor to death. "The money goes to officials all of the way up the line," she says. "It goes to the courts, the people in charge of the prisons. It goes to the doctors, the hospitals, everything."
The Laogai Research Foundation reports that sometimes tens of operations are done at the same hospital on the same day for patients who are essentially walk-ins. China says it has performed about 25,000 transplants in 20 years, but makes no distinction between organs culled from executions and those garnered through accidents and live donors.
Forced labor from China's laogai has always been a source of cash for the country's rapidly advancing economy. And punishment doesn't necessarily end at the point of death, usually a single shot to the back of the head. Families are often forced to pay for the bullet used. But the laogai turned into Execution, Inc. less than 20 years ago after the introduction of Cyclosporine, an immunosuppressant drug that prevents rejection of organs by the recipient's body.
Wei Jingsheng, an agitator at Columbia University's Human Rights Center, testified before the International Relations Committee and Government Reform & Oversight Committee of the U.S. House of Representatives on June 4, 1998, that while he was on death row a guard confided that often organ removal is the means of execution in and of itself. Wei, who now heads his own foundation in Washington, D.C., stated that the guard told him, "There are almost no exceptions. They first are given anesthesia. Just the same as killing a pig. We use cloth to wrap them up and bring them to the execution ground. No one cares if they are alive or dead."
Further, Wei said he had confirmed, through a plan hatched with a 20-year-old cellmate, that executed prisoners were being harvested against their will. The young man, whom he called Zhang, was to cry out, "I'm not sick, I don't need a doctor," if he saw a medical team equipped to harvest his organs waiting at his execution. If there was no evidence of this, Zhang was to scream as the condemned normally would.
After a long stretch of silence, Zhang sent the message. "My first feeling was of satisfaction, knowing that this evidence finally proved this practice. But this feeling was quickly replaced by another," Wei told the congressional committees. "My second feeling was of heaviness, knowing that this young man used his life to record an unbelievable crime. If I did not have the opportunity to tell others of this evil, if I did not have the opportunity to try and stop this evil from continuing, then I would have to apologize to this young man. All this time, I have deeply felt this responsibility. We must stop this practice."
Harry Wu spent 19 years in the laogai, and has also testified before Congress. His Laogai Research Foundation claims that when bullets are used, the target reflects the market: a shot to the head when a liver's wanted, a shot to the chest when corneas are in demand. Amnesty International also reports that a form of lethal injection gaining acceptance in China can be used to kill without damaging crucial organs, and can blur the line between life and death.
Young, nonsmoking prisoners are given blood tests and medical exams to assess compatibility with arriving patients, the investigator explains, and courts set execution dates accordingly.
Long before the U.S. and China clashed in the spy plane incident, the West was wary of the emerging superpower. Wei and Wu have edged the organ trade into the human rights spotlight on China, an arena already crowded with accusations of prison and child labor, coerced abortions, and suppression of religious minorities and Tibetan national aspirations. The nation's trade surplus with America, chilling of freedoms in Hong Kong, and occasional saber rattling at Taiwan have done little to soften sentiments in Washington. Business interests striving to engage China as a strategic ally, rather than competitor through most-favored-nation trade status, membership in the World Trade Organization, and support for its bid to host the Olympics may have a tougher row to hoe now that Diflo is delivering the goods on an explosive Chinese crime that touches on American soil.
Suddenly, what had existed largely as a kind of urban legend, a science-fiction horror story from a distant world, has become very, very real, right here on the streets of New York. Activists say that if it's happening here, it's likely happening in other large cities of North America, from Boston and San Francisco to Vancouver and Los Angeles.
The Chinese government published regulations in 1990‹"On the Use of Dead Bodies or Organs From Condemned Criminals" stating that for a prisoner to be a donor, prior consent must be given by that person or remaining family, unless the body is unclaimed. Human rights activists scoff at that statement, noting that since prisoners are often kept from communicating with family members, there is no one to claim the body, which is harvested and cremated almost immediately. The government also requires that medical teams involved in the procurement of organs act stealthily: "Surgical vans must not display hospital logos; surgeons must not wear hospital uniforms when at the execution site; guards must be present until the organ is removed; and the corpses should be promptly cremated following the removal of the organs."
Human rights groups seeking to determine the source of organs might try matching the dates of operations to dates of executions in the same city, but the method isn't reliable, especially since the government has taken to selectively publicizing its tallies. The Laogai Research Foundation says doctors speaking for the Chinese government claim regulations against contacting the family of a donor prevent them from revealing to patients where the organs come from.
The harvesting enrages physicians like Dr. Diflo. "I think it's a gross violation of human rights and very much at odds with what the transplant community tries to promulgate as the way to go about things. This does not involve appropriate consent. I don't think prisoners are given the option of donating or not donating. It's not done from an altruistic point of view," Diflo says. Even putting aside his reservations about the death penalty, Diflo says, "The central issue is the nonconsensual taking of organs and making human body parts a commodity."
The Laogai investigator agrees. "It's very obviously profit-motivated because if the person can pay extra then they might be able to move up an execution date, or have it arranged for later," she says. "And those who pay more get better treatment." She cites a case where a Chinese patient from Malaysia was allowed to die without anti-rejection medications when his money ran out.
The economics of human organ trafficking are powerful. Patients can live active lives on dialysis thanks to this technology, most don't need a kidney to survive but the inconvenience and discomfort are considerable. Diflo says his patients were "obviously much more troubled by being on dialysis than by getting organs this way."
For patients, the cost of a transplant is far cheaper than a lifetime of dialysis, says Dr. André-Jacques Neusy, head of the dialysis unit at Bellevue and director of the NYU School of Medicine Center for Global Health. Both Bellevue and NYU Medical Center work with Gouverneur hospital in Chinatown.
Bellevue is a public hospital, so it takes all comers. Many of the city's sick immigrants end up here. "We call it the 'Bellevue Express,' because patients head there directly from the airport," remarks Neusy. In addition to being the designated facility for the President and visiting dignitaries, the hospital offers extensive translation services.
Affiliated with the NYU Medical Center, Bellevue is Dr. Diflo's chief source of referral patients who have Chinese prisoners' organs. People who receive a transplant must remain under a doctor's care for an extended period. Thus, patients who buy a kidney from China's death row end up seeking treatment in American hospitals, where the cost can be supported by public funding. Diflo says his patients pay for their anti-rejection drugs with Medicaid and Medicare.
Though no patient would be denied treatment at Bellevue when arriving with an organ of mysterious origin, candidates for domestic transplants must be legal American residents. Even for those eligible candidates the wait for an organ can be extraordinary. There are now more than 75,000 people on waiting lists for organs in the U.S., according to the United Network for Organ Sharing, which maintains the national Organ Procurement and Transplantation Network under contract with the U.S. Department of Health and Human Services.
Fewer than a third of those people are likely to get their organs this year, the group said in March. Immigrants, both legal and illegal, will sometimes visit home rather than relocate, naturalize, or wait, Neusy says. "We've had patients disappear from the dialysis unit and reappear with a kidney," he notes. He was unaware of any who'd gone specifically for kidneys from executed prisoners in China. "It's disturbing to think we have professional colleagues on the other side that would condone this kind of thing," he says.
Dr. Nathan Thompson, also of Bellevue, concurs. "We have had patients who have gone against our advice and come back with transplants. Where they've gotten them I have no idea," Thompson says.
Another Bellevue physician, Dr. Gerald Villanueva, sent Diflo a Chinese American woman who had appeared at the hospital, implanted with a death row kidney. Suffering from hepatitis, the patient became one of the complicated cases referred to NYU. Only after talking to Diflo did Villanueva realize the source of her transplant. "I guess we've all heard about things like this, but it kind of gets you when, for the first time, you see it," he says. "There are things we read about, but when you see it, it's still surprising. I guess it shouldn't be, huh?"
Diflo says that doctors seeing scores of patients daily simply don't have time to probe more deeply into their patients' histories, especially when language is a barrier. And they're not paid to argue with their charges. "I don't really see that confronting them about the ethics involved will really serve any useful function. In addition, we see them during our office hours, in which we can see as many as 50 patients in three hours not really time for prolonged ethical discussions," he says.
Most doctors interviewed for this article agreed that the majority of those organs aren't coming from China. There's a thriving black market in organs sold by live, willing donors in poorer nations with medical know-how, like India. "I believe that both are morally and ethically reprehensible," Diflo says. "If there are degrees of reprehensibility, however, China wins hands down" because the organs are coming from the executed, who are deprived the right of refusal, for profits. Unlike with desperately poor live donors, that's cash that neither the victims nor their survivors will ever see.
Nearly every country touched by the organ trade has laws barring the business; India and Japan are among those who've enacted them only in the past decade as the tide of the organ trade rose. In the United States, the practice of flying to China for organs becomes a crime if arrangements were made for a fee on American soil. But as with the war on drugs, many experts argue that the only real solution to fighting the organ trade is by addressing the demand. People need organs quickly, through humane means. Doctors interviewed floated several ideas.
The most ready cure is for more people to make provisions that their organs be donated at the time of death. Belgium achieves this by presuming organ donation, requiring that people opt out. The doctors noted that while organ donor cards (like those on drivers' licenses) might help tip the balance in discussions with family, the form isn't a binding agreement. Families can still have the final say. And even with that acceptance, families parents must be willing to say goodbye at times when they might falsely believe there's a shred of hope.
"Brain death is a hard concept to get across. Japan only recently accepted it as a legal definition," explains Dr. Dale Distant of the SUNY Downstate Medical Center. "How does a person take this action when their loved one is warm, his heart's going, a machine is making his lungs go up and down; when for all the world he's just in a coma?" In many corners of the world, including part of Asia, people hold strong, entrenched taboos against violating the body after death.
Dr. Neusy would like to create centers in less medically advanced nations where the needy might be screened and matched with potential donors, usually family members, and then prepared before finally being brought together to the U.S. and other rich nations for the operation. Others promote the free market as a way to meet the demand for organs. One group of supply-siders operates a website and on August 26, 1999, a kidney from a live potential donor was offered up on eBay before site managers closed the bidding down.
On the furthest fringe, some scientists are hoping to master techniques that might allow newborns in future generations to be equipped with a genetic repair kit‹stem cells or other tissue frozen at birth or even later for eventual cloning into needed organs. Enterprises like the longevity company YouthCell have been founded on this premise. Scientists are also trying to perfect transplants from livestock into humans.
But social and technological change takes time. Meanwhile, no one expects Chinese bureaucrats to readily forsake an easy source of income like selling organs from the laogai. "If you have a government more or less imposed on the people, you can do that, so in China it's not a problem," says Distant.
Diflo, for his part, says he came forward not to seek attention for himself but in hopes of kicking off public discussion and scrutiny of the issue. "I don't see myself going on a world speaking tour," he says. "The whole reason I spoke up about this is that I was having a difficult time taking care of these patients because of my own repugnance at what had gone on and how things had happened. It really comes from a more personal place. It comes from my own outrage."
This story first appeared in Village Voice.
China's hi-tech 'death van' where criminals are executed and then their organs are sold on black market
DAILYMAIL.UK By Andrew Malone | March 27th 2009
Death will come soon for Jiang Yong. A corrupt local planning official with a taste for the high life, Yong solicited money from businessmen eager to expand in China's economic boom.
Showering gifts on his mistress, known as Madam Tang, the unmarried official took more than £1 million in bribes from entrepreneurs wanting permission to build skyscrapers on land which had previously been protected from development.
But Yong, a portly, bespectacled figure, was caught by the Chinese authorities during a purge on corrupt local officials last year.
He confessed and was sentenced to death. China executed 1,715 people last year, so one more death would hardly be remarkable.
But there will be nothing ordinary about Yong's death by lethal injection. Unless he wins an appeal, he will draw his final breath strapped inside a vehicle that has been specially developed to make executions more cost-effective and efficient.
In chilling echoes of the 'gas-wagon' project pioneered by the Nazis to slaughter criminals, the mentally ill and Jews, this former member of the China People's Party will be handcuffed to a so-called 'humane' bed and executed inside a gleaming new, hi-tech, mobile 'death van.'
After trials of the mobile execution service were launched quietly three years ago - then hushed up to prevent an international row about the abuse of human rights before the Olympics last summer - these vehicles are now being deployed across China.
The number of executions is expected to rise to a staggering 10,000 people this year (not an impossible figure given that at least 68 crimes - including tax evasion and fraud - are punishable by death in China).
Developed by Jinguan Auto, which also makes bullet-proof limousines for the new rich in this vast country of 1.3 billion people, the vans appear unremarkable.
They cost £60,000, can reach top speeds of 80mph and look like a police vehicle on patrol. Inside, however, the 'death vans' look more like operating theatres.
Executions are monitored by video to ensure they comply with strict rules, making it possible to describe precisely how Jiang Yong will die. After being sedated at the local prison, he will be loaded into the van and strapped to an electric-powered stretcher.
This then glides automatically towards the centre of the van, where doctors will administer three drugs: sodium thiopental to cause unconsciousness; pancuronium bromide to stop breathing and, finally, potassium chloride to stop the heart.
Death is reputed to be quick and painless - not that there is anyone to testify to this. The idea for such a 'modern' scheme is rooted in one of the darkest episodes in human history.
The Nazis used adapted vans as mobile gas chambers from 1940 until the end of World War II. In order to make the best use of time spent transporting criminals and Jewish prisoners, Hitler's scientists developed the vehicles with a hermetically sealed cabin that was filled with carbon monoxide carried by a tube from the exhaust pipes.
The vans were first tested on child patients in a Polish psychiatric hospital in 1940. The Nazis then developed bigger models to carry up to 50 prisoners. They looked like furniture removal vans. Those to be killed were ordered to hand over their valuables, then stripped and locked inside.
As gas was pumped into the container and the van headed towards graves being dug by other prisoners, the muffled cries of those inside could be heard, along with banging on the side.
With the 'cargo' dead, all that remained was for gold fillings to be hacked from the victims' mouths, before the bodies were tipped into the graves.
Now, six decades later, just like the Nazis, China insists these death vans are 'progress'.
The vans save money on building execution facilities in prisons or courts. And they mean that prisoners can be executed locally, closer to communities where they broke the law. ...
According to undercover investigations by human rights' groups, the police, judiciary and doctors are all involved in making millions from China's huge trade in human body parts.
Inside each 'death van' there is a dedicated team of doctors to 'harvest' the organs of the deceased. The injections leave the body intact and in pristine condition for such lucrative work.
After checking that the victim is dead, the medical team first remove the eyes. Then, wearing surgical gowns and masks, they remove the kidney, liver, pancreas and lungs.
Little goes to waste, though the heart cannot be used, having been poisoned by the drugs.
The organs are dispatched in ice boxes to hospitals in the sprawling cities of Beijing, Shanghai and Guangzhou, which have developed another specialist trade: selling the harvested organs.
At clinics all over China, these organs are transplanted into the ailing bodies of the wealthy - and thousands more who come as 'organ tourists' from neighbouring countries such as Japan, South Korea, Singapore and Taiwan.
Chinese hospitals perform up to 20,000 organ transplants each year. A kidney transplant in China costs £5,000, but can rise to £30,000 if the patient is willing to pay more to obtain an organ quickly.
With more than 10,000 kidney transplants carried out each year, fewer than 300 come from voluntary donations. The British Transplantation Society and Amnesty International have condemned China for harvesting prisoners' organs.
Laws introduced in 2006 make it an offence to remove the organs of people against their will, and banned those under 18 from selling their organs.
But, tellingly, the law does not cover prisoners.
'Organs can be extracted in a speedier and more effective way using these vans than if the prisoner is shot,' says Amnesty International.
'We have gathered strong evidence suggesting the involvement of Chinese police, courts and hospitals in the organ trade.'
The bodies cannot be examined. Corpses are driven to a crematorium and burned before independent witnesses can view them.
A police official, who operates a 'multi-functional and nationwide, first-class, fixed execution ground' where prisoners are shot, confirmed to the Mail that it is always a race against time to save the organs of the executed - and that mobile death vans are better equipped for the job.
'The liver loses its function only five minutes after the human cardiac arrest,' the officer told our researcher.
'The kidney will become dysfunctional 30 minutes after cardiac arrest. So the removal of organs must be completed at the execution ground within 15 minutes, then put in an ice box or preservation solution.'
While other countries worry about the morality of the death penalty, China has no such qualms.
For the Beijing regime, it is not a question of whether they should execute offenders, but how to do it most efficiently - and make the most money from it.
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