China - Ethical issues and debate
China relies heavily on organ procurement from executed prisoners, and has been a key destination for transplant tourists.
The procurement of organs from executed prisoners has been widely condemned by the international medical community, notably by The Transplantation Society, the Declaration of Istanbul Custodian Group and the World Medical Association. As articulated in the policy of the Transplantation Society:
"It is a fundamental principle for The Transplantation Society that organs and tissues are given freely and without coercion. Because of the restrictions in liberty in a prison environment it is unlikely that prisoners are truly free to make independent decisions and thus an autonomous informed consent for donation cannot be obtained. Further, the financial incentive for recovering organs from executed prisoners may become an incentive to increase the number of such organs available for transplantation. Thus, The Transplantation Society is opposed to the recovery of organs and tissues from executed prisoners and from any other individual where an autonomous consent for the procurement is lacking."
The World Medical Association declares that,
"In jurisdictions where the death penalty is practised, executed prisoners must not be considered as organ and/or tissue donors. While there may be individual cases where prisoners are acting voluntarily and free from pressure, it is impossible to put in place adequate safeguards to protect against coercion in all cases."
A number of public statements by national health authorities and policy changes have been made in China since 2006, indicating that China aims to end the practice of organ procurement from prisoners and develop an allocation system for deceased donor organs. Signs of progress have been welcomed and encouraged by the international community, however serious concerns remain about the ongoing use of organs from executed prisoners.
Below you will find a number of news reports and journal papers discussing this issue: