The ‘altruism’ of China’s death convicts

China is probably one of the most practical nations in the world when it comes to the treatment of condemned criminals. They are not merely executed. As soon as they are killed (usually by a shot in the head), their warm but lifeless bodies are rushed by waiting ambulances to a nearby hospital, where their healthy organs are harvested for immediate transplantation to patients who urgently need them.

It is not certain if the convicts or their relatives are given any say in this, or whether refusal to “donate” is an option. What is clear, according to estimates, is that about two-thirds of all transplanted organs in China are taken from prisoners. BBC cites a Xinhua news agency report saying that as many as 1.5 million people need organ transplants in China today, yet no more than 10,000 operations are performed every year.

This practice has long been condemned by international human rights groups as grossly immoral. China has mostly turned a deaf ear to these protestations, while promoting the impression that no pressure is ever applied on the prisoners. But, recently, China announced that the harvest of organs from executed prisoners will be phased out in the next five years—not because the practice is intrinsically wrong, says the state, but because prisoners are generally not in the best state of health, thus making them unsuitable as donors. This announcement coincides with the launch of a new program aimed at getting the general population to sign up as organ donors. The anticipated success of this program, which goes against a strong cultural belief that the human body must be buried whole at death, is expected to make the harvest of prisoners’ organs unnecessary.

Human rights groups, however, are unconvinced that the move represents a serious attempt to reverse a long-standing policy. No one knows the actual figures, but the number of judicial executions in China is reputed to be the highest in the world today. More than 60 offenses are punishable by death in China, and thousands are routinely put to death every year. That is a lot of harvestable human organs that will go to waste in a society that officially frowns on the sale of organs taken from productive living donors.

I do not know of any other country that maintains the same policy as China’s. But we can safely assume that where a category of human beings, such as condemned prisoners, are stripped of their rights, their treatment as nonpersons will be reflected in the way their bodies are disposed. How many times have we heard of cadavers of overseas Filipino workers being shipped home that, upon autopsy, are found to have missing internal organs?

The possibilities boggle the mind and weigh upon our conscience.

One can imagine what happens when a convict is sentenced to die in one of China’s prisons. He will probably have a pending appeal before a higher court. In most instances, however, he will not know the fate of this appeal until the day he is led to the execution room. In the meantime, his blood type and the condition of his organs will have been carefully monitored and documented. These would have been meticulously matched with the specific requirements of waiting patients. Reports say that some of the recipients have been Chinese patients from overseas who pay a considerable amount of money for organs taken from someone of the same racial stock.

Once a match is made, a prisoner’s execution may then be perfectly timed—postponed or advanced—according to the necessities of the transplant schedule. He would be treated with special care while awaiting execution, fed nourishing meals and relieved of strenuous duties that might affect his health, etc. His situation would be no different from that of an animal being fattened for slaughter.

Contrast this to the experience that a donor and recipient would have if the prisoner’s consent were given in full awareness of the good that a final act of kindness on his part will bring to another human being. The recipient would forever be in his debt, knowing that his life has been extended by someone who knew his need and asked for nothing in return. These are meanings that neither the state nor the market can take away without destroying those things that, in our eyes, make us human.

In many ways, the buying of human organs from people in dire economic straits is not so different from the coerced harvest of prisoners’ organs. The implied consent of the seller would be of the same quality as that supposedly obtained from a “prisoner-donor” on China’s death row. It is not freely given. In one, it is dictated by economic need; in the other, it is constrained by a jailer’s power.

China’s plan to register as many of its citizens as possible as potential organ donors is a step in the right direction. It will definitely increase the number of voluntarily donated organs from nonliving donors. It may even encourage more people to offer themselves as living donors to their kin or close friends. But I am not at all hopeful that it will, by itself, make the harvest of organs from death convicts unnecessary. This inhuman practice, to me, will only end as the consequence of a resolute policy to ban it.

What does all this mean for us in the Philippines? We may not be harvesting organs from death convicts, but we do tend to turn a blind eye to poor people offering their organs for sale. We may have banned organ trafficking, but we can’t ignore the fact that the demand is rising. And people have found ways of going around the law. What we need today is a determined campaign to make people aware of the benefits of organ transplantation, and to enlist more Filipinos as responsible organ donors.