By Ariana Walji and Simi Juriasingani

Organs should be donated voluntarily and with informed consent. This is one of the fundamental ethical principles of organ donation and most countries with a donor registration program have implemented key measures to ensure that no violations occur. For example, countries such as Canada and the United States have created strict guidelines including paperwork requiring the donor’s signature, consultations with social workers, rigorous healthcare screening and several rounds of acquiring informed consent. There are checks and balances throughout the process to ensure that there is no coercion and patients have the right to withdraw their consent for organ donation at any point.

However, certain events in China have highlighted the fact that we live in a world where voluntary organ donation is a privilege and not a right. Despite having one of the largest organ transplant programs globally and procuring numerous voluntary organ donor registrations, China has been implicated in several unethical organ donation practices. In 2013, a Chinese medical official publicly admitted to harvesting organs from executed prisoners without consent prior to regulation change. These changes have raised doubt about the system as getting informed consent from prisoners incites additional ethical concerns. Moreover, multiple investigations have reported evidence of illegal organ harvesting in China from other minority groups, including Uighurs, an ethnic group of Muslims from Xinxiang, and practitioners of Falun Gong, a spiritual group with philosophical roots in Buddhist tradition. While Beijing has denied these accusations on multiple accounts, a growing body of evidence suggests the continuation of unethical practices in China. 

 China’s actions have raised international medical and ethical concerns, with many questioning how a country can continue to carry out these unethical practices without intervention or consequences. The Chinese government’s claims of ethical reform have been called into question on multiple accounts due to their refusal to release organ transplant registries to the public. According to an analysis conducted by BMC Medical Ethics, there exists a variety of proof supporting the case that China has denied the basic human rights of minority groups through illegal organ harvesting. This includes testimonies from ex-prisoners, doctors, and human rights workers, such as David Kilgour and Jennifer Zheng. Undercover footage from inside Chinese hospitals have been reviewed, along with internal Chinese medical records contradicting their claims. Notably, the China Tribunal was initiated in 2018 by the International Coalition To End Transplant Abuse in China. However, the Chinese government declined an invitation to take part in the tribunal, suggesting their reluctance to make appropriate changes and ensure that their healthcare system meets ethical standards.

While China has been able to procure numerous voluntary organ donations over the years, it is important that the process is carried out ethically and voluntarily for all Chinese patients, regardless of their social status, practices or beliefs. Under Canadian healthcare guidelines, which strive to protect the rights of all patients, it is ultimately up to each individual to decide whether they want to donate their organs and their wishes are honoured by their healthcare team.  If we continue to carry out the organ transplant process ethically, we can keep saving the precious lives of those in need while valuing every individual’s  rights and freedom. But for these ethical systems to prevail globally, governments must invest in public education to emphasize the importance of organ donation and ensure that the process of organ donation is voluntary and consensual. Furthermore, every Canadian needs to seriously consider registering to become an organ donor so that we can reduce the save the lives of patients on ever-increasing transplant waiting lists. To learn more about organ donation and to register to become an organ donor, visit beadonor.ca.

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