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The Coalition to Investigate the Persecution of the Falun Gong in China (CIPFG), has asked us to investigate allegations of organ harvesting of Falun Gong practitioners in China. The coalition is a non‑governmental organization registered in Washington, D.C., U.S.A. with a branch in Ottawa, Canada. The request came formally by letter dated May 24, 2006 attached as an appendix to this report.
The request was to investigate allegations that state institutions and employees of the government of the People's Republic of China have been harvesting organs from live Falun Gong practitioners, killing the practitioners in the process. In light of the seriousness of the allegations as well as our own commitment to respect for human rights, we accepted the request.
David Matas is an immigration, refugee and international human rights lawyer in private practice in Winnipeg. He is actively involved in the promotion of respect for human rights as an author, speaker and participant in several human rights non‑governmental organizations.
David Kilgour is a former member of Parliament and a former Secretary of State of the Government of Canada for the Asia Pacific region. Before he became a parliamentarian, he was a Crown prosecutor. The biographies of both authors are attached as appendices to this report.
B. The Allegation
It is alleged that Falun Gong practitioners are victims of live organ harvesting throughout China. The allegation is that organ harvesting is inflicted on unwilling Falun Gong practitioners at a wide variety of locations, pursuant to a systematic policy, in large numbers.
Organ harvesting is a step in organ transplants. The purpose of organ harvesting is to provide organs for transplants. Transplants do not necessarily have to take place in the same place as the location of the organ harvesting. The two locations are often different; organs harvested in one place are shipped to another place for transplanting.
The allegation is further that the organs are harvested from the practitioners while they are still alive. The practitioners are killed in the course of the organ harvesting operations or immediately thereafter. These operations are a form of murder.
Finally, we are told that the practitioners killed in this way are then cremated. There is no corpse left to examine to identify as the source of an organ transplant.
C. Working Methods
We conducted our investigation independently from the Coalition to Investigate the Persecution of the Falun Gong in China, the Falun Dafa Association, any other organization, and any government. We sought to go to China unsuccessfully, but would be willing to go even subsequently to pursue the investigation.
When we began our work, we had no views whether the allegations were true or untrue. The allegations were so shocking that they are almost impossible to believe. We would have much rather found the allegations to be untrue than to be true. The allegations, if true, represent a disgusting form of evil which, despite all the depravities humanity has seen, are new to this planet. The very horror made us reel back in disbelief. But that disbelief does not mean that the allegations are untrue.
We were well aware of the statement of U.S. Supreme Court Justice Felix Frankfurter 1943 to a Polish diplomat in reaction to being told by Jan Karski about the Holocaust. Frankfurter said:
"I did not say that this young man was lying. I said that I was unable to believe what he told me. There is a difference."
After the Holocaust, it is impossible to rule out any form of depravity. Whether an alleged evil has been perpetrated can be determined only by considering the facts.
After the first version of our report was released, on July 7, 2006 in Ottawa, we travelled extensively, publicising the report and promoting its recommendations. In the course of our travels, and as a result of the publicity surrounding the first version, we acquired substantial additional information. This second version incorporates this new information.
Nothing we subsequently discovered shook our conviction in our original conclusions. But much which we later discovered reinforced it. This version presents, we believe, an even more compelling case for our conclusions than the first version did.
D. Difficulties of Proof
The allegations, by their very nature, are difficult either to prove or disprove. The best evidence for proving any allegation is eye witness evidence. Yet for this alleged crime, there is unlikely to be any eye witness evidence.
The people present at the scene of organ harvesting of Falun Gong practitioners, if it does occur, are either perpetrators or victims. There are no bystanders. Because the victims, according to the allegation, are murdered and cremated, there is no body to be found, no autopsy to be conducted. There are no surviving victims to tell what happened to them. Perpetrators are unlikely to confess to what would be, if they occurred, crimes against humanity. Nonetheless, though we did not get full scale confessions, we garnered a surprising number of admissions through investigator phone calls.
The scene of the crime, if the crime has occurred, leaves no traces. Once an organ harvesting is completed, the operating room in which it takes place looks like any other empty operating room.
The clampdown on human rights reporting in China makes assessment of the allegations difficult. China, regrettably, represses human rights reporters and defenders. There is no freedom of expression. Those reporting on human rights violations from within China are often jailed and sometimes charged with communicating state secrets. In this context, the silence of human rights non‑governmental organizations on organ harvesting of unwilling Falun Gong practitioners tells us nothing.
The International Committee of the Red Cross is not allowed to visit prisoners in China. Nor is any other organization concerned with human rights of prisoners. That also cuts off a potential avenue of evidence.
China has no access to information legislation. It is impossible to get from the Government of China basic information about organ transplants ‑ how many transplants there are, what is the source of the organs, how much is paid for transplants or where that money is spent.
We did seek to visit China for this report. Our efforts went nowhere. We asked in writing for a meeting with the embassy to discuss terms of entry. Our letter is attached as an appendix to this report. Our request for a meeting was accepted. But the person who met with David Kilgour was interested only in denying the allegations and not in arranging for our visit.
E. Methods of Proof
We have had to look at a number of factors, to determine whether they present a picture, all together, which make the allegations either true or untrue. None of these elements on its own either establishes or disproves the allegations. Together, they paint a picture.
Many of the pieces of evidence we considered, in themselves, do not constitute ironclad proof of the allegation. But their non‑existence might well have constituted disproof. The combination of these factors, particularly when there are so many of them, has the effect of making the allegations believable, even when any one of them in isolation might not do so. Where every possible element of disproof we could identify fails to disprove the allegations, the likelihood of the allegations being true becomes substantial.
Proof can be either inductive or deductive. Criminal investigation normally works deductively, stringing together individual pieces of evidence into a coherent whole. The limitations our investigation faced placed severe constraints in this deductive method. Some elements from which we could deduce what was happening were, nonetheless, available, in particular, the investigator phone calls.
We also used inductive reasoning, working backwards as well as forwards. If the allegations were not true, how would we know it was not true? If the allegations were true, what facts would be consistent with those allegations? What would explain the reality of the allegations, if the allegations were real? Answers to those sorts of questions helped us to form our conclusions.
We also considered prevention. What are the safeguards that would prevent this sort of activity from happening? If precautions are in place, we could conclude that it is less likely that the activity is happening. If they are not in place, then the possibility that the activity is happening increases.
F. Elements of Proof and Disproof
a) General considerations
China violates human rights in a variety of ways. These violations are chronic and serious. Besides Falun Gong, other prime targets of human rights violations are Tibetans, Christians, Uighurs, democracy activists and human rights defenders. Rule of Law mechanisms in place to prevent human rights violations, such as an independent judiciary, access to counsel on detention, habeas corpus, the right to public trial, are absent in China. China, according to its constitution, is ruled by the Communist Party. It is not ruled by law.
Communist China has had a history of massive, jaw dropping cruelty towards its own citizens. The Communist regime has killed more innocents than Nazi Germany and Stalinist Russia combined. Girl children are killed, abandoned and neglected in massive numbers. Torture is widespread. The death penalty is both extensive and arbitrary. China executes more people than all other countries combined. Religious belief is suppressed.
This pattern of human rights violations, like many other factors, does not in itself prove the allegations. But it removes an element of disproof. It is impossible to say of these allegations that it is out of step with an overall pattern of respect for human rights in China. While the allegations, in themselves, are surprising, they are less surprising with a country that has the human rights record China does than they would be for many other countries.
When there are so many violations of human rights in China, it is invidious to point to only one victim. We nonetheless draw the attention to the victimization of human rights lawyer Gao Zhisheng as an example or a case study. It was Gao who wrote to us last summer, inviting us to come to China to investigate the stealing of vital organs from Falun Gong prisoners of conscience. No visa was subsequently issued by its embassy in Ottawa to do so; he was detained not long afterwards.
Gao wrote three open letters to President Hu and other leaders, protesting a range of abuses against the Falun Gong, including specific cases of torture and murder. Gao also wrote about and condemned the extraction and sale of organs from Falun Gong practitioners. He expressed his willingness to join the Coalition to Investigate Organ Harvesting from Still Alive People.
He was convicted of inciting subversion and on December 2, 2006 given a three-year prison sentence. His removal to custody, however, was suspended for five years; his political rights were removed for a year by the Beijing court. This repression of someone whose only concern is respect for human rights in general and the persecution of Falun Gong practitioners in particular in itself reinforces his concerns and ours.
The International Olympic Committee, in 2001, awarded Beijing the 2008 Olympics. Liu Jingmin, Vice President of the Beijing Olympic Bid, in April 2001, said: "By allowing Beijing to host the Games you will help the development of human rights."
Yet, the result has been just the opposite. Amnesty International, in a statement released September 21, 2006 said:
"In its latest assessment of the Chinese government's performance in four benchmark areas of human rights ahead of the Olympics, Amnesty International found that its overall record remained poor. There has been some progress in reforming the death penalty system, but in other crucial areas the government's human rights record has deteriorated."
The international community, by carrying on with the Olympics in Beijing despite the deterioration of human rights in China in crucial areas, sends to China a message of impunity. The impression China must get is that it does not matter how much it violates human rights; the international community seems not to care.
When China moved from a socialist to a market economy, the health system was part of the shift. From 1980, China began withdrawing government funds from the health sector, expecting the health system to make up the difference through charges to consumers of health services. Since 1980, government spending dropped from 36% of all health care expenditure to 17%, while patients' out‑of‑pocket spending rocketed up from 20% to 59%. A World Bank study reports that reductions in public health coverage were worsened by increases in cost by the private sector.
According to cardiovascular doctor Hu Weimin, the state funding for the hospital where he works is not enough to even cover staff salaries for one month. He stated: "Under the current system, hospitals have to chase profit to survive." Human Rights in China reports: "Rural hospitals [have had] to invent ways to make money to generate sufficient revenue".
The sale of organs became for hospitals a source of funding, a way to keep their doors open, and a means by which other health services could be provided to the community.
One could see how this dire need for funds might lead first to a rationalization that harvesting organs from prisoners who would be executed anyways was acceptable and second to a desire not to question too closely whether the donors wheeled in by the authorities really were prisoners sentenced to death.
The military, like the health system, has gone from public financing to private enterprise. The military in China is a conglomerate business. This business is not corruption, a deviation from state policy. It is state sanctioned, an approved means of raising money for military activities. In 1985, then President Deng Xiaoping issued a directive allowing the People's Liberation Army units to earn money to make up the shortfall in their declining budgets.
Many of the transplant centres and general hospitals in China are military institutions, financed by organ transplant recipients. Military hospitals operate independently from the Ministry of Health. The financing they earn from organ transplants does more than pay the costs of these facilities. The money is used to finance the overall military budget.
There is, for instance, the Organ Transplant Center of the Armed Police General Hospital in Beijing. This hospital boldly states:
"Our Organ Transplant Center is our main department for making money. Its gross income in 2003 was 16,070,000 Yuan. From January to June of 2004 income was 13,570,000 Yuan. This year (2004) there is a chance to break through 30,000,000 Yuan."
Military involvement in organ harvesting extends into civilian hospitals. Recipients often tell us that, even when they receive transplants in civilian hospitals, those conducting the operation are military personnel.
Here is one example. When we were in Asia promoting our report, we met a man who in 2003 flew to Shanghai to obtain a new kidney for the $20,000 USD price negotiated before his departure. He was admitted to the No 1 Peoples' Hospital‑a civilian facility‑and during the ensuing two weeks four kidneys were brought for testing against his blood and other factors. None proved compatible because of his anti‑bodies; all were taken away.
He subsequently went to his home country, returning to the hospital about two months later. Another four kidneys were similarly tested; when the eighth proved compatible, the transplant operation was successfully completed. His eight days of convalescence was done at No 85 hospital of the Peoples' Liberation Army. His surgeon was Dr. Tan Jianming of the Nanjing military region, who wore his army uniform at times in the civilian hospital.
Tan carried sheets of paper containing lists of prospective "donors”, based on various tissue and blood characteristics, from which he would select names. The doctor was observed at various times to leave the hospital in uniform and return 2‑3 hours later with containers bearing kidneys. Dr. Tan told the recipient that the eighth kidney came from an executed prisoner.
The military have access to prisons and prisoners. Their operations are even more secretive than those of the civilian government. They are impervious to the rule of law.
Corruption is a major problem across China. State institutions are sometimes run for the benefit of those in charge of them rather than for the benefit of the people. Occasionally, China engages in "Strike Hard" against corruption.
But, in the absence of rule of law and democracy, where secrecy holds sway and public accounting of public funds is absent, these anti-corruption campaigns seem to be more power struggles than true anti-corruption drives. They are attempts to placate public concern about corruption, politicized public relations drives.
The sale of organs is a money driven problem. But that is different from saying that it is a corruption problem. The sale of organs from unwilling donors combines hatred with greed. A state policy of persecution is acted out in a financially profitable way.
Former Chinese president Deng Xiaoping said: "To get rich is glorious". He did not say that some ways of getting rich are shameful.
Profiteering hospitals take advantage of a defenceless captive prison population in their regions. The people are in prison without rights, at the disposition of the authorities. The incitement to hatred against prisoners and their dehumanization means that they can be butchered and killed without qualms by those who buy into this official hate propaganda.
Albert Einstein wrote:
"The release of atom power has changed everything except our way of thinking...the solution to this problem lies in the heart of mankind. If only I had known, I should have become a watchmaker."
Technological developments do not change human nature. But they do change the ability to inflict harm.
The development of transplant surgery has done much to improve the ability of humanity to cope with failing organs. But these developments in transplant surgery have not changed our way of thinking.
There is a tendency to think of any new medical development as a benefit to humanity. That is certainly the intent of its developers. But medical research, no matter how far advanced, comes face to face with the same old capacity for good and evil.
More advanced techniques in transplant surgery do not mean a more advanced Chinese political system. The Chinese Communist system remains. Developments in transplant surgery in China fall prey to the cruelty, the corruption, the repression which pervades China. Advances in transplant surgery provide new means for old cadres to act out their venality and ideology.
We do not suggest that those who developed transplant surgery should instead have become watchmakers. We do suggest that we should not be so naive as to think that just because transplant surgery was developed to do good, it can do no harm.
On the contrary, the allegation made against the development of transplant surgery in China, that it is being used to harvest organs from unwilling Falun Gong practitioners, would be just the acting out, in a new context, of the lesson Albert Einstein was teaching. We have seen before that modern technologies developed for the benefit of humanity have been perverted to inflict harm. We should not be surprised if this has also happened to transplant surgery.
Deputy Health Minister Huang Jiefu, speaking at a conference of surgeons in the southern city of Guangzhou in mid November 2006 acknowledged that executed prisoners sentenced to death are a source of organ transplants. He said: "Apart from a small portion of traffic victims, most of the organs from cadavers are from executed prisoners." Asia News wrote:
"'Under‑the‑table business must be banned,' Mr Huang said cognizant that too often organs come from non consenting parties and are sold for high fees to foreigners."
China has the death penalty for a large number of offences including strictly political and economic crimes where there is no suggestion that the accused has committed a violent act. To go from executing no one to killing Falun Gong practitioners for their organs without their consent is a large step. To go from executing prisoners sentenced to death for political or economic crimes and harvesting their organs without their consent to killing Falun Gong practitioners for their organs without their consent is a good deal smaller step.
It would be difficult to believe that a state which killed no one, which had no death penalty, which harvested the organs of no one else without their consent, would harvest the organs of Falun Gong practitioners without their consent. It is a good deal easier to believe that a state which executes prisoners sentenced to death for economic or political crimes and harvests their organs without their consent would also kill Falun Gong practitioners for their organs without their consent.
The Falun Gong constitutes a prison population who the Chinese authorities vilify, dehumanize, depersonalize, marginalize even more than executed prisoners sentenced to death for criminal offences. Indeed, if one considers only the official rhetoric directed against the two populations, it would seem that the Falun Gong would be a target for organ harvesting even before prisoners sentenced to death.
China has no organized system of organ donations.  In this it is unlike every other country engaged in organ transplant surgery. Donations from living donors are allowed for family members.
We are told that there is a Chinese cultural aversion to organ donation. Yet, Hong Kong and Taiwan, with essentially the same culture, have active organ donation programs.
The absence of an organ donation system in China tells us two things. One is that organ donations are not a plausible source for organ transplants in China.
Because of the culture aversion to organ donation in China, even an active organ donation system would have difficult supplying the volume of transplants now occurring in China. But the problem is compounded when there is not even an active effort to encourage donations.
Donations matter in other countries because donations are the primary source of organs for transplants. We can conclude that from the absence of a serious effort to encourage donations in China that, for China, donations do not even matter. China has such a plethora of organs available for transplants without donations that encouraging organ donations becomes superfluous.
The absence of a serious effort to encourage organ donations in combination with short waiting times for transplant surgery in China and the large volume of transplants tells us that China is awash in living organs for transplant; people the authorities have ready on hand to be killed for their organs for transplants. That reality does nothing to dispel the allegation of organ harvesting of unwilling Falun Gong practitioners.
Hospital web sites in China advertise short waiting times for organ transplants. Transplants of long dead donors are not viable because of organ deterioration after death. If we take these hospital's self‑promotions at face value, they tell us that there are a large number of people now alive who are available on demand as sources of organs.
The waiting times for organ transplants for organ recipients in China are much lower than anywhere else. The China International Transplantation Assistant Centre website says, "It may take only one week to find out the suitable (kidney) donor, the maximum time being one month...”. It goes further, "If something wrong with the donor's organ happens, the patient will have the option to be offered another organ donor and have the operation again in one week."  The site of the Oriental Organ Transplant Centre in early April, 2006, claimed that "the average waiting time (for a suitable liver) is 2 weeks."  The website of the Changzheng Hospital in Shanghai says: "...the average waiting time for a liver supply is one week among all the patients". 
In contrast, the median waiting time in Canada for a kidney was 32.5 months in 2003 and in British Columbia it was even longer at 52.5 months. The survival period for a kidney is between 24-48 hours and a liver about 12 hours. The presence of a large bank of living kidney-liver "donors" must be the only way China's transplant centres can assure such short waits to customers. The astonishingly short waiting times advertised for perfectly-matched organs would suggest the existence of a large bank of live prospective 'donors'.
Some of the material available on the websites of various transplant centres in China before March 9, 2006 (when allegations about large‑scale organ seizures resurfaced in Canadian and other world media) is also inculpatory. Understandably, a good deal of it has since been removed. So these comments will refer only to sites that can still be found at archived locations, with the site locations being identified either in the comments or as footnotes. A surprising amount of self‑accusatory material was still available as of the final week of June, 2006 to web browsers. We list here only four examples:
(1) China International Transplantation Network Assistance Centre Website
This website as of May 17, 2006 indicated in the English version (the Mandarin one evidently disappeared after March 9) that the centre was established in 2003 at the First Affiliated Hospital of China Medical University "...specifically for foreign friends. Most of the patients are from all over the world." The opening sentence of the site introduction declares that "Viscera (one dictionary definition: "soft interior organs...including the brain, lungs, heart etc") providers can be found immediately!" On another page on the same site is this statement: "...the number of kidney transplant operations is at least 5,000 every year all over the country. So many transplantation operations are owing to the support of the Chinese government. The supreme demotic court, supreme demotic law - officer, police, judiciary, department of health and civil administration have enacted a law together to make sure that organ donations are supported by the government. This is unique in the world."
In the 'question and answer' section of the site are found:
"Before the living kidney transplantation, we will ensure the donor's renal function...So it is more safe than in other countries, where the organ is not from a living donor." 
. "Q: Are the organs for the pancreas transplant(ed) from brain death (sic) (dead) patients?"
"A: Our organs do not come from brain death victims because the state of the organ may not be good." 
(2)Orient Organ Transplant Centre Website
On a page we were informed was removed in mid-April (but can still be located as an archive 12) is the claim that from "January 2005 to now, we have done 647 liver transplants - 12 of them done this week; the average waiting time is 2 weeks." A chart also removed about the same time (but archive still available) indicates that from virtually a standing start in 1998 (when it managed only 9 liver transplants) by 2005 it had completed fully 2248.
In contrast, according to the Canadian Organ Replacement Register 14, the total in Canada for all kinds of organ transplants in 2004 was 1773.
(3) Jiaotong University Hospital Liver Transplant Centre Website
(Shanghai ‑ This is #5 in the list of telephoned centres)
In a posting on April 26, 2006, 
(http://www.health.sohu.com/20060426/n243015842.shtml), the website says in part: "The liver transplant cases (here) are seven in 2001, 53 cases in 2002, 105 cases in 2003, 144 cases in 2004, 147 cases in 2005 and 17 cases in January, 2006," .
(4) Website of Changzheng Hospital Organ Transplant Centre, affiliated with No. 2 Military Medical University
A page was removed after March 9, 2006. (Internet Archive page is available.) It contains the following graph depicting the number of liver transplant each year by this Centre:
In the "Liver Transplant Application" form , it states on the top, "...Currently, for the liver transplant, the operation fee and the hospitalization expense together is about 200,000 Yuan ($66,667 CND), and the average waiting time for a liver supply is one week among all the patients in our hospital...."
For the first version of our report, we did not have time to engage in donor recipient interviews, people who went to China from abroad for transplants. For this version, we engaged in extensive interviews of a number of these recipients and their family members. Summaries of their experience are attached as an appendix to this report.
Organ transplant surgery, as described by the recipients and their relatives, is conducted in almost total secrecy, as if it were a crime which needed cover up. As much information as possible is withheld from the recipients and their families. They are not told the identity of the donors. They are never shown written consents from the donors or their families. The identity of the operating doctor and support staff are often not disclosed, despite requests for this information. Recipients and their families are commonly told the time of the operation only shortly before it occurs. Operations sometimes occur in the middle of the night. The whole procedure is done on a "don't ask, don't tell" basis.
When people act as if they have something to hide, it is reasonable to conclude that they have something to hide. Since organ sourcing from prisoners sentenced to death is widely known and even acknowledged by the Government of China, Chinese transplant hospitals can not be trying to hide that. It must be something else. What is it?
In China, organ transplanting is a very profitable business. We can trace the money of the people who pay for organ transplants to specific hospitals which do organ transplants, but we can not go further than that. We do not know who gets the money the hospitals receive. Are doctors and nurses engaged in criminal organ harvesting paid exorbitant sums for their crimes? That was a question it was impossible for us to answer, since we had no way of knowing where the money went.
China International Transplantation Network Assistance Centre Website
Before its indicated removal from the site  in April, 2006, the size of the profits for transplants was suggested in the following price list:
A standard way of investigating any crime allegation where money changes hands is to follow the money trail. But for China, its closed doors mean that following the money trail is impossible. Not knowing where the money goes proves nothing. But it also disproves nothing, including these allegations.
Chinese transplant professionals are not subject to any ethical strictures separate from the laws which govern their work. Many other countries have self governing transplant professions with their own disciplinary systems. Transplant professionals who violate ethical guidelines can be ejected from their profession by their colleagues without any state intervention.
For transplant professionals in China, we found nothing of the sort. When it comes to transplant surgery, as long as the state does not intervene, anything goes. There is no independent supervisory body exercising disciplinary control over transplant professionals independent of the state.
The Wild West system of transplant surgery in China makes it easier for abusive practices to occur. State involvement and criminal prosecution are inevitably less systematic than professional discipline. Because the penalties for criminal prosecution are greater than the penalties for professional discipline - potential jail time rather than just barring someone from the profession - prosecution cases are more rare than discipline cases.
The absence of a functioning transplant professional discipline system does not mean that abuses are occurring. But it certainly makes it more likely that they will occur.
There are huge gaps in foreign transplant ethics. In many of the countries from which transplant tourism to China originates, transplant professionals have organized ethical and disciplinary systems. But it is rare for these systems to deal specifically with either transplant tourism or contact with Chinese transplant professionals or transplants from executed prisoners. The watch words here seem to be "out of sight, out of mind".
On transplant tourism, the Professional Code of Conduct of the Medical Council of Hong Kong has two principles, in particular, worth emphasizing. One is that, "if there is doubt" as to whether the consent is given freely or voluntarily by the donor, the profession should have nothing to do with the donation. And, the very least one can say about China, in light of the fact that "almost all" transplants come from prisoners, is that there is doubt in almost every case whether the consent is given freely or voluntarily by the donor.
The second is that the onus is on the foreign professionals to ascertain the status of the Chinese donor. The foreign professional is not acting ethically as long as he or she makes no inquiries or only cursory ones. The foreign professional, after investigation, has to be satisfied beyond any doubt before referring a patient to China that consent was given freely or voluntarily by the donor.
The organ harvesting market in China, in order to thrive, requires both a supply and a demand. The supply comes from China, from prisoners. But the demand, in large part, in big bucks, comes from abroad.
In an appendix, we present a critical analysis of the ethics of contact with China on transplants. The Hong Kong principles are the exception rather than the rule. Global professional ethics do little or nothing to staunch the foreign demand for organs from China.
Until July 1st, 2006, the practice of selling organs in China was legal. A law banning their sale came into effect on that date.
In China there is a huge gap between enacting legislation and enforcing it. To take one example, the preamble of the Constitution of China promises for China a "high level" of democracy. But, as the Tiananmen square massacre demonstrated, China is not democratic.
Indeed from what we can tell, the law on organ transplants is not now being enforced. Belgian Senator Patrik Vankrunkelsven, in late November 2006, called two different hospitals in Beijing pretending to be a customer for a kidney transplant. Both hospitals offered him a kidney on the spot for 50,000 euros.
As noted earlier, Deputy Health Minister Huang Jiefu in November 2006 decried the selling of organs from executed prisoners sentenced to death saying "Under‑the‑table business must be banned". Yet, it was already banned, on July 1. His speech must be taken as an official acknowledgment that the ban is not working.
The sort of transplants in which the Chinese medical system engages is illegal everywhere else in the world. But it is not illegal for a foreigner in any country to go to China, benefit from a transplant which would be illegal back home, and then return home. Foreign transplant legislation everywhere is territorial. It does not have extraterritorial reach.
Many other laws are global in their sweep. For instance, child sex tourists can be prosecuted not just in the country where they have sex with children, but, in many countries, back home as well. This sort of legislation does not exist for transplant tourists who pay for organ transplants without bothering to determine whether the organ donor has consented.
There have been some legislative initiatives. For instance, Belgian Senator Patrik Vankrunkelsven is proposing an extraterritorial criminal law which would penalize transplant tourists who purchase organs abroad where the donors are prisoners or missing persons. But these legislative proposals are still in an early stage.
Many states have travel advisories, warning their citizens of the perils in travel to one country to another. The advisories often warn of political violence, or even weather related problems. But no government has posted a travel advisory about organ transplants in China, warning its citizens that, in the words of The Transplantation Society, "almost all" organs in China come from prisoners.
Some, and we would hope, many would-be recipients of organ transplants would hesitate to go to China for transplants if they knew that their organs were coming from people who were non-consenting prisoners. But right now there is no systematic communication to would be recipients of the source of organs in China, either through governments or the medical profession
For instance, the Canadian travel advisory for China, posted on the Foreign Affairs web site gives extensive information, almost 2,600 words, and has a section about health. But organ transplants are not mentioned.
Organ transplantation surgery relies on anti-rejection drugs. China imports these drugs from the major pharmaceutical companies.
Transplant surgery used to require both tissue and blood type matching for the transplant to succeed. The development of transplant anti-rejection drugs has allowed for transplant surgery to circumvent tissue matching. It is possible, with heavy use of anti-rejection drugs, to transplant from a donor to a recipient whose tissues do not match. Only blood type matching is essential. Tissue matching is preferable, to avoid heavy reliance on anti-rejection drugs, but no longer essential. The Chinese medical system relies heavily on anti-rejection drugs.
International pharmaceutical companies behave towards the Chinese transplantation system the same way everyone else does. They ask no questions. They have no knowledge whether their drugs are being used in recipients who received organs from involuntary donor prisoners or not.
Many countries have export control acts, forbidding the export of some products altogether and requiring state permission for the export of other products. But no state, to our knowledge, prohibits export to China of anti-rejection drugs used for organ transplant patients.
For instance, the Canadian Export and Import Permits Act provides:
"No person shall export or attempt to export any goods included in an Export Control List or any goods to any country included in an Area Control List except under the authority of and in accordance with an export permit issued under this Act."
But anti-rejection drugs for transplants are not included in the Area Control list for China.
Some state administered health plans pay for health care abroad in the amount that would be paid if the care were administered in the home country. Where that happens, there is not, to our knowledge, in any country a prohibition of payment where the patient obtains an organ transplant in China.
Transplant tourists need aftercare in their home country. They continue to need prescription and administration of anti-rejection drugs. States which provide government funding for health services typically provide funding for this sort of after care.
Again here, to the funders how the organ recipient got the organ is a matter of indifference. The fact that the organ may have came from an unconsenting prisoner in China who was killed for the organ is simply not relevant to foreign state funding of aftercare for the recipient.
The overwhelming majority of prisoners of conscience in Chinese prisons are Falun Gong. An estimated two thirds of the torture victims in Chinese prisons are Falun Gong. The extremes of language the Chinese regime uses against the Falun Gong are unparalleled, unmatched by the comparatively mild criticisms China has of the victims the West is used to defending. The documented yearly arbitrary killings and disappearances of Falun Gong exceed by far the totals for any other victim group.
Why does the Chinese government denounce so viciously and repress so brutally this one group, more so than any other victim group? The standard Chinese refrain about the Falun Gong is that it is an evil cult.
Falun Gong has none of the characteristics of a cult. It has no memberships, no offices and no officers.
David Ownby, Director of the Centre of East Asian studies at the University of Montreal and a specialist in modern Chinese history, wrote about the Falun Gong in a paper prepared six years ago for the Canadian Institute of International Affairs. He stated that unlike cults, Falun Gong has no mandatory financial obligations, isolation of practitioners in communes or withdrawal from the world. He says:
"Falun Gong members remain within society. In a vast majority, they live within nuclear families. They go to work; they send their kids to school." 
There is no penalty for leaving the Falun Gong, since there is nothing to leave. Practitioners are free to practice Falun Gong as little or as much as they see fit. They can start and stop at any time. They can engage in their exercises in groups or singly.
Li Hongzhi, the author of the books which inspired Falun Gong practitioners, is not worshipped by practitioners. Nor does he receive funds from practitioners. He is a private person who meets rarely with practitioners. His advice to practitioners is publicly available information - conference lectures and published books.
The Chinese government labelling of the Falun Gong as an evil cult is a component of the repression of the Falun Gong, a pretext for that repression as well as a defamation, incitement to hatred, depersonalization, marginalization and dehumanization of the Falun Gong. But this labelling does not explain why that repression arose. The "evil cult" label is a manufactured tool of repression, but not its cause. The cause lies elsewhere.
In order to enforce conformity, Chinese exercise regimes or qigong in all their variations were suppressed in 1949 after the Chinese Communist Party seized office. By the 1990s, the police state environment had become less oppressive for all forms of qigong, including Falun Gong.
Falun Gong includes elements of Confucianism, Buddhism and Taoism. In essence, it teaches methods of meditation through exercises intended to improve physical and spiritual health and fitness. The movement has no political platform; its followers seek to promote truth, tolerance and forbearance across racial, national and cultural boundaries. Violence is anathema.
Li registered his movement with the government's Qigong Research Association. At a time when the movement was falling into official disfavour but before it was banned, in early 1998, Li moved to the United States. But Falun Gong continued to flourish. The Jiang government estimated in 1999 that there were 70 million adherents. That year, the Communist Party of China membership was an estimated 60 million.
Before Falun Gong was banned in July, 1999, its adherents gathered regularly throughout China to do their exercises. In Beijing alone there were more than 2000 practice stations.
The Communist Party, in April 1999, published an article in the magazine Science and Technology for Youth, which singled out Falun Gong as a superstition and a health risk because practitioners might refuse conventional medical treatments for serious illnesses. A large number of Falun Gong adherents demonstrated against the contents of the piece outside the Tianjin editor's office. Arrests and police beatings resulted.
To petition the Government Petition Office in Beijing about these arrests, on April 25th, 1999, 10,000‑15,000 Falun Gong practitioners gathered from dawn until late at night outside the Communist Party headquarters at Zhongnanhai next to Beijing's Forbidden City. The gathering was silent, without posters. Jiang was alarmed by the presence of these petitioners. The ideological supremacy of the Communist Party was, in his view, in danger.
If organ harvesting from Falun Gong practitioners were widespread across China, one would expect some governmental policy directive to that effect. Yet, the secrecy of policy formulation in China prevents us from determining whether such a policy exists.
Nonetheless, we do know that persecution of Falun Gong exists as an official policy. There are some very strong policy statements, attached as an appendix to this report, by the Government of China and the Communist Party of China, calling for the persecution of the Falun Gong, including physical persecution.
The Government of China set up a dedicated bureaucracy assigned with the task of repressing the Falun Gong. This dedicated bureaucracy has representatives throughout China. Because it was established on the tenth day of the six month of 1999, it is called, in shorthand, the 610 office. The 610 office has representatives in every province, city, county, university, government department and government-owned business in China.
According to Li Baigen, then assistant director of the Beijing Municipal Planning office who attended the meeting, during 1999 the three men heading the 610 office called more than 3,000 officials to the Great Hall of the People in the capital to discuss the campaign against Falun Gong, which was then not going well. Demonstrations were continuing to occur at Tiananmen Square. The head of the 610 office, Li Lanqing, verbally announced the government's new policy on the movement: "defaming their reputations, bankrupting them financially and destroying them physically." Only after this meeting were the deaths of adherents at police hands recorded as suicides.
The Falun Gong in China are dehumanized both in word and deed. Policy directives are matched by incitement to the population at large both to justify the policy of persecution, to recruit participants, and to forestall opposition. This sort of vocabulary directed against a particular group has become both the precursor and the hallmark of gross human violations directed against the group.
According to Amnesty International, the Chinese Government adopted three strategies to crush Falun Gong: violence against practitioners who refuse to renounce their beliefs; "brainwashing" to force all known practitioners to abandon Falun Gong and renounce it, and a media campaign to turn public opinion against Falun Gong. 
Local governments were authorized to implement Beijing's orders to repress the Falun Gong. Implementation meant, in part, staged attempts to demonstrate to China's population that practitioners committed suicide by self-immolation, killed and mutilated family members and refused medical treatment. Over time this campaign had the desired effect and many, if not most, Chinese nationals came to accept the Communist Party view about Falun Gong. The National People's Congress then passed laws purporting to legalize a long list of illegal acts done by Falun Gong practitioners against other practitioners.
This incitement to hatred is most acute in China. But it exists worldwide. Chinese officials, wherever they are posted, engage in this incitement as part and parcel of their official duties. In Edmonton, Alberta, Canada, this behaviour became the subject of a police recommendation for prosecution of two Chinese consular officials in Calgary for wilful promotion of hatred against the Falun Gong. The police report is attached as an exhibit to this report.
Incitement to hatred is not specific enough to indicate the form that persecution takes. But it promotes any and all violations of the worst sort. It is hard to imagine the allegations we have heard being true in the absence of this sort of hate propaganda. Once this sort of incitement exists, the fact that people would engage in such behaviour against the Falun Gong ‑ harvesting their organs and killing them in the process ‑ ceases to be implausible.
Former president Jiang's mandate to the 610 office was to "eradicate" Falun Gong. An appendix gives extensive detail about this attempt at eradication through persecution.
The UN Special Rapporteur on Torture's recent report  noted that
"Since 2000, the Special Rapporteur and his predecessors have reported 314 cases of alleged torture to the Government of China. These cases represent well over 1,160 individuals." And "In addition to this figure, it is to be noted that one case sent in 2003 (E/CN.4/2003/68/Add.1 para. 301) detailed the alleged ill treatment and torture of thousands of Falun Gong practitioners."
Furthermore, the report indicated that 66% of the victims of alleged torture and ill‑treatment in China were Falun Gong practitioners, with the remaining victims comprising Uighurs (11%), sex workers (8%), Tibetans (6%), human rights defenders (5%), political dissidents (2%), and others (persons infected with HIV/AIDS and members of religious groups 2%).
Part of a wire story from the Beijing bureau of the Washington Post fully two summers later (5 Aug 2001)  illustrates the severity of the ongoing methods of the 610 office and other agents of the regime against Falun Gong practitioners:
"At a police station in western Beijing, Ouyang was stripped and interrogated for five hours. 'If I responded incorrectly, that is if I didn't say, 'yes,' they shocked me with the electric truncheon,' he said. Then, he was transferred to a labour camp in Beijing's western suburbs. There, the guards ordered him to stand facing a wall. If he moved, they shocked him. If he fell down from fatigue, they shocked him..."
"(Later) he was taken before a group of Falun Gong inmates and rejected the group one more time as the video cameras rolled. Ouyang left jail and entered the brainwashing classes. Twenty days after debating Falun Gong for 16 hours a day, he 'graduated'. 'The pressure on me was and is incredible,' he said. 'In the past two years, I have seen the worst of what man can do. We really are the worst animals on Earth.'"
Ownby noted that human rights organizations
"have unanimously condemned China's brutal campaign against the Falungong, and many governments around the world, including Canada's, have expressed their concern."
He cited Amnesty International's report of 2000 which noted that 77 Falun Gong practitioners had "died in custody, or shortly after release, in suspicious circumstances since the crackdown began in July 1999."
Massive arrests of practitioners are a form of physical persecution which deserves separate attention because of its potential link to organ harvesting. Any person organ harvested against his or her will has to be detained first.
Repression of Falun Gong included sending thousands upon thousands of its practitioners to prisons and labour camps beginning in the summer of 1999. The US State Department's 2005 country report on China , for example, indicates that its police run hundreds of detention centres, with the 340 re-education-through-labour ones alone having a holding capacity of about 300,000 persons. The report also indicates that the number of Falun Gong practitioners who died in custody was estimated to be from a few hundred to a few thousand.
Hundreds of thousands of Falun Gong practitioners travelled to Beijing to protest or to unfold banners calling for the group's legalization. People came almost daily. Author Jennifer Zeng, formerly of Beijing and now living in Australia, informs us that by the end of April 2001 there had been approximately 830,000 arrests in Beijing of Falun Gong adherents who had been identified. There are no statistics available of practitioners who were arrested but refused to self identify. From our interviews with released Falun Gong practitioners we know that the number of those who did not self identify is large. But we do not know how large.
Large numbers of Falun Gong adherents in arbitrary indefinite secret detention alone do not prove the allegations. But the opposite, the absence of such a pool of detainees, would undermine the allegations. An extremely large group of people subject to the exercise of the whims and power of the state, without recourse to any form of protection of their rights, provides a potential source for organ harvesting of the unwilling.
As of December 22, 2006, we have identified 3006 Falun Gong practitioners who died as a result of persecution. These identified victims can be gathered into six groups.
One group is the victims who died from stress related causes precipitated by constant harassment and threats from the authorities. A second is those mistreated in detention and then released alive to their families, but who died subsequently of their mistreatment. The third group is the victims who died in detention of torture and whose bodies were released by the authorities to the family for cremation. The fourth is the victims who died in detention of mistreatment and were cremated while still detained, but whose families got to see the bodies in between death and cremation. The fifth is the victims who died and were cremated in detention without the families ever seeing the bodies. The sixth is the victims who died in detention but we do not have enough information to determine whether the families saw the bodies before cremation.
The bulk of the possible Falun Gong victims of organ harvesting are, from what we can tell, those whose families were not notified of the deaths of their loved ones. This failure to notify had two causes. One was that the practitioners refused to identify themselves to the authorities. The other was that the authorities, though they knew who the practitioners were, refused to notify the families of their detention; as well, these practitioners were not, before death, allowed to contact their families.
However, we can not exclude the possibility that the fifth and sixth group of the identified dead were also victims of organ harvesting. This group numbers about 300. The fifth group in particular raise suspicions. Their names are listed in an appendix.
The large number of Falun Gong practitioners killed by the authorities through torture supports the allegation we are investigating. When the life of Falun Gong practitioners is cheap, there is no particular reason to rule out one cause of death. If the Government of China is willing to kill large number of Falun Gong practitioners through torture, it is not that hard to believe they would be willing to do the same through organ harvesting.
Falun Gong detentions, though in some ways they are just Chinese repression as usual with the Falun Gong being the unlucky targets, present an unusual feature. Falun Gong practitioners who came from all over the country to Tiananmen Square in Beijing to appeal or protest were systematically arrested. Those who revealed their identities to their captors would be shipped back to their home localities. Their families would be implicated in their Falun Gong activities and pressured to join in the effort to get the practitioners to renounce Falun Gong. Their workplace leaders, their co-workers, their local government leaders would be held responsible and penalized for the fact that these individuals had gone to Beijing to appeal or protest.
To protect their families and avoid the hostility of the people in their locality, many detained Falun Gong declined to identify themselves. The result was a large Falun Gong prison population whose identities the authorities did not know. As well, no one who knew them knew where they were.
Though this refusal to identify themselves was done for protection purposes, it may have had the opposite effect. It is easier to victimize a person whose whereabouts is unknown to family members than a person whose location the family knows. This population is a remarkably undefended group of people, even by Chinese standards.
Those who refused to self identify were treated especially badly. As well, they were moved around within the Chinese prison system for reasons not explained to the prisoners.
Was this a population which became a source of harvested Falun Gong organs? Obviously, the mere existence of this population does not tell us that this is so. Yet, the existence of this population provides a ready explanation for the source of harvested organs, if the allegations are true. Members of this population could just disappear without anyone outside of the prison system being the wiser.
For the authors, the investigations which led to this report had many chilling moments. One of the most disturbing was the discovery of this massive prison/detention/labour camp population of the unidentified. Practitioner after practitioner who eventually was released from detention told us about this population. A collection of some of their statements is attached as an exhibit.
What these practitioners told us was that they personally met the unidentified in detention, in significant numbers. Though we have met many Falun Gong practitioners who were released from Chinese detention, we have yet to meet or hear of, despite their large numbers, a practitioner released from detention who refused to self identify in detention from the beginning to the end of the detention period. What happened to these many practitioners? Where are they?
The problem of enforced disappearances is distinguishable from the problem of the unidentified, because, in the case of enforced disappearances, families know that the state is involved. For the unidentified, all the families know is that they have lost track of a loved one. For those victims of enforced disappearances, the families or witnesses know more. They know that the person was at one time in the custody of the state. The state either refuses to acknowledge that the person was ever in their custody or conceals the fate or whereabouts of the person.
There are some Falun Gong practitioners who have disappeared, abducted by the authorities. However, the only disappearances case of which we know are people who were subsequently released and then spoke of their abduction. We know that these victims were made to disappear only after the fact, once they reappeared. It is likely that there are other such practitioners who were never released.
For the unidentified, because family members know only that they have lost contact with a loved one, they do not necessarily turn to the state to ask if the person has been detained. When the person who is missing is the adherent to a practise which is brutally repressed by the state, the tendency of the family to avoid the government is heightened. Nonetheless a few have sought out Chinese government help to find a missing Falun Gong practitioner family member. Some of those cases are listed in an appendix to this report.
Falun Gong practitioners in detention are systematically blood tested and organ examined. Other prisoners, who are not practitioners, sitting side by side, with practitioners are not tested. This differential testing occurs in labour camps, prisons and detention centres. We have heard such a large number of testimonials to this effect that this differential testing exists beyond a shadow of a doubt. These tests and examination happen whether practitioners are held at labour camps, prisons or detention centres. Interview statements testifying to systematic blood testing and organ examination of Falun Gong practitioners to the exclusion of other prisoners are attached as an appendix to this report.
The practitioners themselves are not told the reason for the testing and examination. It is unlikely that the testing and examination serves a health purpose. For one, it is unnecessary to blood test and organ examine people systematically simply as a health precaution. For another, the health of the Falun Gong in detention is disregarded in so many other ways, it is implausible that the authorities would blood test and organ examine Falun Gong as a precautionary health measure.
Blood testing is a pre‑requisite for organ transplants. Donors need to be matched with recipients so that the antibodies of the recipients do not reject the organs of the donors.
The mere fact of blood testing and organ examination does not establish that organ harvesting of Falun Gong practitioners is taking place. But the opposite is true. If there were no blood testing, the allegation would be disproved. The widespread blood testing of Falun Gong practitioners in detention cuts off this avenue of disproof.
The numbers of organ transplants in China is huge, up to 20,000 in 2005 according to China Daily. China has the second largest number of operations done in the world, just after USA.
The large volumes coupled with the short waiting times means that there has to be a large number of potential donors on hand at any one time. Where is and who is this large donor population?
There are many more transplants than identifiable sources. We know that some organs come from prisoners sentenced to death and then executed. Very few come from willing donor family members and the brain dead. But these sources leave huge gaps in the totals. The number of prisoners sentenced to death and then executed and willing sources come nowhere close to the number of transplants.
The number of prisoners sentenced to death and then executed is itself not public. We are operating only from numbers provided by Amnesty International sourced from Chinese public records. Those numbers, when one considers global execution totals, are large, but nowhere near the estimated totals of transplants.
At least 98% of the organs for transplants come from someone other than family donors.9 In the case of kidneys, for example, only 227 of 40,393 transplants - about 0.6% - done between 1971 and 2001 in China came from family donors. 
The government of China admitted to using the organs of prisoners sentenced to death and then executed only in 2005  , although it had been going on for many years. The regime has had no barriers to prevent marketing the organs of "enemies of the state".
According to tabulations constructed from the Amnesty International reports  of publicly available information in China, the average number of prisoners sentenced to death and then executed between 1995 and 1999 was 1680 per year. The average between 2000 and 2005, was 1616 per year. The numbers have bounced around from year to year, but the overall average number for the periods before and after Falun Gong persecution began is the same. Execution of prisoners sentenced to death can not explain the increase of organ transplants in China since the persecution of Falun Gong began.
According to public reports, there were approximately 30,000  transplants in total done in China before 1999 and 18,500 
41 in the six year period 1994 to 1999. Shi Bingyi, vice‑chair of the China Medical Organ Transplant Association, says there were about 90,000  transplants in total up until 2005, leaving about 60,000 transplants in the six year period 2000 to 2005 since the persecution of Falun Gong began.
The other identified sources of organ transplants, willing family donors and the brain dead, have always been tiny. In 2005, living-related kidney transplants consisted of 0.5% of total transplants . The total of brain dead donors for all years and all of China is 9 up to March 2006
44 . There is no indication of a significant increase in either of these categories in recent years. Presumably the identified sources of organ transplants which produced 18,500 organ transplants in the six year period 1994 to 1999 produced the same number of organs for transplants in the next six year period 2000 to 2005. That means that the source of 41,500 transplants for the six year period 2000 to 2005 is unexplained.
Where do the organs come from for all the transplants in China? The allegation of organ harvesting from Falun Gong practitioners provides an answer.
Again this sort of gap in the figures does not establish that the allegation of harvesting of organs from Falun Gong practitioners is true. But the converse, a full explanation of the source of all organ transplants, would disprove the allegation. If the source of all organ transplants could be traced either to willing donors or executed prisoners, then the allegation against the Falun Gong would be disproved. But such tracing is impossible.
Estimates of executions in China of prisoners sentenced to death are often much higher than the figures based on publicly available records of executions. There is no official Chinese reporting on overall statistics of executions, leaving totals open to estimation.
One technique some of those involved in estimating executions have used is the number of transplant operations. Because it is known that at least some transplants come from executed prisoners and that family donors are few and far between, some analysts have deduced from the number of transplants that execution of prisoners sentenced to death have increased.
This reasoning is unpersuasive. One cannot estimate execution of prisoners sentenced to death from transplants unless executions of prisoners sentenced to death are the only alleged source of transplants. Yet, Falun Gong practitioners are another alleged source. It is impossible to conclude that those practitioners are not a source of organs for transplants because of the number of executions of prisoners sentenced to death where the number of executions of prisoners sentenced to death is deduced from the number of transplants.
Can the increase in transplants be explained by increased efficiency in harvesting from prisoners sentenced to death and then executed? The increase in transplants in China paralleled both the persecution of the Falun Gong and the development of some transplant technology. But the increase in transplants did not parallel the increase of all transplant technology. Kidney transplant technology was fully developed in China long before the persecution of Falun Gong began. Yet kidney transplants shot up, more than doubling once the persecution of Falun Gong started. There were 3,596 37 kidney transplants in 1998 and nearly 10,000 in 2005 43.
A second reason that multiple organ harvesting from executed prisoners sentenced to death does not explain the increase in organ transplants is overall disorganization of organ matching in China. There is no national network for the matching and sharing of organs. Doctors decry the wastage of organs from donors, bemoaning the fact that “only kidneys were used from donors, wasting of other organs” 46 . Each hospital manages its own organ supply and waiting list. Patients go from one hospital where there are no ready organs for transplants to other hospitals were transplant surgery takes place at once.  Hospitals refer patients from their own hospital where they say they have no readily available organs for transplant to another hospital which they say does have organs for transplant.  This disorganization diminishes the efficient use of organs.
A third reason that multiple organ harvesting from executed prisoners sentenced to death does not explain the increase in organ transplants is the experience elsewhere. Nowhere have transplants jumped so significantly with the same number of donors, simply because of a change in technology. Year by year statistics for Canada, the United States and Japan are set out in an appendix.
The increase in organ transplants in China parallels the increase in persecution of the Falun Gong. These parallel increases of Falun Gong persecution and transplants, in themselves, do not prove the allegation. But they are consistent with the allegation. If the parallel did not exist, that hypothetical non‑existence would undercut the allegations.
Organ transplant surgery in China is a booming business. There were only 22 liver transplant centres  operating across China before 1999 and 500 in mid - April, 2006
8 . The number of kidney transplantation institutions increased from 106 in 2001 to 368 in 2005.
The money to be made has led to the creation of dedicated facilities, specializing in organ transplants. There is the Peking University Third Hospital Liver Transplantation Centrefounded in October 2002, the Beijing Organ Transplantation Centre  established in November 2002, the Organ Transplant Centre of the People's Liberation Army Number 309 Hospital  established in April 2002, the People's Liberation Army Organ Transplant Research Institute  (Organ Transplant Centre of the Shanghai Changzheng Hospital) established in May 2004 and the Shanghai Clinical Medical Centre for Organ Transplants established in 2001. The Oriental Organ Transplant Centre  in Tianjin began construction in 2002. It is fourteen floors above ground and two floors underground with 300 beds. It is a public facility, built by Tianjin City. It is the largest transplant centre in Asia.
The establishment of these facilities is both an indicator of the volume of organ transplants and a commitment to their continuation. The creation of whole facilities dedicated to organ transplants bespeaks long term planning.
Yet, the organ source for virtually all Chinese transplants is prisoners. There is a debate which this report addresses whether these prisoners have all previously been sentenced to death or whether some of them are detained Falun Gong practitioners who have been sentenced to jail terms only or not sentenced at all. But there is no debate over whether the sources of organs are prisoners; that much is incontestable. The establishment of dedicated organ transplant facilities in China is an overt assertion of the intent to continue organ harvesting from prisoners.
Yet, the Government of China has, both in law and through official statements, said that it would cease organ harvesting from prisoners sentenced to death who do not consent to organ harvesting. And, as set out elsewhere in this report, there is no such thing as meaningful consent to organ harvesting from a prisoner sentenced to death.
The creation of these dedicated facilities raises the question not only what has been the source for so many organs transplanted in the past, but, as well, what will be the source for so many organs which China intends to transplant in the future? From whom will these organs come? The source of prisoners sentenced to death will presumably disappear or diminish substantially if China is genuine in applying to this population its law and stated policy about requiring consent of donors.
The Chinese authorities, to build these dedicated organ transplant institutions, must have the confidence that there exists now and into the foreseeable future a ready source of organs from people who are alive now and will be dead tomorrow. Who are these people? A large prison population of Falun Gong practitioners provides an answer.
A number of family members of Falun Gong practitioners who died in detention reported seeing the corpses of their loved ones with surgical incisions and body parts missing. The authorities gave no coherent explanation for these mutilated corpses. Again the evidence about these mutilated corpses is attached as an appendix to this report.
We have only a few instances of such mutilated corpses. We have no official explanation why they were mutilated. Their mutilation is consistent with organ harvesting.
In the first version of our report, appendix twelve had a photo of a person with stitches after his body was cut open to remove organs. One comment we received back is that the stitches the photos show are consistent with an autopsy.
We observe that organs may indeed be removed for autopsies in order to determine the cause of death. A corpse which has been autopsied may well have stitches similar to those shown in the photo. Outside of China, except for organ donors, that is likely the reason why organs would be removed from a corpse. Similarly, outside of China, when people are blood tested, typically, the test is done for their own health. However, the suggestion that Falun Gong practitioners who are tortured to the point of death are blood tested for their health or that practitioners who are tortured to death are autopsied to determine the cause of death belies the torture experience.
The corpse whose photo we reproduced was that of Wang Bin. Beatings caused the artery in Mr. Wang's neck and major blood vessels to break. As a result, his tonsils were injured, his lymph nodes were crushed, and several bones were fractured. He had cigarette burns on the backs of his hands and inside his nostrils. There were bruises all over his body. Even though he was already close to death, he was tortured again at night. He finally lost consciousness. On the night of October 4, 2000, Mr. Wang died from his injuries.
The purpose of an autopsy report is to determine the cause of death when the cause is otherwise unknown. But in the case of Wang Bin, the cause of death was known before his organs were removed. The suggestion that Wang Bin would be autopsied to determine the cause of death after he was tortured to death is not plausible. There was no indication that the family of Wang Bin was asked for consent before the organs of the victim were removed nor provided an autopsy report afterwards. The suggestion of an autopsy is not a tenable explanation for the stitches on Wang Bin's body.
Mandarin speaking investigators called in to a number of hospitals and transplant doctors to ask about transplants. The callers presented themselves as potential recipients or relatives of potential recipients. Phone numbers were obtained from the internet. These calls resulted in a number of admissions that Falun Gong practitioners are the sources of organ transplants. Since our last report, there are further calls with admissions set out in an appendix.
If the phone numbers was a general number of a hospital, the callers usually started with asking to be connected to the transplant department of the hospital and they first spoke with whoever picked up the phone for some general information of transplant operations. Usually the person would help to locate a doctor or the chief‑physician of the transplant department to speak to the caller. If the doctor was not available, the caller would then call back to look for this specific doctor or chief‑physician next time she called and speak to the doctor, or chief physician.
Usually hospital staff talked to people (or family members) wanting organ transplants, and actively located relevant doctors for them.
Although callers always began by speaking to a hospital or a doctor, sometimes they were referred to prisons or courts, because these were the distribution points for harvested organs. It may seem strange to call a court about organ availability; but systematic organ harvesting in China began with executed prisoners sentenced to death even if it did not end there. It seems that the distribution point for organs from people in the prison system remained the same after China moved on from harvesting organs from prisoners sentenced to death to other prisoners.
One of the callers, "Ms. M", told one of us that in early March, 2006 she managed to get through to the Public Security Bureau in Shanxi. The respondent there told her that healthy and young prisoners are selected from the prison population to be organ donors. If the candidates could not be tricked into providing the blood samples necessary for successful transplants, the official went on with guileless candour, employees of the office take the samples by force.
On March 18 or 19, 2006 M spoke to a representative of the Eye Department at the People's Liberation Army hospital in Shenyang in north-eastern China, although she was not able to make a full recorded transcript. Her notes indicate that the person identifying himself as the hospital director said the facility did "many cornea operations", adding that "we also have fresh corneas." Asked what that means, the director replied "...just taken from bodies".
At Army Hospital 301 in Beijing in April, 2006, a surgeon told M that she did liver transplants herself. The surgeon added that the source of the organs was a "state secret" and that anyone revealing the source "could be disqualified from doing such operations."
In early June, 2006, an official at the Mishan city detention centre told a telephone caller that the centre then had at least five or six male Falun Gong prisoners under 40 years of age available as organ suppliers. A doctor at Shanghai's Zhongshan hospital in mid March of 2006 said that all of his organs come from Falun Gong practitioners. A doctor at Qianfoshan hospital in Shandong in March implied that he then had organs from Falun Gong persons and added that in April there would be "more of these kinds of bodies..." In May, Dr. Lu of the Minzu hospital in Nanning city said organs from Falun Gong practitioners were not available at his institution and suggested the caller call Guangzhou to get them. He also admitted that he earlier went to prisons to select healthy Falun Gong persons in their 30s to provide their organs.
In mid - March of 2006, Dr. Wang of Zhengzhou Medical University in Henan province agreed that "we pick all the young and healthy kidneys..." Dr. Zhu of the Guangzhou Military region hospital in April of 2006 said he then had some type B kidneys from Falun Gong, but would have "several batches" before May 1 and perhaps no more until May 20 or later. An official at the first detention centre in Qinhuangdao city in Liaoning province told a caller in mid May 2006 that she should call the Intermediate People's court to obtain Falun Gong kidneys. The same day, an official at that court said they had no Falun Gong live kidneys, but had had them in the past, specifically in 2001. Finally, the First Criminal Bureau of the Jinzhou people's court in May of 2006 told the caller that access to Falun Gong kidneys currently depended on "qualifications".
Director Song at the Tianjin city central hospital in mid March 2006 volunteered that his hospital had more than ten beating hearts. The caller asked if that meant "live bodies" and Song replied, "Yes it is so." An official at the Wuhan city Tongji hospital two weeks later tells the caller that "(i)t's not a problem” for his institution when the caller says, "...we hope the kidney suppliers are alive. (We're) looking for live organ transplants from prisoners, for example, using living bodies from prisoners who practise Falun Gong, Is it possible?"
The map of China which follows indicates the regions where detention or hospital personnel have made admissions to telephone investigators:
Most of the excerpted phone call texts are in an appendix. For illustration purposes, excerpts of three conversations follow:
(1) Mishan City Detention Centre, Heilongjiang province (8 June 2006):
M: "Do you have Falun Gong [organ] suppliers? ..."
Li: "We used to have, yes."
M: "... what about now?"
Li: "... Yes."
M: "Can we come to select, or you provide directly to us?"
Li: "We provide them to you."
M: "What about the price?"
Li: "We discuss after you come."
M: "... How many [Falun Gong suppliers] under age 40 do you have?"
Li: "Quite a few."
M: "Are they male or female?"
M: "Now, for ... the male Falun Gong [prisoners], How many of them do you have?"
Li: "Seven, eight, we have [at least] five, six now."
M: "Are they from countryside or from the city?"
(2) Nanning City Minzu Hospital in Guangxi Autonomous Region
(22 May 2006):
M: "...Could you find organs from Falun Gong practitioners?"
Dr. Lu: "Let me tell you, we have no way to get (them). It's rather difficult to get it now in Guangxi. If you cannot wait, I suggest you go to Guangzhou because it's very easy for them to get the organs. They are able to look for (them) nation wide. As they are performing the liver transplant, they can get the kidney for you at the same time, so it's very easy for them to do. Many places where supplies are short go to them for help..."
M: "Why is it easy for them to get?"
Lu: "Because they are an important institution. They contact the (judicial) system in the name of the whole university."
M: "Then they use organs from Falun Gong practitioners?"
M: "...what you used before (organs from Falun Gong practitioners), was it from detention centre(s) or prison(s)?"
Lu: "From prisons."
M: "...and it was from healthy Falun Gong practitioners...?"
Lu: "Correct. We would choose the good ones because we assure the quality in our operation."
M: "That means you choose the organs yourself."
M: "Usually, how old is the organ supplier?"
Lu: "Usually in their thirties."
M: "... Then you will go to the prison to select yourself?"
Lu: "Correct. We must select it."
M: "What if the chosen one doesn't want to have blood drawn?"
Lu: "He will for sure let us do it."
Lu: "They will for sure find a way. What do you worry about? These kinds of things should not be of any concern to you. They have their procedures."
M: "Does the person know that his organ will be removed?"
Lu: "No, he doesn't."
(3) Oriental Organ Transplant Centre (also called Tianjin City No 1 Central Hospital), Tianjin City, (15 March 2006):
N: Is this Director Song?"
Song: Yes, please speak."
N: Her doctor told her that the kidney is quite good because he
[the supplier,] practises ...Falun Gong."
Song: Of course. We have all those who breathe and with heart beat...Up until now, for this year, we have more than ten kidneys, more than ten such kidneys."
N: "More than ten of this kind of kidneys? You mean live bodies?"
Song: "Yes it is so."
Caller M called about 80 some hospitals. When calling hospitals in some cases M asked for specific doctors in the called hospitals, and was able to speak to transplant doctors. 10 hospitals admitted they use Falun Gong practitioners as organ suppliers. M also called back to talk to the doctors. 5 hospitals said they can obtain Falun Gong practitioners as organ suppliers. 14 hospitals admitted they use live organs from prisoners. 10 hospitals said the source of organs is a secret and they could not reveal it over the phone.
Caller N made calls to close to 40 hospitals in China, out of which 5 admitted to using Falun Gong practitioner organs. N also called back to talk to the doctors who made these admissions. They were still reachable at the hospitals. N also made calls to 36 various detention centres and the Courts in China, out of which 4 admitted to using Falun Gong practitioner organs.
When calling hospitals, in some cases N would ask for specific doctors in the hospitals called and was able to speak to transplant doctors. N's style was to ask directly the called party, the doctors in the hospitals etc, if they use Falun Gong practitioners' organs.
The typical response she got was that the caller did not expect this question at all, and would pause for a while to think how to respond. After the pause, about 80% did not admit that they used Falun Gong practitioners' organs. About 80% of those who did not admit to using Falun Gong practitioners' organs did admit that they use live bodies who are prisoners. Less than 10 people simply hung up the phone once they heard the question about Falun Gong practitioners.
One of us has listened with a certified Mandarin‑English interpreter to the quoted recorded telephone conversations between officials and callers on behalf of the Falun Gong communities in Canada and the United States. Certified copies of the relevant transcripts in Mandarin and English were provided to us.
The accuracy of the translations of the portions of them used in this report is attested to by the certified translator, Mr. C. Y., a certified interpreter with the Government of Ontario. He certified that he had listened to the recording of the conversations referred to in this report and has read the transcripts in Chinese and the translated English version of the conversations, and verifies that the transcripts are correct and translations accurate. The original recordings of the calls remain available as well. One of us met with two of the callers in Toronto on May 27th to discuss the routing, timing, recording, accuracy of the translations from Mandarin to English and other features of the calls.
We conclude that the verbal admissions in the transcripts of interviews of investigators can be trusted. There is no doubt in our minds that these interviews did take place with the persons claimed to be interviewed at the time and place indicated and that the transcripts accurately reflect what was said.
Moreover, the content of what was said can itself be believed. For one, when weighed against the recent international uproar about alleged organ seizures as the 2008 Beijing Olympics approach, the admissions made at the various institutions are contrary to the reputational interests of the government of China in attempting to convince the international community that the widespread killing of Falun Gong prisoners for their vital organs has not occurred.
A woman using the pseudonym Annie told us that her surgeon husband told her that he personally removed the corneas from approximately 2,000 anaesthetized Falun Gong prisoners in Sujiatun hospital in Shenyang City in northeast China during the two year period before October, 2003, at which time he refused to continue. The surgeon made it clear to his wife that none of the cornea "donors" survived the experience because other surgeons removed other vital organs and all of their bodies were then burned. Annie is not a Falun Gong practitioner.
Annie had earlier told the Epoch Times in a story published in its March 17 issue:
"One of my family members was involved in the operation to harvest Falun Gong practitioners' organs. This brought great pain to our family."
Her interview led to a controversy about whether or not she was telling the truth. For the first version of our report, released on July 7, 2006, we sidestepped the controversy that had arisen about the credibility of her testimony. We interviewed Annie even for our first report. However, the detail she provided posed a problem for us because it provided a good deal of information which it was impossible to corroborate independently. We were reluctant to base our findings on sole source information. So, in the end, we relied on what Annie told us only where it was corroborative and consistent with other evidence, rather than as sole source information.
For this version of our report, we engage the controversy directly. We accept that what Annie says her husband told her was not only told to her but also is credible. Annie's testimony goes a long way to establish, all on its own, the allegation. In an appendix about Sujiatun, we go in detail through the various points in dispute generated by her March 17 interview with the Epoch Times.
There have been two investigations independent from our own which have addressed the same question we have addressed, whether there is organ harvesting of Falun Gong practitioners in China. Both have come to the same conclusion we did. These independent investigations corroborate our own conclusion.
A study by Kirk Allison, associate director of the program in human rights and medicine at the University of Minnesota, was undertaken before our report was released. Though his study was released shortly after our own, on July 25, 2006, Dr. Allison had reached his conclusions earlier, before we released our report. He too concluded that organ harvesting from Falun Gong practitioners was happening.
The other investigation was undertaken by European Parliament Vice President Edward McMillan-Scott. Unlike Dr. Allison and ourselves, Mr. McMillan-Scott was actually able to go to China on a fact finding mission on May 19-21, 2006. There he interviewed two witnesses Cao Dong and Niu Jinping. About his meeting with Cao Dong, Mr. McMillan‑Scott reports that he
"enquired whether he was aware of any organ harvesting camps in China. He said he definitely knew of them and knew people who had been sent to them. He had seen the cadaver of one of his friends, a Falun Gong practitioner, with holes in his body where the organs had been removed."
After Cao Dong left his meeting with McMillan Scott, he was arrested. The authorities in September transferred him to Gansu province and issued an arrest warrant. He was prosecuted in December on four charges. The judges ruled that the case could not go to trial because the case fell within the jurisdiction of the 610 Office in Beijing [the office charged with repression of the Falun Gong.
33) Government of China responses
The Government of China has responded to the first version of our report in an unpersuasive way. Mostly, the responses have been attacks on the Falun Gong. The fact that the Government of China would make attacks on Falun Gong the focus of their responses to our report reinforces the analysis of the report. It is these sorts of attacks which, in China, make possible the violation of the basic human rights of Falun Gong practitioners.
The responses have identified only two factual errors in the first version of our report. In an appendix, in a caption heading, we placed two Chinese cities in the wrong provinces. These errors have nothing to do with the analysis or conclusions of our report.
In an appendix we go into greater detail about the Chinese responses and our reactions to them. Here we note that the fact the Government of China, with all the resources and information at its disposal, resources and information we do not have, was not able to contradict our report in any other way than this suggests that our conclusions are accurate.
G. Further Research
We do not consider even this second version to be the final word on this subject. There is much that we ourselves, given the opportunity, would rather do before we completed this version of the report. But it would mean pursuing avenues of investigation which are not now open to us. We will welcome any comments on its contents or any additional information individuals or governments might be willing to provide.
We would like to see Chinese hospital records of transplants. Are there consents on file? Are there records of sources of organs?
Donors can survive many forms of transplant operations. No one can survive a full liver or heart donation. But kidney donations are normally not fatal. Where are the surviving donors? We would like to do a random sampling of donations to see if we could locate the donors.
Family members of deceased donors should either know of the consents of the donors, or alternatively, the family members should have given the consents themselves. Here, too, we would like to do a random sampling of immediate family members of deceased donors to see if the families either consented themselves to the donations or were aware of the consent of the donor.
China has engaged in a major expansion of organ transplant facilities in recent years. This expansion likely would have been accompanied by feasibility studies indicating organ sources. We would like to see these feasibility studies.
Based on our further research, we are reinforced in our original conclusion that the allegations are true. We believe that there has been and continues today to be large scale organ seizures from unwilling Falun Gong practitioners.
We have concluded that the government of China and its agencies in numerous parts of the country, in particular hospitals but also detention centres and 'people's courts', since 1999 have put to death a large but unknown number of Falun Gong prisoners of conscience. Their vital organs, including kidneys, livers, corneas and hearts, were seized involuntarily for sale at high prices, sometimes to foreigners, who normally face long waits for voluntary donations of such organs in their home countries.
How many of the victims were first convicted of any offence, serious or otherwise, in legitimate courts, we are unable to estimate because such information appears to be unavailable both to Chinese nationals and foreigners. It appears to us that many human beings belonging to a peaceful voluntary organization made illegal eight years ago by President Jiang because he thought it might threaten the dominance of the Communist Party of China have been in effect executed by medical practitioners for their organs.
Our conclusion comes not from any one single item of evidence, but rather the piecing together of all the evidence we have considered. Each portion of the evidence we have considered is, in itself, verifiable and, in most cases, incontestable. Put together, they paint a damning whole picture. It is their combination that has convinced us.
1) The current form of dialogue between Canada and China over human rights should cease. In hindsight, the Government erred in agreeing to the talk fests in exchange for Canada no longer co-sponsoring the yearly motion criticizing China's government at the then UN Human Rights Commission.
2) All detention facilities, including forced labour camps, must be opened for international community inspection through the International Committee for the Red Cross or other human rights or humanitarian organization.
3) The sentence against Gao Zhisheng should be lifted. His right to practise his profession should be restored.
4) China and every other state now party to the Convention against Torture, including Canada, should accede to the Optional Protocol to the Convention against Torture.
b) Organ Harvesting
5) Organ harvesting in China from prisoners should cease.
6) The military in China should get out of the organ transplant business.
7) Organ harvesting of unwilling donors where it is either systematic or widespread is a crime against humanity. Criminal authorities in China should investigate the charge of organ harvesting from unwilling donors for possible prosecution.
8) Foreign states should enact extra-territorial legislation penalizing participation in organ harvesting without consent.
9) State medical funding systems should deny reimbursement for commercial organ transplants abroad and aftercare funding for those benefiting from such transplants.
10) Any person known to be involved in trafficking in the organs of prisoners in China should be barred entry by all foreign countries.
11) Until China stops harvesting organs from prisoners of any sort,
i) foreign governments should not issue visas to doctors from China seeking to travel abroad for the purpose of training in organ or bodily issue transplantation,
ii) foreign medical transplant personnel should not travel to China for training or collaboration in transplant surgery,
iii) contributions to scholarly journals on transplant research drawn from the Chinese experience should be rejected,
iv) medical professionals abroad should actively discourage their patients from travelling to China for transplant surgery,
v) pharmaceutical companies should not export anti-rejection drugs or any other drugs solely used in transplantation surgery to China,
vi) foreign states should ban the export of anti-rejection drugs or any other drugs solely used in transplantation surgery to China.
12) The onus should be on foreign professionals to determine beyond any reasonable doubt that the source of organ donation in China is voluntary before there is any referral to China or any cooperation with China relating to organ transplants.
13) The medical profession in every foreign country should set up a voluntary reporting system to accumulate aggregate data about patients who have travelled to China for transplants.
14) Chinese hospitals should keep records of the source of every transplant. These records should be available for inspection by international human rights officials.
15) Every organ transplant donor should consent to the donation in writing. These consents should be available for inspection by international human rights officials.
16) The Government of China should promote voluntary organ donation from its own population.
17) Foreign states should issue travel advisories warning its population that organ transplants in China are sourced almost entirely from unconsenting prisoners, whether sentenced to death or Falun Gong practitioners.
C) Falun Gong
18) The repression, imprisonment and mistreatment of Falun Gong practitioners should stop.
19) The harvesting of organs of Falun Gong practitioners should cease.
20) Governmental, non-governmental and inter-governmental human rights organizations should take seriously the charges this report addresses and make their own determinations whether or not they are true.
To accept the recommendation that the harvesting of organs of unwilling Falun Gong practitioners should cease would mean accepting that the allegations are true. All the other recommendations we make do not require accepting that the allegations are true. We suggest adoption of these other recommendations in any case.
Most of the recommendations make sense and could be implemented whether the allegations are true or false. Several recommendations are addressed to the international community, asking the community to promote respect within China of international standards about organ transplants.
We are well aware that the Government of China denies the allegations. We suggest that the most credible and effective way from the Government of China to assert that denial is to implement all of the recommendations addressed to it which could be implemented whether the allegations are true or false. If these recommendations were implemented, the allegations considered here could no longer be made.
To all those are sceptical about the allegations, we ask you to ask yourself what you would suggest to prevent, in any state, allegations like these from becoming true. The common sense list of precautions to prevent the sort of activity here alleged have pretty much all been missing in China.
Every state, and not just China, needs to lay in its defences in order to prevent the harvesting of organs from the unwilling, the marginalized, the defenceless. Whatever one thinks of the allegations, and we reiterate we believe them to be true, China is remarkably undefended to prevent the sorts of activities here discussed from happening. Until the recent legislation was in force, many basic precautions to prevent the abuses here discussed from happening were not in place. That legislation does not fill the gap unless and until it is comprehensively implemented.
There are many reasons why the death penalty is wrong. Not least is the desensitization of the executioners. When the state kills defenceless human beings already in detention for their crimes, it becomes all too easy to take the next step, harvesting their organs without their consent. This is a step China undoubtedly took. When the state harvests the organs of executed prisoners without their consent, it is another step that becomes all too easy and tempting to take to harvest the organs of other vilified, depersonalized, defenceless prisoners without their consent, especially when there is big money to be made from it. We urge the government of China, whatever they think of our conclusions about organ harvesting from Falun Gong practitioners, to build up their defences against even the slightest possibility of the harvesting of organs from the unwilling.
All of which is respectfully submitted,