When Deborah Collins-Perrica, APRN, informed us of an editorial in
The Lancet titled “Weaning China off organs from executed prisoners” and told
RNL that a response that she and transplant coordinator Liz Kerr, RN, CCTC, had written to the journal was published—“Organ transplantation in China: Concerns remain”—we wanted to learn more and contacted her for an interview. Below, Collins-Perrica, who works for the nonprofit organization Doctors Against Forced Organ Harvesting (DAFOH) and also has a full-time clinical practice as a psychiatric advanced practice nurse, answers questions about a topic unfamiliar to many nurses.
RNL: How did you become acting nurse liaison and editor for Doctors Against Forced Organ Harvesting (DAFOH)?
During the mid-1990s, I was working with a psychiatric team caring for cardiac patients, some of whom were heart-transplant recipients. I was also pursuing a graduate degree and doing some freelance writing. I had a steadfast interest in nursing ethics and in the lived and spiritual experiences of transplant patients. Eventually, these interests blossomed, and I did an independent descriptive research study that included interviews with 40 post-transplant patients over nine years. It was not published but can still be found in the dusty stacks at the University of Saint Joseph in Connecticut.
As a freelance writer and researcher, taking on editorial work was a natural step for me. And as a nurse, I hold to high ethical standards in my professional practice and writing. When I heard about Doctors Against Forced Organ Harvesting and the work the organization was doing, it was a good fit for my interests in both journalism and ethics. My work started with basic writing tasks, and today, the group’s website
has become a major resource of materials and archives on ethics that relate to this topic.
Founded by medical doctors in 2007, DAFOH is a nonprofit, nongovernmental organization based in Washington, D.C., USA. The group aims to provide the medical community and society with objective findings about unethical and illegal organ harvesting. Removal of organs from a donor without obtaining prior free and voluntary consent is considered a crime against humanity, as well as a threat to nursing practice and the medical sciences in general.
As the role evolved, I took on research projects, writing feature articles about ethics, editing drafts and articles for this international group, and helping to develop website content. The workflow for my job as consulting nurse liaison and a member of the organization’s international team is very efficient. Because DAFOH is a benevolent group of professionals, communication is honest, open, and tolerant. Moreover, my nursing role enhances the overall work of advocacy, adherence to ethics, and effectiveness of the effort.
RNL: What do you find most interesting about your work?
Forced organ harvesting is a niche field of interest, especially for a nurse. Although the problem exists in several countries—we are even hearing about ISIS having a hand in it—it is only in China where we see a widespread, government-sanctioned system that promotes this brutal practice for profit. David Matas, an international human rights lawyer in Winnipeg, Manitoba, Canada, estimates that transplant tourism in China is a billion-dollar business.
RNL: What do you find most challenging?
There is an almost complete lack of transparency in China on this subject, which poses a particular challenge
for journalists. To ensure validity and reliability, even simple writing tasks on this subject involve some level of research and investigative work.
Even with the best of intentions, it is difficult to awaken people to something this disturbing. Nursing leadership globally has yet to publicly address this issue. Transplant patients receive complex, multidisciplinary care, both pre- and post-transplant. Is a nurse bound, as a whistleblower, to report to authorities a patient who returns to the country of origin after an unethical and illegal transplantation has occurred in China or elsewhere?
Experiences of nurses who take part in forced organ harvesting or caring for transplant tourists in China are unknown. We cannot assume they act voluntarily; nurse researchers Mei-che Pang and colleagues (2003) reported that Chinese nurses are motivated first by values, and the care they provide is driven by ancient principles of goodness. Thus, nurses in China may be subject to a unique form of abuse when it comes to organ harvesting.
Taking organs from prisoners who are deprived of freedom is unethical by all standards, worldwide. In a country where organ donation is a cultural taboo, China has taken, under a ruling implemented in 1984,
solid organs for transplantation from prisoners. In response to mounting criticism from the international community, the Chinese Communist Party (CCP) recently announced
that executed prisoners are no longer being used as sources of organs, but the CCP has failed to verify this claim or allow objective observation. Most importantly, the regime has neither acknowledged, nor admitted, extraction of organs from prisoners of conscience.
The United States, as a leader in promoting human rights around the world, has an urgent responsibility to focus on rescuing this most vulnerable victim group. To provide rapid, made-to-order transplants for international tourists who choose not to wait for an ethically derived organ, it is estimated that prisoners have been killed for organ harvesting by the thousands in China to provide for over 10,000 transplants annually (Matas, 2012). Renowned organ harvesting investigative journalist Ethan Gutmann (2014) puts the estimated total number at over 65,000 killed for their organs in the last decade.
Connections also exist between persecution of religious adherents and forced organ harvesting. In atheistic China, spiritual groups are ostracized. Falun Gong, a Buddhist sect that has been subjected to a massive propaganda campaign and vilified by the Communist regime as a cult and enemy of the government, is the largest such prisoner-of-conscience group.
Special Rapporteur Manfred Nowak, in a 2007 report
to the United Nations, noted that “organ harvesting has been inflicted on a large number of unwilling Falun Gong practitioners at a wide variety of locations, for the purpose [of] making available organs for transplant operations" (p. 60). The nonviolent Falun Gong, known for daily meditation, qigong exercises, and adherence to a healthy lifestyle (smoking, drinking, and addictions are discouraged), has supplied the most viable organs, and at premium prices, in China. Without any rights, this vulnerable population is regarded as just so much biomass.
The Falun Gong problem has been investigated since 2006, with congressional hearings, reports, books, and dozens of journal articles published.
Gutmann, E. (2014). The slaughter: Mass killings, organ harvesting, and China’s secret solution to its dissident problem. Amherst, NY: Prometheus.
Matas, D., & Trey, T. (Eds.). (2012). State organs: Transplant abuse in China. East Sandwich, MA: Seraphim Press.
Mei-che Pang, S., Sawada, A., Konishi, E., Olsen, D.P., Yu, P.L.H., Chan, M., & Mayumi, N. (2003). A comparative study of Chinese, American and Japanese Nurses' perceptions of ethical role responsibilities. Nursing Ethics, 10,