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Oct. 2, 2025 - Epoch Times
01:05:54
The Secret Organ Industry in CCP Hospitals | Matthew Robertson
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Time Text
There's at least one instance where a hospital and uh a work camp are literally next door to each other uh with a crematorium.
In 2005, a Chinese official publicly admitted that China was sourcing the vast majority of its organs from prisoners.
The Chinese regime claims they've stopped, but have they really?
Chinese medical publications show quite explicitly that the donor was not deceased by any medical or legal criterion.
For over a decade, Matthew Robertson has been researching China's organ transplant system.
There are accounts by survivors of strange medical examinations, urine tests that are repeated, ultrasounds of abdominal organs, CT scans, blood tests.
Fluent in Mandarin Chinese.
Robertson is a China program research fellow at the Victims of Communism Memorial Foundation.
In a state like China, the medical profession does not have actual professional autonomy.
Like it's an arm of the state.
He's the co-author of a number of research papers on this topic.
They created a market in the organs of their political enemies.
This is American Thought Leaders, and I'm Yanya Kellech.
Matthew Robertson, such a pleasure to have you on American Thought Leaders.
You describe it as state-sponsored organ trafficking.
Sometimes it's called forced organ harvesting.
I've described it as a murder for organs industry in communist China.
Bottom line is something terrible is happening over there.
And if you were to s describe it to someone who's maybe skeptical or who hasn't heard about it and you know might find it unbelievable, how would you explain that to them?
I think you might start with what the standard way that organs are procured and transplanted in most countries around the world.
And that is from voluntary donors to recipients based on medical need and kind of states around the world create a system that facilitates this altruistic uh transfer, where there is uh you know a tragedy that has resulted in um most typically brain death, as is in the case of vital organs.
The individual is brain dead, declared so in hospital, and then there is a an organization that facilitates you know, gains permission if they weren't already a donor, and then that's the kind of transplantation that we're mostly familiar with.
So at least until 2015, and probably subsequently, um, China's model of organ transplantation was very different.
Almost the sole source of organs were prisoners of one kind or another.
So that's death row prisoners, prisoners of conscience slash political prisoners.
Um in some cases simply uh uh beggars who like homeless people who were kidnapped um and killed, according to you know, PLC media reports.
When I'm talking about state-sponsored organ trafficking, I'm talking about state military and paramilitary hospitals who have a transplant wing, um, and they're performing transplants, but the organs that are obtained procured illicitly,
often by killing prisoners, and then they are uh distributed not by medical need by but by the ability to pay cash um to you know, the recipient.
There are some private hospitals, though those are run by surgeons as a kind of a side hustle, and those surgeons are of course, you know, affiliated with the state or they're like party officials um or they're like uh you know the party secretary of a hospital or whatever.
Um, but that's basically how China's organ transplantation system operated and almost certainly continues to operate.
What would you say is the strongest evidence you've seen that this whole thing, which sounds almost unbelievable is real.
I think ironically the strongest evidence is simply the utterances of Chinese officials themselves.
You could look at an official statement um by someone like um Dr. Huang Tia Fu, who was the former Vice Minister of Health and is now kind of the great eminence of the transplant system, he's sometimes called the transplant Tsar.
He has him admitted almost everything I just said.
The idea that Chinese hospitals procured organs from prisoners, that's not disputed by the Chinese medical establishment, that there was buying and selling of organs is not disputed.
Kind of where is the dispute is the identity of the donors.
That's uh a matter of some controversy.
Um then perhaps um the matter of scale or sophistication or organization or you know, systematicity, these kind of questions.
I think each piece of the puzzle has like a different kind of evidentiary um uh trail.
We could think about something like the involvement of surgeons in the execution process.
The evidence there is Chinese medical publications that you know show uh quite explicitly um that the donor was not deceased um by any medical or legal criterion um at the time of the procurement, and therefore, you know, there's a violation of the donor rule.
And so you're you're saying they they were killed by the organs being removed.
Yes.
So the the heart, the removal of the heart is the proximate cause of death in those cases.
Um that's what our paper shows.
And then for other pieces, like for example, uh, okay, Trey you talk trafficking, so what's the evidence of trafficking?
So I mean, in that case, it's even more straightforward because you look at um hospital websites before they were all taken down in you know 2006, seven, and um, but they're all in the way back machine or otherwise archived, and they would have, you know, price lists on their website for the organs.
So okay, so they're clearly being sold.
It's uh pay for treatment, so it's all kind of like the transactions are cash for um the organs.
So there's not like a kind of um, or there wasn't at that time a kind of a state health insurance system that would cover these treatments.
There's an interesting one that relates to like there's there's one really interesting piece of evidence that when you kind of dig into it, has so many different really interesting implications about things we cannot observe that is is worth like discussing.
Do you want me to please?
Okay.
This is uh a phenomenon called emergency transplants.
Emergency liver transplants specifically.
So I'll explain what that means.
If a um patient in you know any country has um acute hepatic failure, their their liver fail fails, if they do not receive a new liver within a short period of time, um, then they are going to die.
Um because the liver is required, it's a vital organ.
And so um, you know, a patient in the United States or Australia or the UK, um, for them to get that organ, they present at the hospital, their condition is is diagnosed and the need for an organ is established, and then they're basically they're first on the waiting list,
and if in 24 to 48 hours or whatever there is a tragedy, there is a car crash or or some other incident that renders a compatible donor um brain dead, and that compatible donor um you know has already registered as an organ donor or their family agrees for them to become a donor, then the recipient will get that liver and you know their life will be saved.
Um, how do you do emergency transplants when you don't have voluntary donors?
So the Chinese government has never explained that.
What we know is that um in 2005 they published the annual report of the liver transplant registry at the time that had like uh a subsection, like had a a certain number of the total number of the total hospitals doing organ transplant.
And then in 2006 they published this same annual report, and these have both been deleted from the internet.
Um and they showed I'm not gonna get the numbers exactly, but it was something like 25%, and then the other was um was close to 30%.
There were that many that were emergency done on an emergency basis, and then the remainder were done on an elective basis.
So if you don't have voluntary donors, this is what the government says, therefore all the organs are coming from prisoners, and yet to get uh a liver, you need a compatible donor who has recently died.
Then you kind of have two possibilities.
And then so one is that um it just so happened in every single case that a prisoner was going to be executed on that date when the need for that liver arose, and that prisoner happened to have a compatible blood type, and um that prison and that hospital had some connection, so it had to be local.
So the kind of the the difference, you know, in the UK it could be the entire country, but in China there was no um computerized system for allocating organs, and so it would have to be local.
So that's one.
So there's like you can see like a chain of increasingly implausible conditions that would allow, you know, that and even then it's it's um from executive prisoners.
And the other is that they have blood typed and then killed on demand um the liver donor.
Um a lot of the evidence is of this sort.
There is some um you know, something that you can see that doesn't make sense in official publications, and then there are different like um inferential possibilities, like ways to explain this outcome.
And then but they all strangely point in one direction.
Well, so the the highly implausible one in this case would be that there were death penalty and they happened to be killed at that time, blah blah blah.
But then the kind of far more plausible one is that actually the Chinese state had blood typed some much larger number of uh of um of donors, because if you're gonna have so many that are on this emergency basis, then you must need a larger pool from which to draw from.
And that would have to be at many places nationally because there's a you know dozens of hospitals in this um in this um data set.
And so you would that just this one like page in these two uh documents, it has these kind of like this a ripple of implications about what that actually means in terms of the logistics, uh donor sources, um, you know, what must have been happening to enable that to have been reported.
And then sometimes so some of these hospitals before there was international attention in 2006 by Noah Kilgore Made Us and everything else that went on then, they were they were saying like we have the we have the bodies, or was to that effect, like very explicit statements that they have the donors ready.
Right.
I remember people were calling up and saying, Yeah, we can set it up for you.
Yeah.
Like on the other end of the line.
Yes.
Which is I mean unbelievable when I think about it.
It's been a while since they looked at that data, that evidence, by the way.
But yeah, I think people just don't believe the phone calls were real in those cases, because they're like, well, how could those be real?
Interesting um thing.
I did like a l like a sub study of just those phone calls.
And so I spoke to the investigators who made the phone calls, and then like got their the download of their Skype records from their actual account, they let me log into their account and downloaded them, and it's got like the call time and date, and then the duration of the call, and then like match that to the the actual audio file, and then it's got the numbers they called, and then I would call those numbers back and like say, is this, you know, the so-and-so hospital?
And they would say, who is this?
And then I would hang up.
And like so I confirmed to my satisfaction that like the call records they showed that they made that call to that number of that length of time and then the audio matched it.
So I mean the the calls are real.
But yeah, it's sh it's like for anyone who's actually looked at the transcripts, it's rather extraordinary that these things would just be said on the telephone.
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So just hit the link in the description below and now back to the interview.
So when it comes to the identity of the organs, you mentioned that this is contentious the identity of the source of the organs.
So what what is it that you've come to believe based on your extensive research?
So the most contentious point on that is whether they came from Falan Gong or not.
And then kind of the more contemporary um question is are they coming from Uyghurs or not?
And on both of these, so I think you could think of the calls as direct evidence potentially like if you believe the calls.
Well you have like surgeons on the call saying yeah we've got you know the Falun Gong organs.
Are they like upselling?
Are they just uh are they just running their mouths on you know a random phone call.
The the way that I have approached this I have a paper as part of my dissertation that specifically um looks at this question of like the identity of the organs um because that's significant.
If the organs are coming from death penalty prisoners, they have a situation where the state so you can explain the the emergency transplants potentially even by death penalty prisoners where um the state has blood type prisoners but they just haven't actually carried out a formal judicial execution until they've been required for an organ.
And the other possibility is obviously um they're doing extrajudicial executions of political prisoners and so prior to um you know 2017 2018 when the mass detention of Uyghurs took place, the repression of Falongong was the largest repression of a religious group in China.
And so there was mass detention starting in 99.
And so the in terms of the organ transplantation system would not expect without any prior information that you know the growth of transplantation and the detention of a particular religious dissident group would be connected.
And but if you look at indicators of transplantation activity, several key indicators suddenly go up in the year 2000.
So you know six months after the repression and so for um my work what I've been able to gather is a large corpus of medical publications.
So I downloaded something like a hundred thousand um PRC medical papers and usefully they're in like a single database.
And they show when you kind of do a lot of things to code them according to their content and whether they are like a a clinic like a clinical paper about a particular transplant.
They suddenly go up in the year 2000.
And then they dip a little bit in early 2006, which happens to be when the actual the revelations of forced organ harvesting is it's called.
It was when I first realized it was real that I felt the evidence they I mean I didn't want to believe it.
I remember right very distinctly this seems so outlandish, but I felt at that point the evidence was compelling enough that it was real.
Sure.
So that's like, you know, you have this temporal um observation.
There's two explanations, right?
When you see like, you know, mass repression of this group, mass detentions, and then um, you know, blood tests, you know, these um these phone calls, targeted organ examinations.
There are some particularly um acute cases where a a surgeon has another hat of like the the leader of an anti-phalungong propaganda group.
And that's unusual.
Like why would uh a liver transplant surgeon also be specifically involved in um like repressing a religious minority.
And then on the other side there are there's um a well-known case of a of a security official who performed a lot of transplant, oversaw a lot of transplant operations.
So the security official was directly involved um in the repression of this group.
And so it's evidence like that, blood tests, organ examinations, and so on.
You've got to explain the outcome that you observed, which is a lot more transplants.
So you've either got this explanation, well, like they came from this group, or you need you basically have to say that um it was actually death row.
And so that the death row system is an order of magnitude larger than anyone has observed.
Uh, and moreover, that it continued to grow even as all indicators about uh death row showed that it was um receding.
And so these are you know, the reports by human rights organizations based on their estimates and discussions with Chinese officials, some leaked documents, and then um significant reforms to the death penalty system in 2007, that centralized review to the Supreme People's Court.
I mean, there's a lot of law associated with the death penalty system.
That is a topic that has received far more scholarly attention than organ trafficking.
Um so it is a very implausible, at least I claim is a highly unplausible set of hypotheses or like claims that you would, you know, have to advance, you would have to show that is actually death penalty all along.
And I'm not clear th there's not a third like competing hypothesis for this outcome.
So I think to the extent that it's contentious, it's driven by uh I would imagine just a simple lack of knowledge of the observations, just you know, the outcome, like lots of transplants and a lot of growth in the transplant, you know, infrastructure.
So there's so many different ways of measuring that growth.
There's like the number of surgeons, uh, the um the number of hospitals performing transplants, that is like new hospitals and hospital wings, you know, the advancement in uh uh different kinds of transplants because a liver can be transplanted in different ways.
And so Chinese surgeons are like have been on the cutting edge of like surgical um improvement in actual performing transplants.
And you need to do a lot of transplants for these things.
So like everything shows there were lots more transplants being done.
Um and so you can't you have to explain that.
So the paper I have is the dissertation is like looking at the competing explanations and then chasing down data that supports or doesn't support either of them.
And I mean, bottom line is it's uh the the other explanation isn't very plausible.
I mean, I I of course I'm familiar with your work.
Uh yeah.
Yeah.
Well, so the other ex the death row explanation hasn't even been seriously advanced.
But it's the only alternative.
But no one's like come out and claimed that.
This paper, um, execution by organ procurement breaching the dead donor rule in China.
Yeah.
I often use that uh paper, and thank you for co-authoring it with Jakob Levy as one of the closer things to a smoking gun.
Because I mean it's written into the transplant literature that these transplant surgeons and researchers are killing people by extracting their organs.
As you meant as we discussed earlier.
It's shocking.
I mean it's shocking to me that they let you publish with that headline, actually.
And I'm really glad they did, because I think a whole lot of people suddenly understood something they didn't understand before.
What kind of interest has that paper generated?
You know, I guess what has come from out of that subsequently.
Um the most I mean two things to me strike me as interesting about that paper.
So the finding itself wasn't the shocking part to Dr. LeVee and I. It was that we actually saw the data.
So like both of us were prepared to believe that this was real based on work that had already been done.
And then but we were only surprised to find that we could actually count lots of them through some, you know, looking through these papers with some basic coding methods that had now you can be done way easier with AI.
But anyway.
Um so the that we found them at all was like the surprising part to us.
And then the other was that it wasn't actually new information.
It had already been shown by um world organization to investigate the persecution of Falan Gong.
So it's an advocacy group that you know has all this kind of evidence on the repression of Falan Gong.
And then um in um uh paper, and it might have even been two papers by um Lee Hue Guer and some colleagues, uh where it had been shown that you know there were instances of this.
So I think what um Dr. LeVee and I added was simply uh a systematic uh methodology and then getting it into a journal.
But the actual bare facts were not new.
Um that I f that's interesting because it kind of suddenly something becomes real because uh an institution in a position of authority has declared it to be so effectively.
But it was already real before we, you know, um got it published.
So I think that's interesting because a lot of this kind of seems to hinge on questions of authority.
Who has been authorized to declare you know some something to be a fact about this topic?
Aaron Powell So you use a lot of these computational methods.
You mentioned that AI, some of them can be done better with AI language models today.
Um can you just give me a basic picture of like what you do, what you specialize in, your kind of career trajectory?
Aaron Powell Yeah, the field is called computational social science or um social data science is another word for it.
But it's simply um using computers and um it's like building data sets out of um creating data sets out of text, you know, wrangling text into grids, extracting variables from unstructured text and then doing statistics on them.
For example, with the medical papers, um that was um like many months and thousands of lines of code um just to get into the website and to get download all the all the files.
That's only the beginning because once you've got it, you s now need to like extract the text from the PDF files.
So it's a lot of just very grunt work.
Yeah.
There's nothing glamorous about it.
So it used to be really hard to do that uh before AI.
So you had to actually write code yourself.
But now you can just tell the computer to write your code as long as you know exactly what it is you want.
So and so but so how did you get into this?
Well, I was frustrated with the um the epistemic status um of the topic.
So that is some people thought it was real and some people didn't think it was real.
There seemed to be taboos around figuring out what's going on and and doing so properly.
Also I had a great deal of ignorance about what it actually means to do uh scientific research, especially on a topic like this, and so um I wanted to figure out like well, how do you actually produce knowledge, like what methods do you need to create reliable knowledge on like things that are hard to study?
It's interesting to reflect in hindsight that it's not um it's not clear that the actually producing knowledge artifacts changes what people think you would think it would, but it's it there's not like uh like a necessary relationship between those two.
It's not one to one, yeah.
Right, but it does help.
I'd like to think so.
I can tell you it does, because again, you know, that's this is the reason why I often cite your paper, uh the execution by organ procurement paper, because it's it's highly compelling uh knowledge which was created as you described, or or at least resurfaced and validated.
Yeah.
Sure.
So there it also there's a certain um it relies on authority to a degree.
So we trust that because it's the American Journal of Transplantation, the reviewers have done their job and and so on.
I think it's uh based on my uh basically in my opinion, I think it's particularly valuable because it's as you mentioned, it there's a bit of a taboo around this issue, right?
And all sorts of in in academia, in the transplant industry, all sorts of areas, as you as you well know, yet um it was actually validated by a very I guess prestigious authority on the issue.
And so I felt that that actually elevated the issue considerably.
Sure.
Right.
Because I would imagine they actually experienced some pressure or some thought about to perhaps not to do it, as as is often the case with with publishing contentious things.
In my mind, the use of felon gong practitioners for these organs, I think that's been pretty well established through your work and the work of some others.
However, um there's the next claim is that um that at some point Uyghurs started being used the same way.
And to me, this makes perfect sense because when unfortunately this issue wasn't dealt with in any meaningful way, and these types of crimes against humanity have a way of spreading when they're left completely unchecked.
Right.
So it makes perfect sense that that would happen.
Um we know that Ethan Guttman, who's one of the you know big researchers on this issue, is working on a book as we speak, looking at this question when it comes to Uyghurs.
He's written a one of the more definitive books on the issue in the past, The Slaughter.
Um but what what what in your mind is the reality of that, of of this having moved or at least uh uh you know incorporating the Uyghurs as uh as a source?
To begin with.
You have a situation where you know, hundreds of thousands to up to a million to over a million, who knows, a large number of people have been incarcerated, it's been described as a genocide by the US State Department.
And then we know from the Xinjiang police files, this is a leaked um cache of documents um that was leaked to uh my colleague Adrian Zenz at the Victims of Communism Memorial Foundation.
Um so that shows that there's been um a mass blood testing of this population.
And then there's large-scale DNA collection as well.
And then there are um accounts by um survivors of strange medical examinations.
So urine tests that are repeated.
It's not clear what condition that's aiming to detect.
Um so it's not just urine tests but uh like um ultrasounds of abdominal organs, uh CT scans, uh urine tests, blood test.
So these are and and especially when they're repeated.
So they don't seem to be aimed to assess the general health of the detainee.
They seem targeted.
Um and then there are or there's at least one instance where a hospital and uh a work camp are literally next door to each other with a crematorium.
That's in an RFA report.
Um and that's strange.
Recently the um the government announced that they were building more hospitals in Xinjiang.
There is still many transplants being performed but the official explanation that they're from voluntary donors seems at least partially implausible um because the figures appear to have been manufactured.
So the the the the registry data associated with the reform program appears to have been um falsified based on a a simple equation.
We have a a paper about that that was published in 2019 so it's rational to believe that Uyghurs are being harvested for their organs.
And I feel like I'm not sure what else as an analyst one is permitted to say necessarily like we don't even have such a clear um like outcome that is crying for an explanation because we don't even know the number of transplants anymore.
So like before 2006 and seven and even into twenty tens, there's a lot of stuff being published on Chinese hospital websites.
And then when a whole lot of international attention kind of started coalescing on it, it seems a lot of that just got pulled and then now there's a a voluntary transplant system and surgeons aren't going to the media and just mouthing off about we did 2000 liver transplants at our hospital last year and things like this.
And so our our ability to even observe the activity is diminished.
And so I mean that's the state of affairs there.
So I like I have a book chapter about it and I use the words of um you know vulnerability you know so they're they're obviously vulnerable to this abuse.
You know this question of vulnerability is really interesting and very important and I I think um actually is piece of the is a piece of the evidentiary pool because when it comes to the Felongong for example, right, you have a population that the dictator at the time has said should be eradicated.
That doesn't mean to didn't necessarily mean to kill everybody re-educate them, transform them.
But the language as we know language is very strong and of course these types of things can escalate easily from something that could mean at the beginning you know re-educate them or something like that to something that makes it a lot easier for someone to to do things of this nature.
And or you know the unwritten rule that all felong deaths will be considered suicides.
It's okay to torture these people in extreme ways to re-educate them right.
Or the fact that they don't reveal their names because you know they don't want to implicate their relatives or have problems.
So they're you have this huge nameless population in incarcerated population and people there's just are dying because of torture.
And so you would you really miss anybody if because they were going transplanted and you wouldn't even know that that's what happened, right?
It's a unique kind of scenario that these people are existing into the vulnerability I think is an incredibly important part which often I guess is overlooked even when I talk about the issue.
You mentioned something um about uh you know language used and I just remembered so the surgeon that I spoke about that was the both a liver transplant surgeon and then he's involved in like anti phalangong activities.
So on the question of language, I found a a book that he was the editor of and it was stamped um internal circulation, Napal Fighting.
And he writes in like the foreword to this book that um uh phalangong is a cancer on society.
This struck me because he's a liver transplant surgeon, like he r he he removes cancer.
You can see the sense in which he probably thinks if he's killing these people it's not bad.
Like if he's writing that these are these are evil people who are destroying the foundations of our society and there are cancer and so on and so on.
Like it's genocidal language obviously.
One of the things that struck me after first reading your your paper again execution by or organ procurement was that, you know, clearly this practice, I mean you did this was not an exhaustive search of all the transplant literature in China that you looked at and you found I think it was seventy one cases in that paper that where this dead donor rule was violated.
Mm-hmm where people were being killed by the organ extraction itself.
There's probably a lot more right?
Well so the the funnel is like this the transplant is performed some number of those transplants that get performed have a paper written about them or are included in a paper.
If you think how many transplants a doctor might do, what portion of them actually get written into a paper is probably a fraction.
So like there's a there's initial selection there that not even could we find the paper or was it in the database and did we find it with our search, but was it even written up?
So that yeah but yeah.
So that's like the first thing and that's why we probably only got seventy one.
You know, did we find it in our database, did we include it properly in our um in our keyword searches and stuff.
We had to chalk several dozen that didn't have a very explicit statement um about intubation.
So that is the insertion of a um of uh of the breathing tube and the ventilation of the patient.
So where we where it said that they were ventilated we didn't include those because it didn't say the specific word intubate, chargwan.
And so we could have declared one hundred and something if we used a slightly less stringent criteria and we have like several paragraphs that explain you know why we think they really you know should have been part of it but we just wanted to be extremely careful in like you know segregating the ones that were explicit about intubation, this specific act of intubation and then the probably what was identical the turning on of the ventilator.
There's probably a lot more that's like kind of what I what we're we're get what we're getting at here.
But but the issue is that because there's so many of this so much of this reality happening where people are being killed by the organ extraction itself, it's kind of become normalized for surgeons to do this.
So surgeons have become murderers.
I mean there is a there's just a technical challenge in the procurement of a heart from someone who is alive and like walking around.
Like you can't kill kill them so that they're like their heart stops beating because then the heart will not resuscitate you know in the host.
What I'm saying is there's not really another way to do um heart transplants from executive prisoners.
So the way that it could be done theoretically is somehow the judicial system is able to conduct an execution that um is a a brain death execution.
So it can't be like a firing squad probably can't be hanging or or some other method because it has to be a very targeted method of killing that is only brain death killing and then Um they would need to be intubated immediately by the medical people, and that's how the medical, you know, establishment or the like the profession of doctors could be kind of insulated from the actual act of killing.
That is highly logistically complex.
In a state like China, the medical profession does not have actual professional autonomy.
Like it's an arm of the state.
And I like that's the key.
So when you say like doctors have become killers, they're yeah, it's how you d define a doctor, I suppose like because the thing that goes into doctor, so we have a lot of connotations to the term doctor, like, well, they they're kind of um they understand themselves to be a doctor, so there's like this hypocritic oath, there are professional associations, you have kind of like all this um uh kind of institutional scaffolding around this role.
So in a state like China, some of those things are present, but they're also controlled by the communist party.
And so I think that goes somewhere to explaining kind of what we see, because if kind of the medical field is an arm of the state, then it becomes less surprising, perhaps.
Because you know, the doctors are perhaps acting in their capacity not merely as doctors, but as agents of you know, the as a state entrusted with a certain responsibility, you know, to conduct this particular activity, they don't have much choice in.
Because they can't say, well, no, I don't I don't want to do that.
Or the consequences of saying no, I'm not gonna do that area.
Well, they're extreme.
Yeah, like I mean, I've heard people being concerned with their own lives.
If you're if you're a doctor at a military hospital and the supervisor says we're going to, you know, retrieve organs now, you can't just say, Oh, sorry, boss.
Like, I don't I'm not super into that.
So how did this whole thing begin?
I mean, my my contention is that you know, the system first and foremost provides an unlimited on-demand source of organs for every party elite forever.
That's the systems that that that has some huge value above and beyond the financial value, right?
It's something that's kind of unimaginable for most people and in most settings.
Um your thoughts?
To begin with, before there was um like marketization or the privatization of the healthcare system, um and you know, the reform era.
There were there were transplants happening, you know, in the 70s and the 80s.
Of course, 80s is you know, the economy is is changing and state controls are being lifted.
Um through so the earliest that we can trace the origins of the CCP healthcare system, um, there has always been uh like uh a chair or a vice chair of the health care committee of the CCP.
It's called the Bal Jenwei, who has been a transplant specialist.
And so like the personal uh physician to Joen Lai uh was a transplant specialist.
So what can you infer from that?
Well, to begin with, a little bit more about this healthcare committee is probably helpful.
So the CCP, the leadership has um their own special healthcare system.
And I just want to jump in, this is incredibly important to know.
This is not obvious to everybody that's watching this.
No, and also it's also unusual in that so there is a there's a whole paper just about the CCP's healthcare system for treating the elite by its Taiwan Shen.
Um it so one, not funny, but like unexpected consequence of um is this tightly controlled healthcare apparatus, so it delivers like the very best health care that China can offer, mostly through uh military hospitals.
But in cases where officials have been um you know not in line with party leadership, healthcare has actually been withheld from them.
Um and so it's even a tool of control for the leadership.
But in any case, um so you have this system that delivers, you know, top-notch health care through certain um mostly military hospitals.
It's always had a transplant official.
And since uh so since the 90s, there've been defectors and different kinds of information about organ harvesting.
So this is all like pre-Falongong stuff.
And um there wasn't at that period, like China wasn't wealthy like it was in the 2000s, and there was a limited pool of donors.
And so as I read it, you kind of have this confluence of events where China is um getting rich, it's being integrated into global economy, surgeons who have done um training in Japan or the United States are coming home,
and um the healthcare system has been um basically de facto privatized and China has an economic growth model that is based on directly incentivizing officials,
it's called prebendalism is the fancy term, but it's where um a form of graft is uh incentivized and encouraged and allowed as a means of economic development, where officials who grow their local economies or their work units are allowed to skim off that that growth.
And hospitals are no exception.
And and then suddenly you have an influx of like this detained population that can apparently be killed with impunity.
Um at a time when, you know, like hospitals are being privatized and you have this um, you know, talent in transplantation.
Um so you were asking like how did this all begin?
And like that's my reading of it.
So I'm not sure, like we can't know if there was an order, hey, you know, kill these people.
Um but I argue you don't require, like that's not a necessary condition for what we observe.
You just need it's just markets.
Like it's just they created a market in the organs of their political enemies.
You know, they were filling a demand because the demand for organs is very big, and if you just have these people detained, you can make them effectively slave laborers, or you could monetize them by converting their bodies into organs.
So it's not like it's it's it's rational under the conditions of that system to monetize them.
Like I I didn't see anything that's so hard to believe or so implausible.
Like we might be shocked, we might say, well, that's really bad or whatever.
But I I just mean within the constraints of that system, with the incentives of that system, it just seems so obvious.
Oh, and the and the abject lack of moral boundaries in that system, you know, it's another would be another piece to add.
Um sure.
You need a definition of morality and blah blah blah.
But sure.
Sure.
I mean m morality that us and most people that would be watching the show, uh the basic level of morality, like you don't kill people for monetary gain.
Right.
Yeah, sure.
I mean, we're talking about such macabre things, please continue.
So well, cause that cause what you say is really interesting, because I think implicitly the objection or the the the aspect of it that is um perhaps leads to a lack of credence in these claims is that they seem really bad.
And so therefore, it couldn't really be that bad.
But I think it's helpful to just put aside how we think about whether it's good or bad.
And just look at the actual constraints and incentives of the actors in that system.
Because then you would see, probably everyone would agree with all the things I said.
It's obvious.
But then you basically have to...
Like everything bottoms out at some absurdity heuristic.
And so you kind of...
It's whether you think...
it's more absurd that the actors in that system would elevate this these notions of morality however we think of them in that environment and like that seems to me way less plausible than that they would just respond to the incentives that they're actually operating under.
Well and I just what's something you just reminded me of that I haven't thought of in years but there was this I think official directive against the Fengong it was something like um bankrupt them financially destroy them physically destroy their reputations.
I think there were three things like this the destroy them physically part again sort of you know speaks to the incentive structures and the incentive structures as we know in a communist society whatever that whatever is set at the top your success as a party member or a societal member is your ability to implement the strategies or tactics or whatever that are set at the top however inhumane or macabre they may be you use the term extractive repression.
Explain that when political scientists look at um cases where authoritarian states repress their population or subgroups of their population and it is thought to be a cost you're expending you know the resources of your security apparatus and you're maybe undermining your legitimacy and so on.
I'm simply attempting to direct attention to a form of repression that is profitable and which the state can then use to enhance its capacities through the act of repression.
So it's not a cost to the state because they simultaneously profit financially, both individual surgeons and then hospitals and the medical system.
But China wins recognition globally for being a leader in transplant techniques and publishing in top journals and kind of winning the praise.
Not kidding.
of Western surgeons for innovations in transplantation that happened in China.
Again it's about making sense of this you know this form of very unusual form of state activity and to try to unpack how it does make sense.
So that's like where the term comes from and how I've tried to kind of puzzle depuzzle the issue.
So as you were discussing this earlier I was one of the revelations when we were making Finding Manny the Holocaust documentary you made about my wife's father was I just having even read a lot of literature I hadn't realized how important Jew slave labor was to the Nazi war machine to the German war machine.
It was unbelievable how many of these slave labor camps you know and then which were later funneled into the into the death camps there were right and how important that was so there was this attempt at extracting whatever value was possible never mind you know later you know collecting the gold fillings and God knows what else right at the death camps themselves.
But that that that's a really interesting observation.
You just reminded me of something we've talked about before which is just the odd reality this is something you know having sat in this looking at this issue for 20 years I had never considered how odd it is that this extractive process of you know monetizing Human beings of your own population for a state to actually be, you know, at some level selling the body parts of their own citizens to foreigners.
Aaron Powell It somehow seems perhaps more perverse that it would it is is one state's own citizens and then the beneficiaries are citizens of foreign countries.
But following the logic of the market, you could see, well, foreigners are going to pay more.
And the kind of the demand for an organ is very high because that's a life.
That's someone's life.
So they're willing to pay lots of money, obviously.
Um again, it makes sense if you think about it.
Aaron Powell Here in the US where we're interviewing, there's a number of pieces of legislation now that have actually passed the House.
There's one that's still in in committee in the House and are now at the Senate trying to deal with this issue, right, in various ways.
Um, broadly speaking, there's you know, sanctioning individuals that are involved would be in some of part of that.
Some of it is actually creating a reporting system where the government has to kind of gather data to try to figure out what's going on with it in more detail.
Another part is um you know, preventing certain medical systems from paying in the case of you know insurance or Medicare or something kind of paying, that's more at the state level at the moment, although the one in this bill in committee is does that as well.
I'm curious if you have any thoughts on this sort of legislation to to try to deal with this issue somehow for you know people in the civilized countries.
Um it seems like a fairly good initial response.
I mean, we say initial, but it's 2025 and this issue has been known about for over 20 years.
So the kind of remedies I think if we accept or believe that PRC doctors have done all these things, it is also simultaneously interesting and unusual that they simultaneously wish to be part of global health governance or um they don't want to be a pariah state.
And so PRC health officials have made tremendous efforts to try to make sure that they're not considered a pariah state.
And so that includes extensive interactions with global medical bodies and experts and surgeons in the United States and elsewhere.
And so legislation that prevents them from entering the United States has got to be awkward and embarrassing for them at the very least.
It means that the conferences can't be held here.
Um if you think of it in terms of all the the scale of remedies, it seems not even beginning to redress you know the the gravity of what's alleged.
Um it seems better than nothing to the extent that a state wishes to craft policy in response to this.
I think it's really interesting and illustrative to compare the the kind of global reaction to organ transplant the kind of the organ trafficking or transplantation um abuses to what happened with psychiatric abuses by the PRC.
So in the mid-umps, China was again, it was actually an abuse against Falan Gong primarily, and then others as well, um, where the state was using psychiatric care homes,
but you know, psychiatric torture facilities and um injecting these people with drugs and um they had a whole uh diagnosis of mental illness associated with specifically like qi gong induced psychosis and they had various uh medicalized um uh methods of detaining people for their religious beliefs,
and then torturing them to elicit confessions and so on.
Aaron Powell But just I just want to clarify this.
They they created a diagnosis to allow them to incarcerate Felangong practitioners for practicing their faith.
Yes.
Yep.
So this is quite well known.
Um and the reason, in fact it's so well known, is because of a man called Robin Munro, um, who is like a chief inspiration for me.
He was associated with like he was a researcher for human rights watch during this period.
And he did a lot of really groundbreaking work on abuses in orphanages and all kinds of things.
And then so his work on this topic, psychiatric abuse.
Um he with um HRW at the time went to the World Psychiatric Association conference, I think it was in um Japan at the time in the since it's the mid-2000s, and they gave everyone like a copy of his report on these abuses.
And so that created like, you know, and then they had a media campaign because it's human rights watch, like it's uh it's a credible international human rights organization.
And so kind of the weight of that organization, he you know, corraled it and or there was internal buy-in or whatever, but they threw their weight behind this and they like mobilized their resources and they like browbeat the international psychiatric establishment into taking China to task for like using psychiatric doctors as part of you know uh uh a religious repression campaign.
And the um China Psychiatric Association was being threatened with being kicked out of the WPA, the World Psychiatric Association, and so the upshot was China the CPA um acknowledged no wrongdoing and you know, and it was a scurrilous allegations and all this sort of thing.
But the abuse stopped like it actually stopped.
Um so it appears that there's been uh a resurgence in this method of abuse, but legitimately, this is a campaign where the PRC was doing this particular kind of abuse,
there was a channel of pressure applied to them through like a combination of uh of uh of a respected human rights group, uh media, and then the professional associations with clear consequences for um Chinese psychiatrists who then one imagines applied,
you know, back pressure internally that like we can't be doing this, like China will lose face.
It's not just gonna be bad for us, psychiatrists, Chinese psychiatrists, keeping in mind that they may not have even wanted as a professional body to be associated with this, but they don't have a choice.
So anyway, so that was like the outcome there.
So if you like contrast that to the transplant case, I mean everything is different.
So you have no human rights watch or amnesty international who has thrown their weight behind this and said um, you know, even on the margin, not even said, you know, the pattern of evidence is is disturbing or whatever, you know.
And so there's been nothing.
And then um kind of influential media have not reported on it, or when they have done so, they have um sought to cast out.
Like, well, whatever's going on, it's probably not what they say.
Or or sometimes they say they'll say, well, Falun Gong practitioners claim that.
Yeah.
As opposed to like there's this well-established body of evidence that claims that.
Sure.
Yeah.
And so there's all sorts of ways of using language to subtly delegitimize perspectives and so on.
And so um the effect, like this is my reading, the effect of all this is that there's no kind of environment under which the Transplantation Society or the World Health Organization or other relevant bodies who are kind of the global interface with the Chinese transplant establishment.
So they're not incentivized to put pressure on them.
There's no consequence for not caring about it or doing anything about it.
And so there's no pressure on the China transplant establishment.
And so there's no incentive to even change the activity.
But I'm sure like if if the state, like the US government, wanted to like actually put pressure on like professional associations and so on.
Like the states have all kinds of tools.
They're very powerful entities that can do things in the world.
So if you would like list of all the possible things that could be done, it would be as long as you're on.
And the legislation is going to address some of them.
Of course, depending with you if you looked at all the tools that the US government has to change realities, I'm sure there's a countless more things that it could do.
Right.
Well, no, it's in it, but it's what's really fascinating from what you just told me, which I wasn't familiar with the details of how how this how this all came to pass, is there's a playbook of something that worked.
Yeah.
And you could replay that.
And this is something, frankly, that almost anyone could participate in if they're part of their, you know, of a human rights organization, or could choose to become part of one, or could, you know.
Well, the key is it's elite, it was elite networks that led to that effect.
So it kind of like many things depend on people who have more power doing things.
I mean some of those people are are certainly watching right now.
Well, this has been an incredible illuminating conversation for me.
Um and it's great kind of to finally have you here and uh on the show.
Um, you know, I I often talk about your work as part of my work.
Um and uh a final thought as we finish, perhaps?
I think that anyone who is um organ harvesting curious is wondering if this is actually a thing.
I would say just actually read the papers.
Just look at them and like use your own brain to assess the evidence.
Well, Matthew Robertson, it's such a pleasure to have had you on.
My pleasure.
Thank you all for joining Matthew Robertson and me on this episode of American Thought Leaders.
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