Image description: Surgeons and nurses pictured in an operating theatre during a procedure

Organ trafficking, forced organ harvesting and unethical organ transplantation are global issues. A worldwide shortage of organs has seen demand far outstrip the supply available through legal national transplantation programmes in a number of countries. As a result, instances of transplant tourism – the practice of travel for organ transplantation involving organ trafficking, forcibly harvested organs or organs that have been acquired in exchange for financial gain – have doubled in the last twenty years, now accounting for over ten percent of the world’s transplants. 

In March 2020, an Independent People’s Tribunal called the China Tribunal constituted the first independent legal analysis of all available evidence regarding forced organ harvesting in China and stated that ‘The Tribunal’s members are certain – unanimously, and sure beyond reasonable doubt – that in China forced organ harvesting from prisoners of conscience has been practised for a substantial period of time involving a very substantial number of victims.’ Significant among the victims are people incarcerated on the basis of their faith and/or ethnicity, including Falun Gong practitioners (Buddhist Qigong), Uyghurs, Tibetans and House Church Christians.  In its judgment the Tribunal found that China’s campaign is a ‘crime against humanity’ constituting one of the world’s ‘worst atrocities committed’ in modern times. The Tribunal, chaired by renowned British Barrister Sir Geoffrey Nice QC, called for action from ‘individuals, bodies, and governments … given the conclusion that the tribunal has reached.’

In 2022, the UK government banned organ tourism. Pressure has now mounted on medical institutions, medical practitioners and academics, of whom large numbers are currently involved in active collaboration with China, to apply caution when interacting with transplantation professionals in China and other high-risk countries and, if necessary, to take preventative and punitive measures.

In April this year, Wayne Jordash QC and his organisation Global Rights Compliance (GRC) published a ‘world first’ business and human rights Legal Advisory Report and Policy Guidance targeting transplant-related collaborations with China.  The Advisory sets out the legal risks of international collaborations in transplant medicine, research and training, and the hard and soft law obligations that govern those partnerships. It states that entering and/or maintaining relationships with Chinese institutions entails the highest risk of complicity in international crimes.

The Advisory outlines the responsibilities and obligations of medical institutions and their professionals under the United Nations Guiding Principles on Business and Human Rights (‘UNGPs’) and the International Bill of Human Rights, and highlights the obligation to respect the human rights and fundamental freedoms upon which other international conventions and legal frameworks that address trafficking in human organs are built. The UNGPs make clear that medical institutions and transplant-associated entities should, in all contexts, ‘treat the risk of causing or contributing to gross human rights abuses as a legal compliance issue wherever they operate.’

The Policy Guidance provides detailed guidance on developing, implementing, and evaluating minimum human rights due diligence processes to avoid contributing to human rights abuses and complicity in international crimes. It includes illustrative approaches to assess whether relationships with institutions may cause, contribute to, or be linked to unethical organ transplantation, organ trafficking, and forced organ harvesting. It calls for the severing of ties with countries where prevention, mitigation and remediation are not possible.

The final recommendation of the China Tribunal was that doctors and medical institutions, industry and businesses – most specifically airlines, travel companies, financial services businesses, law firms, and pharmaceutical and insurance companies – together with individual tourists, the education industry and the arts should now recognise that they are interacting with a criminal state. The Advisory addresses medical institutions, namely hospitals, universities, professional societies, medical journals, independent professional bodies, transplantation societies, medical schools and associated medical professionals in the field of organ transplantation, and it focuses on collaborations such as clinical training, clinical research, grants and funding, and the provision of medical equipment and drugs.

The medical community must join in the global effort to stamp out all unethical organ sourcing and stop the trade in human misery. The GRC Legal Advisory Report and Policy Guidance provide the necessary framework to make this happen.