In our lifetimes, organ transplants have shifted from rare, nearly experimental treatment to a relatively mainstream panacea for ailments. So mainstream in fact, that insurance companies routinely include in their plans provisions for those covered to receive organ transplants.

We have all read the touching accounts of a young father in dire need of a transplant; had it not been for the generosity of total strangers who had lost their child in a horrible car accident, the young father would not have survived. The entire action of organ donation has been framed as a final act of selflessness, a way for grieving families to let their dearly departed live on in someone else.

While the rise of organ transplants has led to some cavalier attitudes toward our bodies – “Well, I can always get another” – it also has become a treatment to which many believe all should have access. While debates usually center around whether public monies should be appropriated for those who cannot afford transplants, legislation in the last two years has provided for expanded Medicare coverage for transplants.

Most of the criticism surrounding the system of distributing organs are the current “local first” guidelines that match recipients and donors geographically rather than on the basis of most urgent medical need. Because the waiting list for organs has grown from 14,000 patients in 1988 to 66,000 in 1999, nearly 5,000 people die annually while awaiting the transplants they need.

Crudely put, organ transplants are a scarce commodity.

Enter China, and its shady human rights record. In what The New York Times called “one of its most intense crackdowns in years” the Chinese government is putting to death around 10,000 people this year. Human rights groups believe that most of the people sentenced are innocent – that they have been hastily convicted or tortured into confession.

The transplant industry in China has spiked, and it is not because the Chinese are going to the DOT in throngs to get a little “Y” on their driver’s licenses. The major source of organs in China are the Chinese executed by the state, and the major centers of organ transplantation are government and military hospitals.

Because of traditional Chinese beliefs about keeping the body intact after death, individuals don’t volunteer their organs for donation after execution, nor do their families consent. However, the central government allows organ harvests from unclaimed bodies of executed prisoners. If families believe that a steep fine will accompany claiming the body, the organs may be harvested before the family is able to claim the body.

According to interviews with former Chinese prison officials, the system for organ procurement in China was neither haphazard nor sporadic. When executions were scheduled the cadavers were sold – think futures – for around $45. The prisoners’ blood would be drawn to determine a type match, and in some cases an anti-coagulant was administered shortly before the execution to optimize the state of the organs when harvested.

Harvest teams would stand by with specially equipped ambulances and within 15 seconds after the prisoner was shot, the team would remove and preserve the organs, racing to the transplant center with police escort.

Desperation among foreigners – Southeast Asians, Japanese, and Americans – to receive badly needed organ transplants has led to an influx of foreign nationals to China seeking transplants. For a price comparable to the rates in the United States, but 10 times that for the native Chinese rate, foreigners can jump the donor waiting lists in their home countries and receive a transplant. The patients then return to the United States for continued care, paid for, in some cases, by Medicaid or Medicare.

For American doctors, the increase in transplant patients seeking organs abroad creates a massive ethical problem. By treating those who go to China for the organs they need, some doctors feel they would be acquiescing with the practice. The U.S. House of Representatives has a bill in committee that would prohibit issuing a visa to any citizen of China who seeks to enter the United States for training in transplantation, but thus far, no deterrents are in place for people who leave the United States to receive organ transplants, such as cutting them off from public health funding if they chose to go abroad for transplants.

While no action by the United States could curb the practice in China, by trying to decrease American demand for such practices is more palatable than condoning organ harvest from prisoners executed in China.

Rachel Faber Machacha is a graduate in international development studies from Emmetsburg.