Subcommittee on International Human Rights Committee on Oct. 21st, 2014

[The Chair, Conservative, Scott Reid]

You have one minute.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

I'm not that quick.

Thank you, Mr. Chair.

[The Chair, Conservative, Scott Reid]

I wonder if I could follow up on one point before I go to the next questioner?

You said Israel shut this down. Did Israel adopt a regime similar to what you suggested: a statute saying that it is an offence to go to China for this purpose?

[Dr. Damon Noto]

The answer is yes. The first thing they enacted was that no medical insurance within Israel could pay for any type of organ transplantation abroad. Then they put policies in place to make it illegal to travel for medical tourism, especially transplantation, to China. So the answer is yes.

[The Chair, Conservative, Scott Reid]

Thank you.

Ms. Grewal, please.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

Thank you, Chair, and thank you to our witnesses today for their time and presentations.

When we look at the Kilgour/Matas report and the actions of the European Parliament and the UN, have they caused any real change on the ground in China? Did China slow organ trafficking at all because of this international attention?

[Dr. Damon Noto]

There has been some effect. One is that a lot of it went underground. There were a lot of things that we had access to before the Kilgour/Matas report. They had an open public register that we could actually look at in Hong Kong. That closed after the Kilgour/Matas report. The information became harder to get, but as for whether this mass system slowed, we don't feel that it did. The only thing that might have slowed it was the Olympics in Beijing. I don't really think the Kilgour/Matas report had an effect. The fact that they made it open to the public, and made it more widely known, had ripples, but did not really slow the amount of transplants that were occurring.

[Ethan Gutmann]

I think there is another aspect, which is that it slowed the rate of public executions in China. Again, these are prisoners who are on death row. It appears to have had an effect on slowing down that rate. Supposedly they are closing some of the labour camps, although we don't actually see a sign of a lessening of the overall population in Laogai if you put together everything: prisons, labour camps, black jails, mental hospitals, and detention centres. So in fact it's a kind of reorganization.

But these clearly seem to be oriented towards western consumption. One of the problems we've had in this—if you think of it as an activist struggle of some kind—is that some doctors look at this and just say, “Well, nobody should be executed for their organs, period”. Others are looking—and I guess I'd put myself in with Kilgour and Matas, who are much more concerned with prisoners of conscience. We really think this steps over a very serious line.

In Europe, because they're very against the death penalty, they often equate Liaoning province and Texas as being practically the same thing.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

Regarding organ transplant tourism, how many so-called international tourists are there annually, and do you have the number of Canadians travelling to China for this each year?

[Dr. Damon Noto]

There are thousands of tourists. I don't know the number of Canadians. I can say that there are over 100 from the U.S. a year. I know those numbers; I don't know Canadian numbers. But by far for America the number one place to go for organs is China, and it's increasing every year. I don't know the Canadian numbers, but if you look at all the countries, there are thousands of people going to China for organs.

[Ethan Gutmann]

Anecdotally—and I hate to plug another author's book—Daniel Asa Rose wrote a book called Larry's Kidney, a very humourous account of his getting a kidney for his ne'er-do-well cousin in China.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

Can one of you expand on the demand for organs in China? Is legislation against organ trafficking enough to stop the demand for organs? How does this demand get addressed in a healthy way?

[Dr. Damon Noto]

Do you mean the demand to get organs? That demand is huge worldwide, and I don't think enacting laws is going to stop the demand. I do believe that it would stop Canadian citizens on a large scale from going over to China, but that demand we're looking at is going to be there for years to come.

[Ethan Gutmann]

I don't want to say that the revenue stream is really the significant thing. If you were stopping organ tourism coming from Canada, perhaps that's not the most salient point. But it is true that there are cases, at least unverified, of people having paid up to $2 million for one of these organs. If you're talking about some extremely wealthy person, the kind of person who could easily exist in Japan, Canada, or the United States, it's very possible that some people have paid these sorts of figures. That is an incentive.

It is true that the Chinese pay half the foreigner price. They pay sometimes much less than the foreigner price. For example, if we take the $62,000 U.S. wanted for a kidney back in 2004, the Chinese were paying sometimes as low as $2,000 for that same kidney, so there is a monetary point.

But I think the larger point is this, that China has great ambitions in the medical field. They see this as what they call a pillar industry—pharmaceuticals. They see themselves as the new Rome, the new FDA, where people will go to do their experiments and go for drug approval. Any message that this body can send them saying, “No, you're not there yet” is very important. It does have a massive impact, far beyond what you might recognize.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

My last question goes to Mr. Gutmann. It seems that China's criminal system has an incentive to kill its prisoners in order to supply the health care system with new organs, so how do you break that connection between China's criminal justice system and its health care system?

[Ethan Gutmann]

What we hear not so anecdotally from World Organization to Investigate the Persecution of Falun Gong, which actually has a very strong investigative team of native Chinese who go in and make phone calls and get to know people who are involved in this business, is what they describe as a bidding system, almost a bidding war for judges between the armed police on the one side and the military hospitals on the other.

In other words, the military hospitals were always given carte blanche to do organ harvesting of prisoners of conscience. The armed police are trying to move into the action, and that's where we're at. The legal system, I'm afraid, is totally corrupt and of course that is the larger tragedy of this whole thing, that you've taken the two most respected professions in any society—well, perhaps not the legal one in our society—but certainly doctors are number one in any society, and it has been deeply corrupted.

[The Chair, Conservative, Scott Reid]

Professor Cotler, go ahead, please.

[Irwin Cotler, Liberal, Mount Royal, QC]

Thank you, Mr. Chair.

As has been said, we've had witness testimony on these matters more than once, principally from David Kilgour and David Matas.

I have to say that I feel that today is a tipping point in this whole matter because a number of considerations have emerged from your joint testimony today, which I think really are the basis for what needs to be done at this point, and that is to sound the alarm.

First, there is an ongoing crime against humanity being committed. There has been some sense—and maybe this has been part of what the Chinese authorities have managed to accomplish—that somehow there has been an abatement or that they have turned away from it, etc. I think the first thing that emerges is that there are ongoing crimes against humanity.

Second, these are state-sanctioned. I think that's an important dimension to it.

The third is that it is targeting political prisoners—mainly Falun Gong but not only Falun Gong—in the manner in which it is targeting minorities and the vulnerable in China.

The fourth thing is that there is an ongoing culture of impunity, and nobody has been held responsible.

The final thing—and this is where it becomes the responsibility of us as parliamentarians—is that if we remain silent, we effectively are complicit in all of the above things that I mentioned.

I've introduced a private member's bill to do what you've suggested, Dr. Gutmann, which is to criminalize organ tourism. It has been seconded by my colleague here Judy Sgro. But since I am a member of the Liberal party, the third party, it will not go anywhere. I'm also low on the totem pole, etc. in terms of getting a private member's bill considered.

This to me is something we have to get the government onside with, because unless we have governmental backing for it, it will go nowhere. That's what I think makes your comments propitious for the Prime Minister and the foreign minister, who will be visiting China shortly. I'm not saying that their bringing it up will have an impact; I'm saying that their not bringing it up would have an impact, because then China could therefore infer that we don't take it seriously.

So I think, therefore, number one, the representations in China have to be made by our leadership. Number two, we have to push that private member's bill to try to get it to be a governmental bill.

Finally—and this is what I wanted to put as a question on this—how can we internationalize the advocacy? How can we create a critical mass of advocacy around the points you mentioned, so that there will end up being a mobilization of shame against the human rights violated, in this instance in China, that will have some effect?

[Dr. Damon Noto]

I can talk only from a medical perspective. Our goal has always been to have the international medical community make it very difficult for China.

I'll give you an example. These Chinese transplant surgeons and the Chinese Medical Association are still members of the international transplant society. Their memberships have not been revoked even though they don't comply with any of the international standards for ethical transplantation. They continue to want to engage with China, to keep them in, to keep talking with them, instead of actually forcing them and saying, “Listen, you can't be a member and you can't join our meetings and you can't give presentations unless you can abide by these standards”.

We keep having different types of standards for China, whether we're interacting with it economically or medically. If different countries could put pressure on their own organizations—for instance, we are working on the American Medical Association—and their transplant societies and say, “Listen, we really need to do something about China being a member of any of these organizations”, that would put pressure on them, from at least a medical aspect, to say, “Listen, you have to knock this off. You can't be a member of our international community and continue to do these unethical crimes against humanity”.

[Ethan Gutmann]

I'd just add that there are several states certainly—I've testified in Scotland—that have shown a huge interest. Whether they're independent or not, they control their health policy, and they control their education policy. They've shown a lot of interest in stopping organ tourism, and they've seriously considered it.

In New South Wales in Australia, the Greens wrote up a very intricate and beautifully designed bill that would have stopped organ tourism. They even did it without actually mentioning China. This was their very clever way of doing it, but they apparently hade a fair amount of bipartisan support, even though they're Greens.

I think there are other states. I live in London, and I don't expect Westminster to move quickly on this. It's the world's bank, and London is the world's banker, but it is interesting to note this sort of strange confluence of Scotland, Australia, and potentially Canada. These are the countries that could really change everything, because they could put that kind of pressure on Westminster. So even to consider it, or even to have some kind of cooperation with these other parties out there, some sort of coordination, could make a major change. If Westminster were to change its mind, if Westminster were to feel a lot of pressure—the Irish too, by the way, have shown a lot of interest—one can imagine that Berlin could change its mind too.

[Irwin Cotler, Liberal, Mount Royal, QC]

I might add that I borrowed from the Australian model and did not mention China specifically for the purposes of mobilizing more support.

[The Chair, Conservative, Scott Reid]

Thank you.

We go now to Mr. Schellenberger.

[Gary Schellenberger, Conservative, Perth—Wellington, ON]

Thank you.

Thank you for your presentation today.

I've heard in this committee about many tragic occurrences, about things that you just wouldn't realize would still happen in this world today.

A very good friend of mine donated a kidney to his sister quite a number of years ago. She survived for 26 years, I think, as a live transplant recipient. She just passed away a couple of years ago.

I know you can't transplant hearts and have two people living at the end, but with kidneys, some liver transplants, or partial liver transplants, is that part of what goes on in China now?

[Dr. Damon Noto]

We believe it occurs in very small numbers. It's almost insignificant, when you look at the total number of transplants being performed every year, that those are taking place. Typically, if it's from the prisoner system, obviously they are executed and cremated. There are very few people coming forward to donate for a relative or a friend in that type of perspective. There has been an increase over the past couple years in the Chinese literature, but it's been small.

[Ethan Gutmann]

It's not terribly well verified, either. I mean, one of the reasons we have that picture of the three surgeons is that it was one of the very rare occasions where somebody actually donated their organs. It was released for that reason. Even so, the surgeons still look awfully nervous about the whole thing.