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Since then, Dr. Diflo, director of the renal transplant program at the New York University Medical Center, has seen half a dozen such people, typically young Chinese American women. The surgeon says his patients weren't distressed about snatching organs from the condemned, but he was overwhelmed by the implications.
Unable to shoulder the burden alone, on January 11, Diflo took his "horror at a real ethical quagmire" to the medical center's Ethics Committee.
Diflo is the first American doctor to talk publicly about this experience, and he did so only after being drawn out by the Voice. The gruesome practice has been documented among ethnic Chinese communities throughout Asia, but so far every attempt to prove that people were leaving U.S. soil to buy organs from China's massive death row has failed.
"To tell you the truth, the original rationale for bringing this situation to the Ethics Committee was my own discomfort in taking care of these patients. I was outraged at the way in which they obtained their organs, and I had a great deal of difficulty separating that fact from the care of the patient," Diflo told the Voice.
"Several patients were very up-front and candid about it, that they bought an organ taken from an executed convict for about $10,000," Diflo recalls. "Most of the patients are ecstatic to be off of dialysis, and none has seemed particularly perturbed regarding the source of the organs."
There's no telling how many kidney buyers returning to the U.S. have gone for follow-up care at a less elite institution or stayed within secretive medical channels recommended by their brokers. Diflo gets his patients on referral from recognized hospitals. "Patients sort of arrive on their doorstep and they don't know what to do. Not everybody who's had a transplant is cared for by a transplant specialist. I tend to see the more complicated ones," Diflo says.
Of all medical disciplines, organ transplantation is perhaps the most bittersweet. Transplants are gifts that coax life from death, that close the door for one person while opening the future for another. But the outright sale of organs is abhorrent to nearly all surgeons in the field. Selling organs is a felony under a 1984 federal law that was spearheaded by then senator Al Gore, and is punishable by up to five years in prison and a fine of up to $50,000. Live or executed prisoners in the U.S. are forbidden to donate an organ, even for free, except to family members under special circumstances.
In China, human rights groups say, citizens have been executed for nonviolent offenses like taking bribes, credit card theft, small-scale tax evasion, and stealing truckloads of vegetables. Political dissidents have also been sentenced to death. Chinese embassy officials did not respond to requests for comment, but in the past the government has denied promoting the for-profit organ trade.
Diflo says he and his colleagues wrestled with the issue in a debate that was "quite lively and revealing, but the bottom line was that we take care of patients who come to us, regardless of their situationmoral, ethical, financial, or social. Although I might find what they had done reprehensible, I was still nonetheless obligated to care for them in the best way that I knew how, and that is what I do."
But Diflo refuses to let it end at that. "Because it is not really appropriate for me to take my outrage out on the patients who come to me, I began to think that I would be better off addressing the root problem, the pilfering of organs from prisoners in China. That is what pushed me to pursue this further," he says. And so he's going public.
America-based human rights activists have sought this break for years.
The trafficking of human organs from Chinese executions to American residents is "something we've always known was going on but something we've never been able to document," says an American investigator working for the Laogai Research Foundation, a group founded by renowned human rights crusader Harry Wu and named for the gulags of China.
The Federal Bureau of Investigation partnered with Wu in 1998 in a sting operation aimed at netting two suspected organ brokers who resided in Queens. Wu posed as a board member of a renal clinic in Aruba and got the men, Wang Cheng Yong and Fu Xingqi, to not only arrange for patients to fly to China for kidneys but to also smuggle corneas, which can keep for weeks when frozen, for sale abroad. The case was dismissed when a key witness fled the U.S. and refused to return to testify. The Laogai Research Foundation also discovered a doctor advertising himself as an organ broker in a Chinese-language newspaper published in the U.S. but no physical evidence was ever uncovered. In 1998, the FBI raided the Los Angeles offices of a man the feds said had presented himself as an organ broker, but it's unclear whether the scheme led to any transplants.