A Dull Knife Poised


Dr. Thomas Diflo’s Hippocratic oath has taken him from the operating room to Capitol Hill. Diflo, director of renal transplant surgery at NYU Medical Center, will testify Wednesday before the House of Representatives Subcommittee on International Operations and Human Rights about patients who have come to him implanted with organs bought from China’s death row.

Human rights advocates say the hard cash paid by patients flying to China for the transplants has corrupted the Chinese judicial system by providing a market incentive for additional executions in a nation that already kills more prisoners each year than the rest of the world’s countries combined. Senate leaders, including New York’s pair of Democrats, have expressed “horror” at the allegations, but no hearings on the issue are yet planned in the upper house of Congress.

Diflo first shared his experiences with the Voice (see “ China’s Execution, Inc.,” May 8) after the paper chased down a rumor that he’d expressed concerns before an NYU Medical Center Ethics Committee. “My whole point of talking to you was spreading this information as far as I could, and I was surprised how far this has spread,” said Diflo, who by going on record made real what had been a dark suspicion in the human rights community in the United States for years.

The doctor was outraged by the practice, but he might nevertheless find himself at odds with his hosts in Washington. The chairwoman of the subcommittee, Representative Ileana Ros-Lehtinen of Florida, a Republican known for backing anti-Castro Cuban causes, has drafted a bill to ban Chinese physicians from entering the United States “for training in organ or bodily tissue transplantation.”

When he read the bill, Diflo was taken aback. “That sounds a little Draconian. It seems kind of shortsighted, really,” he said.

Harry Wu, a human rights crusader who has spent decades in Chinese prisons, says he helped model the bill on one prohibiting Chinese doctors involved with contraception from entering the U.S. because of the communist government’s program of coerced abortions.

Wu, founder of the Laogai Research Foundation, an investigative nonprofit named for China’s gulag, is adamant. His group issued a report with the troubling charge that the cause of death of some Chinese prisoners is the organ harvesting itself, done by doctors.

Wu hopes the bill will cut through the static of rationalizations with which doctors in China have surrounded themselves—excuses Wu compares to the “greater good” German physicians manufactured to help them get through human experimentation during the Holocaust.

“Chinese doctors feel very honored to come to the United States. This bill will send a strong message to the people committing this practice: You are not a doctor. You are involved with murdering and you are violating human rights,” Wu explained. Because prisoners’ organs make up the lion’s share of China’s supply, a sweeping American law wouldn’t accidentally net innocent doctors, he asserted.

University of Rochester physician and medical ethicist Mark Fox is also revolted by a system that may reward doctors for participating in executions for profit, but he shares Diflo’s reservations about the proposed ban. “Our thought generally has been that while those stories raise concerns, we still have an obligation within the medical and scientific transplant community to broaden knowledge. We have a responsibility to provide training even if there are limits on how we can influence how it’s applied in another context,” he said. Fox, the incoming ethics committee chairman for the United Network for Organ Sharing, said American doctors must use personal exchanges to “communicate our values.”

If there are butchers in China masquerading as transplant physicians, Fox and Diflo would rather deprive them of a market by tackling the American organ shortage. Diflo puts his faith in a combination of public education and emerging technologies. Fox said that to shorten years-long waiting lists, doctors must prescribe a more bitter medicine that “runs contrary to everything physicians are taught.” They must learn to look many patients in the eye and say no. “We don’t do a good job of saying, ‘You’re too sick to benefit.’ “