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World first: Landmark study exposes transplant research community failings on ethical standards

New research led by academics at Macquarie University reveals that the transplant research community has failed to implement ethical standards in banning the publication of research using material from Chinese executed prisoners.

• Major study calls for the retraction, pending investigation, of over 440 studies on the outcomes of 85,477 transplants due to concerns over the legitimacy of organ donation from executed prisoners

• Over 92 per cent of the studies in question failed to report whether organs were sourced from executed prisoners and 99 per cent failed to disclose if organ sources had provided consent for transplantation

• Concerns mount over the large body of unethical research that now exists, raising issues of complicity and moral hazard in peer-reviewed transplant research being used here in Australia, as well as globally Sydney,

Wednesday 6 February 2019.

A landmark study, led by researchers at Macquarie University and published in BMJ Open, has uncovered mass failings in complying with international ethical standards concerning the publication of peer-reviewed research on transplant organs sourced from Chinese executed prisoners.

The world first study found that research published in peer-reviewed English language journals between January 2000 and April 2017 regarding transplantation of organs, did not meet the ethical standards of international medical bodies such as the World Health Organization (WHO), The Transplantation Society, and the World Medical Association.

The study exposed mass failings and very poor compliance with ethical standards in the reporting of organ donors:

• 99 per cent of studies failed to report if organ donors had given consent for transplantation

• 92 per cent of studies failed to report whether organs were sourced from executed prisoners

• 19 studies, involving 2688 transplants, claimed that no organs from executed prisoners were used. However, these studies took place prior to 2010, when there was no volunteer donor program in China.

Lead researcher, Professor of Clinical Ethics Wendy Rogers from Macquarie University, believes the studies need to be retracted and investigated and that agreed standards for reporting transplant research for peer-reviewed papers would help stop publication of unethical research. “The world’s silence on this barbaric issue must stop. Researchers and clinicians who use the research risk complicity by accepting Chinese methods of organ procurement. Research which has used unethically obtained materials has no place in peer-reviewed journals. As an academic community we need to come together to say enough is enough” said Professor Rogers. She and her co-authors propose an international summit to develop and implement standards for reporting organ procurement.

“It is extremely concerning to us as academics, as it should be to the medical research community at large, that there is now a large body of unethical research that transplant researchers in Australia and internationally may have used and benefited from. To maintain ethical standards, this research should be retracted pending investigation into each of the individual papers,” she added.

The use of organs from executed prisoners is widely condemned around the world because of the potentially coercive situation of being on death-row, which can undermine the possibility of ethicallyvalid consent. In some cases, consent may not be being sought at all.

China has long received condemnation for harvesting organs from executed prisoners from organisations like Amnesty International who have led campaigns calling for an end to the practice. However, as late as 2014, 90 per cent of transplant organs in China were sourced from executed prisoners, according to Dr Huang Jiefu of the Chinese Organ Donation Committee.

Members of an independent people’s tribunal recently gave a draft judgement which concluded that forced organ harvesting from prisoners of conscience has taken place in China and on a substantial scale, adding to concerns about the source of the organs used in the transplants reported in this research.

In 2006, The Transplantation Society explicitly stated that it would not accept conference papers based on research involving organs sourced from executed prisoners, setting the standard for medical journals across the world. However, this new research has found major breaches of this ethical standard. Most recently, The Transplantation Society has reissued a requirement for all journals to reject papers that do not abide by ethical principles to ensure compliance among the research community.

This is the first time that a study has been conducted to track the progress of the transplant community in blocking publication of research that uses organs from executed Chinese prisoners.

A recent Australian parliamentary inquiry has recommended that the Australian Government do more to combat organ trafficking and transplant tourism which accounts for nearly $2.3 billion a year. China claims to have banned the practice of organ harvesting from executed prisoners from January 2015 and implemented a zero-tolerance policy, however several charities and pressure groups suggest that the practice is still continuing.

ENDS Rogers, W., Robertson, M., Ballantyne, A., Blakely, B., Catsanos, R., Clay-Williams, R., & Fiatarone Singh, M. (2019). Compliance with ethical standards in the reporting of donor sources and ethics review in peer-reviewed publications involving organ transplantation in China: A scoping review. BMJ Open.

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