This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0791.HHS
DATE: 1/23/2022
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HM 791 Organ Harvesting Practices of the People's Republic of China
SPONSOR(S): Fischer and others
TIED BILLS: IDEN./SIM. BILLS: SM 1108
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Health & Human Services Committee Morris Calamas
2) Judiciary Committee
SUMMARY ANALYSIS
Organ donation is the process of surgically removing an organ or tissue from one person (the donor) and
transplanting it into another person (the recipient). Transplanting in such cases is necessary because the
recipient’s organ has failed or has been damaged by disease or injury. Transplantable organs include the
liver, kidneys, pancreas, heart, lung, and intestine. Transplantable tissue includes skin, bone, heart valves,
tendons, veins, and corneas. Forced organ harvesting is removing a person’s organ, or part of an organ,
without their consent, which can cause the death of the ‘donor.’
Before 2005, the People’s Republic of China’s (China) relied on organ procurement from executed prisoners.
China publicly admitted to the use of organs from executed prisoners for transplants in 2005, with up to 95%
of the organ transplants in China deriving from prisoner executions. In 2010, China began reforming its organ
transplantation system by developing a voluntary organ donation and allocation infrastructure. Chinese
officials announced that hospital-based voluntary donations would be the sole source of organs beginning in
2015; however, no changes to laws or regulations accompanied such announcement. The use of prisoner
organs remains legal in China.
The China Tribunal (Tribunal) is an independent body established to look into forced organ harvesting from
individuals and prisoners of conscience in China. The Tribunal concluded that, among other things, more
organ transplants take place than the voluntary donations would support, and that forced harvesting
continues in China.
HM 791 urges the President and Congress to:
Condemn China for the practice of forcibly removing human organs for transplants;
Pass legislation and measures that prohibit collaboration between U.S. pharmaceutical and medical
companies and any Chinese counterparts linked to forced organ harvesting; and
Ban people who have participated in forced organ harvesting from entering the U.S. and provide for
the prosecution of such people.
Legislative memorials are not subject to the Governor’s veto power and are not presented to the Governor
for review. Memorials have no force of law, as they are mechanisms for formally petitioning the federal
government to act on a particular subject.
This memorial has no fiscal impact on state or local governments. STORAGE NAME: h0791.HHS PAGE: 2
DATE: 1/23/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Organ and Tissue Donation in the United States
Organ and tissue donation is the process of surgically removing an organ or tissue from one person
(the donor) and transplanting it into another person (the recipient). Transplanting in such cases is
necessary because the recipient’s organ has failed or has been damaged by disease or injury.
1
Transplantable organs include the liver, kidneys, pancreas, heart, lung, intestine.
2
Transplantable
tissue include skin used as a temporary dressing for burns, serious abrasions and other exposed
areas; bone is used in orthopedic surgery to facilitate healing of fractures or prevent amputation; heart
valves are used to replace defective valves; tendons are used to repair torn ligaments on knees or
other joints; veins are used in cardiac by-pass surgery; and corneas can restore sight.
3
A single organ
donor can save up to eight lives and over seventy-five more can be improved through organ donation.
4
Despite advances in medicine and technology, and increased awareness of organ donation and
transplantation, more donors are needed to meet the demand for transplants.
5
As of January 2022,
120,000 children and adults are waiting for a life-saving organ transplant, including 5,000 Floridians.
6
In
2021, 41,354 organ transplants were performed in the United States, reflecting an increase of 5.9
percent from 2020.
7
Living donor transplants on the other hand significantly decreased in 2020 due to
COVID-19.
8
While they increased in 2021, the numbers remain lower than in previous years. In 2021, a
total of 6,541 living donor transplants were performed nationwide.
9
Forced organ harvesting is removing a person’s organ, or part of an organ, without their consent, which
can cause the death of the ‘donor.’
10
Forced Organ Harvesting in China
Before 2005, the People’s Republic of China’s (China) organ transplant practices relied on forced organ
harvesting and organ procurement from executed prisoners. The rate of voluntary donation of organs
was low due to a lack of a cadaver organ donation system and overall donation system. Between 1977
and 2009, a total of 130 voluntary deceased organ donations were reported, however approximately
120,000 total organs were reported as transplanted in China during the same period. China publicly
admitted to the use of organs from executed prisoners for transplants in 2005, with up to 95% of the
organ transplants in China deriving from prisoner executions.
11
1
Cleveland Clinic, Organ Donation and Transplantation, https://my.clevelandclinic.org/health/articles/11750-organ-donation-and-
transplantation#:~:text=Organ%20donation%20is%20the%20process%20of%20surgically%20removing,one%20of%20the%20great%2
0advances%20in%20modern%20medicine (last visited Jan. 20, 2022).
2
Id.
3
Donate Life Florida, Frequently Asked Questions, https://www.donatelifeflorida.org/categories/donation/ (last visited Jan. 20, 2022).
4
Health Resources and Services Administration, What Can Be Donated, https://www.organdonor.gov/learn/what-can-be-donated (last
visited January 14, 2022). https://optn.transplant.hrsa.gov/data/ (last visited Jan. 20, 2022).
5
U.S. Department of Health and Human Services, Organ Procurement and Transplantation Network,
https://optn.transplant.hrsa.gov/news/all-time-records-again-set-in-2021-for-organ-transplants-organ-donation-from-deceased-donors/
(last visited Jan. 20, 2022).
6
Supra, note 3.
7
Supra, note 5.
8
Id.
9
Id.
10
The Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China, Judgment, March 1, 2020,
https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf (last visited Jan. 20, 2022).
11
Kirk, Allison C., et al, BMC Med Ethics 16, Article number 85 (2015), “Historical development and current status of organ
procurement from death-row prisoners in China,” https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-015-0074-0 (last
visited Jan. 20, 2022) STORAGE NAME: h0791.HHS PAGE: 3
DATE: 1/23/2022
Beginning in 2010, China began reforming its organ transplantation system by developing a voluntary
organ donation and allocation infrastructure, and requiring all organ transplants to be allocated solely
through the China Organ Transplant Response System (COTRS).
12
The organ procurement,
transplant, and allocation data contained in COTRS is not publicly available.
13
China’s practice of organ
procurement shifted from prisons to hospital-based voluntary donors declared dead by physicians.
14
Chinese officials announced that hospital-based voluntary donations would be the sole source of
organs beginning in 2015, however no changes to laws or regulations accompanied such
announcement, meaning the use of prisoner organs remains legal.
15
United Nations Concerns
In June, 2021, a group of United Nations (U.N.) human rights experts raised concerns over China
carrying out forced organ harvesting on detainees from ethnic, linguistic, or religious minorities,
including Falun Gong practitioners, Uyghurs, Tibetans, Muslims, and Christians. Such detainees may
be forcibly subjected to blood tests and organ examinations through ultrasounds and x-rays, without
informed consent, the results of which are entered into COTRS. The U.N. reports detainees are held
without explanation of or warrants for their arrest. The most common organs removed from prisoners
are hearts, kidneys, livers, and corneas.
16
The Chinese Government responded to the U.N. in September, 2021, stating that the allegations of
organ harvesting came from “actors” who “repeatedly engage in slander and rumor-mongering on the
issue of human rights in China.”
17
China Tribunal
The China Tribunal (Tribunal) is an independent body established by the International Coalition to End
Transplant Abuse in China
18
to look into forced organ harvesting from individuals and prisoners of
conscience in China and to investigate what criminal offenses, if any, have been committed by state or
state-approved organizations or individuals in China who may have been engaged in forced organ
harvesting.
19
The Tribunal has seven members from various countries outside of China, including
England, the United States, Iran, and Malaysia. Members include multiple human rights attorneys, a
medical school professor, a historian, and a businessman. The focus of the Tribunal was on forced
harvesting that results in death, as no evidence exists of forced harvesting where the ‘donor’ survives.
20
The Tribunal analyzed witness statements, publicly available information and admissions from the
Chinese government, and telephone calls to Chinese hospitals and government officials.
21
The Tribunal
reported that:
22
12
Id.
13
Robertson, Matthew P., et al, BMC Medical Ethics 20, Article number 79 (2019), “Analysis of official deceased organ donation data
casts doubt on the credibility of China’s organ transplant reform,” https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-
019-0406-6 (last visited Jan. 20, 2022).
14
Supra, note 11.
15
Paul, Norbert W, et al, BMC Med Ethics 18, Article number 11 (2017), “Human rights violations in organ procurement practice in
China,” https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-017-0169-x (last visited Jan. 20, 2022).
16
United Nations Human Rights – Office of the High Commissioner, China: UN human rights experts alarmed by ‘organ harvesting’
allegations, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=27167&LangID=E (last visited Jan. 20, 2022).
17
Permanent Mission of the People’s republic of China, Reply from China dated 9 August 2021 to the Office of the High Commissioner
for Human rights, published Oct. 9, 2021, https://spcommreports.ohchr.org/TMResultsBase/DownLoadFile?gId=36489 (last visited Jan.
20, 2022)
18
The International Coalition to End Transplant Abuse in China, established in 2014, is a non-profit, independent, non-partisan coalition
composed of lawyers, academics, ethicists, medical professionals, researchers, and human rights activists dedicated to ending forced
organ harvesting ion China. Its Advisory Committee contains members from multiple countries outside of China, including Australia,
Canada, the United States, New Zealand, and a former surgeon from China who is currently based in the United Kingdom.
19
China Tribunal, China Tribunal – Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China,
https://chinatribunal.com/ (last visited Jan. 20, 2022). A prisoner of conscience is any person who is physically restrained (by
imprisonment or otherwise) from expressing an opinion which he or she honestly holds and which does not advocate or condone
personal violence.
20
Id.
21
Id.
22
Id. STORAGE NAME: h0791.HHS PAGE: 4
DATE: 1/23/2022
Wait times promised by Chinese doctors and hospitals for organs to be available were
extraordinarily short;
Minority populations, including Falun Gong and Uyghurs were tortured;
The number of transplants performed were much greater than the number of eligible, voluntary
donors; and
A massive infrastructure development of facilities and medical personnel for organ transplant
operations was underway before a voluntary donor system was planned.
The Tribunal concluded that there must have been another unidentified source of organs other than
voluntary donors and that there is no evidence the practice of forced harvesting has stopped. The
unidentified sources were likely prisoners of conscience, including Falun Gong practitioners, Tibetan
Buddhists, House Church Christians, and the Uyghurs.
23
Legislative Memorials
Legislative memorials are not subject to the Governor’s veto power and are not presented to the
Governor for review. Memorials have no force of law, as they are mechanisms for formally petitioning
the federal government to act on a particular subject.
Effect of the Memorial
HM 791 urges the President and Congress to:
Condemn China for the practice of forcibly removing human organs for transplants;
Pass legislation and measures that prohibit collaboration between U.S. pharmaceutical and
medical companies and any Chinese counterparts linked to forced organ harvesting; and
Ban people who have participated in forced organ harvesting from entering the U.S. and provide
for the prosecution of such people.
B. SECTION DIRECTORY:
Not applicable.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
23
Id. STORAGE NAME: h0791.HHS PAGE: 5
DATE: 1/23/2022
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This memorial does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
No rulemaking is necessary to implement the memorial.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES