Science, Ethics, and Removing Organs from Those Who’d Rather Keep Them

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The best show on television right now is The Good Place and I will hear absolutely no argument against it. It’s hilarious, heartwarming, and so fucking smart that it makes me want to pick up my old college philosophy books. Almost. I mean, if I hadn’t sold them for ramen money immediately after classes ended.

It’s all about philosophy, and goes into many of the different philosophies that humans have tried to come up with to make sense of the world and our place in it, and particularly the way we treat one another. I enjoy it for the same reason I kind of hated my college philosophy classes: because it’s so damn confusing sometimes to figure out what’s right once you start examining why you think some action is good or bad, morally speaking.

I turn your attention to the news that Wendy Rogers, Professor of Clinical Ethics at Macquerie University in Australia, has published a report demanding that more than 400 scientific studies be retracted because they may have been based on organs that had been harvested nonconsensually from Chinese prisoners. I already don’t know what to think and we haven’t even made it past the headline yet.

For several years now, human rights activists, world leaders, and scientific journals have called on China to stop harvesting the organs of their prisoners without consent, and China claims that they’ve mostly stopped it although there still is no such law on the books. But the numbers don’t look good for them, seeing as they claim they’re transplanting a fraction of the organs they actually are. It’s obviously still happening, and it appears to be more frequent than volunteered organ donation, so Rogers examined hundreds of studies from the past decade and found that 99% of them didn’t prove they got consent in their research on transplanted organs.

As an example of the type of research we’re talking about, the Guardian points out that in 2017 a prestigious journal retracted one study looking at the outcomes for liver transplants over the course of four years in one Chinese hospital. Important data, but they counted more than 500 livers in that time period, a number that would have been absolutely impossible with the number of known organ donation volunteers in China at that time.

Immediately, I have an ethical dilemma. Several, in fact! The first is this: should we throw away good science that was done via unethical practices? Do the ends justify the means? Let’s quickly look at one of the biggest examples of this in science: there are about 30 known Nazi experimentation projects performed on human prisoners, and we have the data from these experiments today. They’re applicable to those studying hypothermia, chemical weapons, fertility, and other fields. If you take an extremely simplified view of it, you could say that the experiments have already been done and if the data can help human lives in the future, it would be unethical to not use it. But things are always more complicated: what if using that data inspires other people to perform unethical experimentation on humans, because again, maybe the result will justify it? Then the ethics become a bit more muddled.

Philosophy aside, there’s a scientific reason to discard it: unethical research is often badly done research. In 1990, Dr. Robert L. Berger published a detailed investigation of the Dachau hypothermia experiments in the New England Journal of Medicine, finding that they were “riddled with inconsistencies” and showed clear evidence of data falsification and fabrication. And when you step back to think of it, it becomes pretty obvious: the Nazis may have had a few smart guys working for them, but overall it was a an evil, fucked up regime that believed absolute fairytales like, well, the idea of Ultima Thule being a magical place full of giant ubermensch. A “scientist” who has no problem putting hundreds of innocent people in cold vats of water until they froze to death also probably wasn’t big on things like double blinding and statistical significance. And when his bosses are super pleased with doing things like that to someone simply because of their ethnicity or religion, you know he’s going to want to keep them happy with his results, even if it means fudging some numbers here and there. He’s not going to be keen to be the next experimental subject, after all.

So there, I’ve deftly avoided making a philosophical opinion by showing that there’s an empirical reason to discard science that is done with unethical practices. Whew!

To get back to the Chinese transplant case, I still had some other ethical concerns, though, specifically related to the point of these studies: organ donation. Is it unethical to take a dead person’s organs without their consent?

I know this may not win me many fans, but my gut has always said “no.” The ethical thing, in all cases, is to take every last bit of a dead body that might be useful to living humans and put it to use. Eyes, heart, liver, kidneys, whatever someone else needs — the dead don’t need it anymore and even if you have some superstitious idea of what should be done to a body after death, that shouldn’t supercede someone else’s right to live. Once you’re dead, you no longer deserve bodily autonomy. It’s like “the needs of the many outweigh the needs of the few” but instead it’s more like “the needs of the many outweigh the desires of the none.” None, because you’re dead.

So in that case, with that philosophical outlook, does it make it unethical that these studies involve organs that were harvested without permission? Again, in that simplified world, no. Easy call. If it’s always ethical to harvest organs, it’s ethical to study them.

But again, it’s not that simple. I know, it’s annoying, isn’t it? Here’s the problem: those organs aren’t just going to sick people who need them. They’re going to tourists, who can pay for them. This has resulted in an entire capitalist industry being built around the harvesting of organs. Combine that with an industry built around the imprisonment and subsequent execution of political adversaries, and now you have people who are in prison for disagreeing with the Chinese government, who are then executed at a specific date and time primarily because a new person has shown up looking to pay good money for their kidneys, or what have you. And now you have a government that is being rewarded for executing its critics, and boom, there goes your perfectly ethical solution.

And it actually gets worse, if you can believe it. Generally you harvest organs from dead people, but Amnesty International claims that China’s definition of “dead” doesn’t match the rest of the world’s, and so they are frequently pulling organs out of people while they’re still alive, simply to fill the demand.

And that is the mental journey I went down after reading this news — from thinking there’s no way prominent journals should retract 400 scientific papers to realizing that they absolutely, 100% should as a scientific, moral, and ethical necessity.

Rebecca Watson

Rebecca is a writer, speaker, YouTube personality, and unrepentant science nerd. In addition to founding and continuing to run Skepchick, she hosts Quiz-o-Tron, a monthly science-themed quiz show and podcast that pits comedians against nerds. There is an asteroid named in her honor. Twitter @rebeccawatson Mastodon Instagram @actuallyrebeccawatson TikTok @actuallyrebeccawatson YouTube @rebeccawatson BlueSky

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