Here is a case study that I found interesting enough to post (c. NSU, 2006):

Kidneys, livers, corneas, and other body parts from executed Chinese prisoners are being transplanted into U.S. citizens and permanent residents who otherwise would have to wait years for organs. Many of the patients come back to the U.S. for follow-up care, which Medicaid or other government programs pay for.

The transplants in China, which doctors in both countries say are increasing, have presented the U.S. medical establishment with an ethical dilemma. Should U.S. doctors treat patients who have received organs from executed Chinese prisoners; and, if so, would they be tacitly condoning the practice and encouraging more such transplants? Yet, should they rebuke patients who, often in desperation, participate in a process that some transplant advocates condemn as morally wrong?

Executed prisoners are China’s primary source of transplantable organs, though few of the condemned, if any, consent to having their organs removed. Some of the unwitting donors may even be innocent, having been executed as part of a surge of executions propelled by accelerated trials and confessions that sometimes were extracted through torture.

The U.S. transplantation society states that decisions to donate organs must be made freely and without coercion or exploitation of any sort. It opposes any organ donations by prisoners, even to their relatives, because the circumstances of incarceration make it impossible to ensure that the decision is not unduly influenced by secondary benefits, such as an improved diet, that a prisoner may stand to gain.

U.S. doctors, however, say that there is little they can do to stop the flow of prisoner organs to the U.S., because China’s supply is growing, just as is the U.S. demand. More transplantable organs are available in China, because more people are being executed. This year, 5,000 prisoners or more are likely to be put to death during a nationwide anti-crime drive. Many of them will be stripped of their vital organs, though there is no available data to say exactly how many. Chinese government policy allows the harvesting of organs if the prisoner or the prisoner’s family has given written consent, or if the body is not claimed. In practice, however, the rules are often ignored, and illegal harvesting tolerated.

China, moreover, has made great strides in transplant techniques, having performed 35,000 kidney transplants since its first successful one in 1961. As a result, transplant centers have opened around the country, some with special wards catering to high-paying patients. Hospitals welcome foreign patients, because they pay as much as 10 times the price local patients pay for the same operation.

If you were formulating a policy on this practice, what ethical issues would you consider?