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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
  1. Wendy Rogers1,2,
  2. Matthew P Robertson3,
  3. Angela Ballantyne4,
  4. Brette Blakely5,
  5. Ruby Catsanos6,
  6. Robyn Clay-Williams7,
  7. Maria Fiatarone Singh8
  1. 1 Department of Clinical Medicine and Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
  3. 3 Human Rights Law Foundation, New York, USA
  4. 4 Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
  5. 5 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  6. 6 No institutional affiliation, Sydney, Australia
  7. 7 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  8. 8 Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Wendy Rogers; wendy.rogers{at}mq.edu.au

Abstract

Objectives The objective of this study is to investigate whether papers reporting research on Chinese transplant recipients comply with international professional standards aimed at excluding publication of research that: (1) involves any biological material from executed prisoners; (2) lacks Institutional Review Board (IRB) approval and (3) lacks consent of donors.

Design Scoping review based on Arksey and O’Mallee’s methodological framework.

Data sources Medline, Scopus and Embase were searched from January 2000 to April 2017.

Eligibility criteria We included research papers published in peer-reviewed English-language journals reporting on outcomes of research involving recipients of transplanted hearts, livers or lungs in mainland China.

Data extraction and synthesis Data were extracted by individual authors working independently following training and benchmarking. Descriptive statistics were compiled using Excel.

Results 445 included studies reported on outcomes of 85 477 transplants. 412 (92.5%) failed to report whether or not organs were sourced from executed prisoners; and 439 (99%) failed to report that organ sources gave consent for transplantation. In contrast, 324 (73%) reported approval from an IRB. Of the papers claiming that no prisoners’ organs were involved in the transplants, 19 of them involved 2688 transplants that took place prior to 2010, when there was no volunteer donor programme in China.

Discussion The transplant research community has failed to implement ethical standards banning publication of research using material from executed prisoners. As a result, a large body of unethical research now exists, raising issues of complicity and moral hazard to the extent that the transplant community uses and benefits from the results of this research. We call for retraction of this literature pending investigation of individual papers.

  • organ donation
  • china
  • publication ethics
  • scoping review
  • executed prisoners

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Footnotes

  • Contributors All authors contributed substantially to the conception and design of the work and to the analysis and interpretation of the data. All authors contributed to revisions and approved the final draft. All authors agree to be accountable for all aspects of the work in ensuring that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Specific individual contributions in addition to the above: WR led the drafting of the paper and contributed to data extraction. MPR contributed to literature searching and data extraction. AB contributed to literature searching and drafting sections of the manuscript. BB contributed to data extraction and preparation of figures and tables. RC contributed to data extraction. RC-W contributed to resolving data extraction outcomes. MFS contributed to the Introduction. The lead author (WR, the manuscript’s guarantor) affirms that the manuscript is an honest, accurate and transparent account of the study being reported. No important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Dr AB is a member of the New Zealand Advocacy & Initiatives Committee (NZAIC) of the International Coalition to End Transplant Abuse in China, Dr BB has nothing to disclose, Dr RC has nothing to disclose, Dr RC-W is a member of the Australian Advocacy and Initiatives Committee of the International Coalition to End Transplant Abuse in China, Professor MFS is a member of the Ethics Committee of Doctors Against Forced Organ Harvesting, and a member of the Australian Advocacy and Initiatives Committee of the International Coalition to End Transplant Abuse in China, MPR reports that he is an occasional expert contributor to the International Coalition to End Transplant Abuse in China, Professor WR is a Director of the NGO ’International Coalition to End Transplant Abuse in China' and is chair of its International Advisory Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The full list of 445 included studies is published in online supplementary file 3.

  • Patient consent for publication Not required.

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