Making Repression Pay: The Political Economy of Organ Trafficking in China

Abstract

States kill for many reasons: to punish criminals, suppress dissent, or as part of warfare. Sometimes, they kill for profit. This thesis explores how the People's Republic of China transformed repression into a lucrative industry by trafficking the organs of both death penalty and political prisoners, whom they killed in the process. Drawing on extensive empirical evidence and innovative computational methods, I show how China's organ transplantation system grew rapidly by exploiting vulnerable prison populations. This process -- which I term extractive repression -- not only generated substantial economic rents for state and medical actors but also advanced China's standing in global transplant medicine.

The case of state-sponsored organ trafficking in the PRC challenges conventional wisdom about the relationship between repression and development. It demonstrates how, under certain conditions, violence can fuel economic growth and technological advancement rather than impede them. By framing human organs as 'lootable assets' akin to natural resources, this research contributes to literature on the political economy of authoritarianism, predatory states, and the commodification of human life.

The thesis is a mixed-methods project. It leverages large language models, computational text analysis, and forensic statistics to uncover evidence of unethical medical practices in an authoritarian context. At the same time, it contains extensive qualitative analysis of Chinese-language primary source documents. It relies on both statistical and qualitative evidence to advance its claims.

The format of the thesis is a compilation of published works. There are four papers, three of which have been published, one of which is presented here in manuscript form. The structure is as follows:

1. Introduction 2. [Draft manuscript] Extractive repression: Human organ markets in the People's Republic of China 3. [Published in the American Journal of Transplantation, 2022] Execution by organ procurement: Breaching the dead donor rule in China 4. [Published in the edited volume The Xinjiang Emergency, 2022] Predatory biopolitics: Organ harvesting and other means of monetising Uyghur 'surplus' 5. [Published in BMC Medical Ethics, 2020] Analysis of official deceased organ donation data casts doubt on the credibility of China's organ transplant reform