Concentric: Literary and Cultural Studies 40.2
September 2014: 203-218
DOI: 10.6240/concentric.lit.2014.40.2.10
Accepting/Rejecting: China’s Discursive
Reconfiguration of Zoe for a New Era in
Organ Donation
Melissa Lefkowitz
Program Officer, U.S.-Asia Law Institute
New York University, USA
Abstract
In the Chinese state’s attempt to rectify its organ shortage, an openly
acknowledged problem nationwide, it must harness the body as a source of life.
Whose bodies, exactly, form the crux of this paper, and it is here that Giorgio
Agamben’s work is useful for a discussion that expands beyond a biopolitics
centered on disciplines and technologies of power. Drawing upon articles in the
U.S. and Chinese media, this paper analyzes the disparate logics inherent in
media coverage following the establishment of China’s voluntary organ donation
system in 2010. Though conceived at a great distance, Agamben’s bios/zoe
dialectic operates as a fitting tool in the examination of an emergent discourse
that is evolving in China, one that harnesses a rhetoric centered on value(s),
scientific rationalism and charity in order to re‐define zoe(s) and reinforce the
legitimacy of the state.
Keywords
Agamben, biopolitics, China, organ donation, international NGOs
 This paper would not exist were it not for the encouragement of Susan Greenhalgh (Harvard),
for whom I originally drafted this article. I am deeply grateful to her for her comments on this paper,
as well as for providing me with a thorough introduction to the world of “biopolitics.”
204 Concentric 40.2 September 2014
On March 23, 2012, The New York Times (NYT) ran an article summarizing a
conference that took place in Hangzhou, China, in which the People’s Republic of
China’s (PRC) Vice Minister of Health Huang Jiefu outlined the state’s plan to end
the practice of transplanting organs from executed prisoners, a “step” that would
address “one of the country’s most criticized human rights issues” (Bradsher). The
article quotes Huang’s statement that “the pledge to abolish organ donations from
condemned prisoners represents the resolve of the government” and then follows up
with this analysis: “Mr. Huang did not acknowledge any ethical issues involved in
taking organs from prisoners. Instead, he raised a medical issue, saying that the rates
of fungal and bacterial infection in organs . . . were often high” (Bradsher). The article
continues with a summary of China’s execution rate and issues of consent
surrounding the donation of prisoners’ organs, the country’s recently promulgated
voluntary organ donation regulations, and the criticism the country has received in
its unwillingness to follow the World Health Organization’s recommendation that
organs be taken only from people who are brain-dead, rather than from those whose
hearts have stopped.
If we were to summarize the situation from this one source, China would be a
site of individual disciplining, population technology, and dispassionate exclusion of
its de-politicized bodies. The NYT’s coverage of China’s organ transplant methods
conjures an image of China that evokes Michel Foucault’s description of a
“biopolitical” state that, on one hand, regards the body as a machine to be optimized,
and on the other, as a “species body”—a population—that can be supervised through
a series of interventions and regulatory controls (Foucault 139). In China’s attempt
to rectify its organ shortage, which is fast becoming a population problem, it must
harness the body as a source of life whose forces can be extorted. Whose bodies,
exactly, form the crux of the article, and it is here that Giorgio Agamben’s work is
useful for a discussion that expands beyond a biopolitics centered on disciplines and
technologies of power. In this discussion of prisoners in particular, it is apparent that
there is a politics at play here centered on inclusion and exclusion, where a state holds
power over “bare life” (zoe) in order to recognize and valorize another form of life,
one that resides in the polity (bios) (Agamben 8). It is this darker version of the
sovereign and the subject that the NYT calls to mind in its description of the haphazard
mining of prisoners’ bodies, whose zoe functions as a source of a richer life for
China’s bios.
For all of the article’s thorough coverage of the content covered in the
conference and the issues located at its periphery, it fails to mention one of the most
critical elements of the state’s planned transition: an organ donation system borne out
Melissa Lefkowitz 205
of a collaboration between the Ministry of Health (MOH) and the Red Cross Society
of China (RCSC) that has been underway since March 2010, founded on just that
which the article accuses the state of lacking, a discourse of ethics and equity.
Following the launch of China’s voluntary organ donation system (qiguan fenpei yu
gongxiang xitong), a multitude of Chinese articles praising the initiative were
published across multiple media outlets. While prisoners—those Chinese bodies who
have been stripped of their citizenship—occupy a modest presence within Chinese
media, the articles direct their focus on the eradication of a thriving organ trafficking
market; the protection of a poor population constantly at risk of exploitation; a shift
toward policies that subscribe to an internationally-sanctioned ethics of organ
extraction; and the overall modernization of the state.
Underpinning these focal points, I argue, is what Vivienne Shue puts forward
as the three components in the Chinese state’s “logic of legitimation and the pursuit
of harmony and stability” (31): truth, benevolence, and glory. This paper explores
how Chinese coverage of the country’s volunteer organ donation system defines zoe(s)
and reinforces the legitimacy of the state through rhetoric centered on value(s),
scientific rationalism, and charity. As a means of formulating a comparative analysis
of recent discursive trajectories, this paper first examines the U.S. media’s coverage
of China’s mode of regulating and disposing of bodies, and then delves into articles
that have surfaced in China’s domestic media since the establishment of its organ
donation system.
“The exception, of course”:
U.S. Media Coverage of Organ Transplants in China
In the articles that have been published since 1991 in the United States on
China’s organ donation practices, almost all at least mention China’s reliance on
prisoners for its organ transplants, and the majority focus on a black market that has
emerged as a result of China’s extreme shortage of donors.1 These two focal points—
China’s reliance on prisoners and its rampant black market—present the view that
juridico-institutional procedures, paired with a larger focus on humanitarian practices,
are what lack in China’s organ donation system. An exhaustive examination of these
articles is beyond the purview of this paper. However, excerpts sampled from several
articles written over the past two decades will no doubt prove revealing.
1 I was able to garner this information by conducting a New York Times article search using the
terms “organ transplant” and “China,” <http://query.nytimes.com/search/sitesearch/#/organ+
transplant+china/>.
206 Concentric 40.2 September 2014
The first article written on this topic ran in the NYT in 1991, under the heading
“Kidney Transplants in China Raise Concern About Source.” The article hinges on a
businessman who had been advertising “transplant packages” to doctors in Hong
Kong. While the offer was not illegal, it prompted a debate over the “ethical and
medical problems of kidney transplants performed in China,” namely that doctors
had reservations regarding the source of the kidneys. “Are we talking about the sale
of organs?” one doctor asked, adding that if the source was an executed prisoner,
“that raises a lot of ethical questions, too” (Basler). The article then calls the reader’s
attention to the Chinese MOH’s reticence regarding the use of executed prisoners’
kidneys, and doctors’ skepticism toward Chinese patients’ willingness to give up
kidneys, which would go against the traditional belief that the body must be buried
intact. The article concludes with hard numbers illustrating Hong Kong’s shortage of
donated organs.
Running throughout this article is the tension between trustworthy, ethicsminded physicians and a corrupt trade in China that relies both on the life of the
politically-exiled and the poor. The “ethical questions” are not raised explicitly,
perhaps because a universal ethics revolving around the use of kidneys was difficult
or impossible to articulate. Two other binaries arise in the piece: an opposition
between Chinese tradition and a coordinated, progressive system; and one between
shortage and excess. While Hong Kong has a shortage of people who are willing to
donate, China has an “excess of kidneys,” the cost of which is “relatively cheap
compared with the cost in Western countries” (Basler). What we find here is a piece
that draws a connection between bodies and their material value, a point to which I
will return shortly.
Ten years later, in an article entitled, “China Resists Efforts to Make Donation
of Organs Feasible,” the executed prisoner is once again invoked as the example of
zoe, the “exception, of course” as the reporter, Craig S. Smith, phrases it, who reveals
the brutal underbelly of a nation that has yet to adopt “proper laws” for organ donation.
In this critique of China’s juridico-institutional structure, the reporter points the
reader toward the palliative that can cure China of its “secretive and unsavory practice
fraught with harrowing abuses and ethical sinkholes”: the Red Cross Society of China
(Smith).2 Eight years before the RCSC and the MOH pair up to address China’s organ
shortage, the organization is framed as the institution that can “change attitudes”
toward traditionally-accepted sentiments toward organ donation. The article ends
2 I borrow the term “juridico-institutional” from Agamben, who juxtaposes this term with
“biopolitical,” but ultimately argues that the intersection of the two marks the “original activity of
sovereign power” (Agamben 6).
Melissa Lefkowitz 207
with an appeal from a Chinese hospital director for a “modern civilization and
globalization” that can only be achieved through the establishment of “the brain death
standard by law” (Smith). Here, the eradication of an un-“modern” approach to the
body arises as a necessity for the elimination of a state practice that, perhaps too
obviously, abuses the body that has already been ejected from the polity, the prisoner.
The Red Cross, through educating the public, can relieve the Chinese state of the
burden of harvesting the organs of de-politicized lives.
In 2009, four years after the state’s official acknowledgement that it routinely
harvests organs from executed Chinese convicts, the NYT ran an article on China’s
announcement of the inauguration of the MOH-RCSC collaboration (the voluntary
organ donor program). In the lead paragraph, the system is described as a plan to
“overhaul a system that now harvests a vast majority of its organs from black-market
sellers and executed prisoners and leaves millions of ailing people without hope of
getting transplants” (Wines). In the second paragraph, Vice Minister of Health Huang
Jiefu is cited saying that the system “will benefit patients regardless of social status
and wealth” (Wines). Despite this reference to the state’s desire to create an equitable
system, the rest of the article is devoted to identifying a relationship between the
dearth of convicts’ organs and the need for a black market. In a determinedly ironic
twist, the article uses Huang’s statement as a point of departure for a piece that seeks
to reveal the use of political pariahs for the sustenance of not just the greater Chinese
bios, but for its wealthy contingent of these political beings.
What do these articles’ blatant criticism of the Chinese government’s organ
harvesting and donation practices say about the representation of Chinese bodies in
the U.S. media? When viewed through the lens of Agamben’s social construct, we
see zoe manifested in the form of a person stripped of her political rights, a “bare life”
whose political existence is inextricably bound to the status of citizenship. This
concept follows Hannah Arendt’s argument in “The Decline of the Nation-State and
the End of the Rights of Man,” in which she forcefully states that “the world found
nothing sacred in the abstract nakedness of being human,” here implying that a
human’s “loss of a polity” effectively “expels his from humanity” (295).
Combating Chaos:
Reconfiguring zoe for a Chinese Public
In the Chinese context, the “value” of bodies relate not only to those who have
refused to abide by the regulations imposed by an authoritarian regime; rather, as we
shall see, “value” positions the body as a literal and figurative source of
208 Concentric 40.2 September 2014
commodification. In this section, I will discuss another type of zoe, one which
emerges out of a discourse surrounding the purchase and sale of organs through the
Chinese black market. This is the zoe that Agamben refers to as the life that exists
prior to modern politics’ “intimate symbiosis” with it; in other words, bare life is
biological life itself, prior to its characterization as the antipode to a politicized life
(120; emphasis added). Didier Fassin expounds on this zoe through the concept of
“bio-inequality,” which expands beyond a Foucauldian analysis of normalization to
one that allows for an infusion of “meaning and value” into people’s bare lives, which
ultimately determines the “sort of life people may or may not live (“Another Politics”
49). In Fassin’s rendering, these types of bodies are given value through means
supposedly external to the state, and yet the process is never truly “outside politics”
(“Humanitarianism” 509): rather, the logic of infusing value into bodies rests on the
assumption that the “world order . . . is made up of the powerful and the weak,”
thereby creating and essentializing victims (“Humanitarianism” 511).
On April 6, 2012, Xinhua, the PRC’s official press agency and largest news
agency in China, ran an article announcing the impending trial of five people in
Chenzhou, a city in south China, who were involved in the illegal trading of a kidney
extracted from a seventeen-year old who bought an iPhone and an iPad with the
22,000 yuan (approximately $3,300) he earned from the transaction. The article
focuses on the actors—three businessmen, a hospital contractor, and a surgeon—who
found the donor on an online chat room (“17 sui”). The same day, the article was
replicated in Xinhua’s English edition, with some additional information appended:
the article mentions the teen’s current renal complications, China’s large donorpatient gap, the 2007 regulations banning organizations and individuals from trading
human organs, and the government-led voluntary organ donation system currently
operating in sixteen of China’s thirty-one provinces, meant to “combat the illegal
trade” (“5 charged”).
The timing of the article, published exactly two weeks after Huang Jiefu’s
official pronouncement of the success of the voluntary organ donation system’s pilot
study, calls attention to the element of publicity inherent in the production of scandal.
Anthropologist Lawrence Cohen, whose work centers on the contemporary debate
surrounding the ethics of organ sales in India, finds public conversation critical to the
rationalization of emergent discourses regarding life in his site of inquiry. According
to Cohen, two publicities exist in India’s media culture: “scandalous publicity,”
which “demands a single public united in opposition to a piracy that yokes together
imaginary and real tissue flows” and an “ethical publicity,” the purpose of which is
to rationalize “logics that posit an identity (‘life for life’) between the life of a
Melissa Lefkowitz 209
comparatively wealthy person in organ failure and that of the debtor pressed to sell
one of her organs” (290). Cohen’s “publicities” have relevance in the Chinese context.
Since the announcement of the voluntary organ system, numerous articles detailing
the new system, its problems and successes, and its necessity in the face of the black
market have run in China’s media outlets. The majority of these articles fall into the
latter category, “ethics publicity,” while several are clearly scandal-focused, as seen
in articles praising the shutdown of underground organ transplant rings. 3 In this
section, I examine articles written since the announcement of the voluntary organ
donation system that are representative of scandal and ethics publicity pieces. 4
Beginning with the scandal category, I hope to shed light on an emergent discourse
that seeks to undo the attribution of monetary value to the body. In my examination
of ethics-focused articles that take as their subject the voluntary organ donation
system, I intend on unpacking the complex relationship that the state is currently
trying to establish between the state and the body.
As mentioned in the introduction, Vivienne Shue argues that truth, benevolence
and glory are ideals on which the concept of a good government is founded, and have
been at least since the late imperial era (30). In the post-Mao era, Shue argues, “truth,”
historically concerned with Confucian learning or Daoist cosmology, is based on
“modern scientific rationalism and pragmatic empiricism.” Not only is this
knowledge “non-falsifiable,” it is figured as “morally sound and good” in its capacity
to furnish China with the tools that will eventually bring it to a state of modernization
(33). Benevolence, expressed in paternalist policies during the Mao era, now takes
shape in “small acts of patronage” by local officials or “massive government-led
efforts” centered on charity through foundations and emergency funds (34). The last
element, “glory,” is sustained through a narrative of a “rising China” that will no
longer suffer through the bullying from stronger nations (34). This not only involves
a nationalist posturing, but is enmeshed in the discourse of enhancement, namely of
the country’s transnational prestige and military expertise. Following her analysis of
these ideals in a contemporary context, Shue warns, and I follow, that these ideals—
while historically present in Chinese governance—encompass multifaceted and
numerous logics.
3 For example, see “16 Charged in China’s Biggest Illegal Organ Scam,” China Daily, March 01,
2012,
accessed
April
28,
2012.
<http://www.chinadaily.com.cn/usa/china/201203/01/content_14732874.htm>.
4 For the sake of style, from here on I will assume that the reader acknowledges that the terms
“scandal” and “ethics” are meant for analysis, and will cease to wrap them in square quotes.
210 Concentric 40.2 September 2014
Scandal Publicity: Valuing the Body through
Traditional Means
As with most scandals, the story of the seventeen-year old who sold his kidney
for 22,000 yuan attracted an enormous amount of attention. According to an article
published in the English-language version of Xinhua, responses numbered in the
thousands, mostly along the lines of “morbid curiosity,” according to the article’s
author (“Illegal Organ Deals”). A Chinese-language search on the Xinhua website
yielded several articles on the incident, two of which I would like to examine here.
Following the incident, Southern Daily (Nanfang Ribao), Guangdong’s official
newspaper, surveyed people in the area to ask what they thought someone’s motives
would be to sell a kidney. Respondents offered many reasons for selling their organs,
such as having funds to purchase an iPhone4S and being able to financially cover a
girlfriend’s abortion (“Mai shen”).
As with the scandal, this survey itself elicited many responses. Two of them,
written a day after the publication of the article in Southern Daily, overlap on themes
that we have encountered previously in the U.S. media’s coverage of organ
transplants in China: somatic integrity and the dangers inherent in commodifying
one’s body. In an article published in Hexun Information Technology, one writer
directed his anger not toward those who swindle, but to those who sell their kidneys,
or the maishen of China’s population. In five short paragraphs, the author advises
these illegal donors to remember that it is of utmost importance to keep one’s body
intact; that selling an organ for quick money ironically slows people down, as they
become physically ill later; that when a person is a slave to money, his values become
distorted; and that overindulging in material objects leads to the decay of one’s
dignity, shame, and a life of unrestrained unscrupulousness (“Mai shen”). An
editorial published the same day in the Chongqing Times (Chongqing Shibao)
presents a similar line of argument, but with an added element of sympathy for those
who choose to give up their dignity for material success and cheap wealth. The article
concludes with the premonition that if the world continues to glean happiness from
material goods (wuzhi xingfu), then the story behind the iPhone incident will
eventually turn into a problem that will be difficult to avoid.
What do these articles reveal about the discursive relationship between organ
transplants and life itself? For one, the attention paid to somatic integrity is bound up
in a residual truth discourse that associates the extraction of organs not with a
performance of “tradition,” but with something much deeper than that, dignity
(zunyan). The concept of somatic integrity has its roots in Confucian and Buddhist
Melissa Lefkowitz 211
tradition. In Confucian tradition, the lack of a full body in the afterlife bars a person
from receiving sacrificial offerings from her descendants; in Buddhist tradition, the
person is robbed of the chance of being reborn (Brook et al. 15). Though scientism
looms large in state discourse, this “truth” maintains a strong presence, as it continues
to infuse the body with a value even after it has made its way into the ground. A
body’s worth, despite being gift-based in the Confucian sense, is framed as the
opposing element to a force so strong it literally tears people’s bodies apart. The body
as commodity is both the largest fear and the only answer for a poor population that
believes that its only entrance into the polis—that realm where purchasing power
guarantees entry into politics and the domain of a hyper-neoliberal landscape—is
through one of their body’s only surpluses: the extra kidney. The purpose of scandal
publicity in this landscape is to do what Cohen observes in the India example: “The
production of scandal . . . maintains the image of a distinctive state apparatus that can
intervene to regulate medical abuses against the poor” (298). As the state removes
itself from the complex linkages of state and market forces, it creates an alternative
logic that justifies its role in the regulation of bodies. Scandal publicity, as it is
manifested in the context of organ transplants in China, vilifies both the perpetrators
and the participants of a blood economy in which the body as life itself, bare life,
takes on a monetary value. 5
Ethical Publicity: Re-evaluating Life for the Sake of Humanity
Unlike coverage in the U.S., articles on the organ donation system in China
omit a discussion of the usage of convicts for organ donation in the country. In a
search conducted in both Chinese and English, two mentions were found. One,
published in 2012 directly after a conference during which Huang Jiefu publicly
pronounced the end of the practice, directs the reader’s attention to contaminated
organs and the eventual reduction of execution; the other, which centers on the
voluntary organ donation system, states that the system will reduce reliance on
convicts, whose organs will no longer be used within three to five years (“China to
Abolish”; “Zhongguo renti”). This avoidance of prisoners as a topic for ethical debate
5 It is possible to shift from here into an examination of the Chinese body as a commodity within
a capitalist framework, as Ann Anagnost does in her article, “Strange Circulations: The Blood
Economy in Rural China,” in which she examines the means by which Chinese residents in Henan
expended themselves “in service to a commodity fetishism” through the sale of their blood (513).
However, as this is an analysis of state-run media, my focus is on how the state positions capitalist
logics in its media coverage, not whether or not organ transplants are a product of capitalist-driven
(as opposed to state-driven) incentives.
212 Concentric 40.2 September 2014
suggests that engaging in a discourse of ethics with regard to political zoes is not high
on the agenda within the context of this issue. In this section, I investigate the “truths,”
“benevolent” acts, and aspirations for “glory” that converge to re-formulate the
Chinese zoe in discourse propagated throughout Chinese media. A discourse centered
on equitable treatment, this ethical publicity nevertheless continues to perpetuate a
zoe and a bios that exist in a symbiotic relationship with one another, bound to the
state.6
Though rarely acknowledged, coded references to the use of prisoners’ organs
appear often in Chinese media coverage of the volunteer organ donation system, in
the form of the numerical figure. As anthropologist Susan Greenhalgh notes in her
article on population governance under the one-child policy, “figures not only
constitute the domain of interest, population; they also define the problematizations
adopted” (357). Therefore, it is not surprising that a ratio of 1.5 million to ten
thousand, that being 1.5 million patients in need of organ transplants each year to the
available ten thousand donors, is often invoked and maintains a ubiquitous presence
in articles covering the topic of organ donation, harvesting, and transplants.7 The ten
thousand, approximately four thousand of which represent prisoners’ organs, remain
faceless and nameless.8 The figure operates not only as a stand-in for prisoners and
the problem, but for the cause of the problem, as well. It exists as an entity unto its
own, natural in a fashion analogous to Adam Smith’s invisible hand. In April 2012,
in one of Xinhua’s most extensive articles written on organ transplants, the “dire
imbalance in the country’s organ supply” (gongqiu yanzhong shiheng) is framed as
the cause for the development of a rampant black market (“Juanxian”). Returning to
Shue, we find the overarching problem of China’s organ transplant system articulated
in terms of a scientific rationalism. It is not the prisoners who are the problem; rather,
our attention should be directed to the gap between the 1.5 million and the ten
thousand, as that is where the “real” or “true” problem lies.
The solution and its subsequent benefits are also articulated in this language. In
the same article, a remedy for the chaos is put forward: “a unified and standardized
system” (tongyi guifan tixi). An article published two months later in Xinhua notes
6 Cohen sees this configuration in the Indian context as a logic founded on economic inequality
(290). While this is relevant for the Chinese state, I do not equate the two situations.
7 Articles that mention this figure abound. A search simply for “organ transplant” in China Daily
is
quite
revealing.
<http://search.chinadaily.com.cn/searchen.jsp?ch=2%40usa&second
search=ON&searchText=organ+transplant>.
8 This number is based on the estimated number of executions carried out in China during this
period, according to The Dui Hua Foundation, a San Francisco-based human-rights organization
(“Criminal Justice”).
Melissa Lefkowitz 213
that since the launch of China’s organ donation system, 207 people have donated a
total of 546 organs, and ends with a time frame of three to five years before prisoners
will phase out of the country’s organ transplant supply (“Zhongguo renti”). The
numbers denote the urgency of the situation, speaking for all of the participants
involved. While the logic of benevolence remains intact, the pairing of the Red Cross
and the MOH appears to open the door for an emergent ethical discourse. In the article,
Huang is cited saying, “China should build as soon as possible a donation system in
line with the national conditions and international ethics” (“China Launches”). The
article continues as follows:
Official estimates indicate that 1.5 million Chinese need organ
transplants each year, but only 10,000 operations are performed because
of a severe shortage of donors. Nationwide, 164 medical institutions on
the Chinese mainland are licensed to carry out organ transplants. The
government has launched a review after reports surfaced that some
hospitals were illegally doing organ surgeries for foreigners, according
to a report by China Daily earlier this month . . . Organ transplants in
China are covered by the 2007 regulations that ban organ trading and
trafficking and “transplant tourism” for foreigners. (“China Launches”)
Framed as the savior for “changing attitudes” in the NYT’s coverage eight years
prior, the RCSC now figures as a partner in China’s initiative to introduce a new
system of ethics into the country. The way the article continues is indicative of the
government’s stance regarding sites of legitimate surgeries, acts that may be
considered “unethical,” and the legal framework that seeks to regulate a rampant
black market that seeks to commodify bodies for both domestic and foreign use. It is
also telling that while the term “international ethics” suggests the government’s
involvement with transnational institutions, the RCSC, an organization engaged in
“humanitarian work,” as it is advertised on its website, works to “assist the
government” in carrying out the Geneva Conventions and its Additional Protocols,
as well as civil diplomacy and disease prevention initiatives (“Introduction to the
RCSC”). While recognized as a legal member of the International Federation of the
Red Cross (IFRC), its good deeds are nevertheless inextricably linked to the
benevolence of the Chinese state. What this means for the program, then, is that those
who are involved in it receive the approval from an imaginary international
community whose ethics span national borders, but from the Chinese state as well.
214 Concentric 40.2 September 2014
And yet, the presence of the Red Cross within this program implies that the
state must negotiate its “shortage” problem along with an organization that upholds
the IFRC’s fundamental principles of “humanity,” “impartiality,” “neutrality,”
“independence,” “voluntary service,” “unity” and “universality” (“Introduction to the
RCSC”; “The Seven Fundamental Principles”). In one article, a physician and
proponent of the organ donation system relates the volunteering of one’s organs as
“charity” (cishan) (“Juanxian”). How this figures into a discussion of bare life is of
interest here. Agamben asserts that humanitarian organizations approach the body in
terms of its bare life, life unqualified by the political and social (133). This is the
same life that we encounter in the responses to Southern Daily’s survey, the life that
uses its body as a form of capital—the body that the Chinese state upholds as its
prime example of zoe in its scandal publicity. Drawing on this, Didier Fassin argues
that the discourse of humanitarianism requires a re-working of Foucault’s concept of
biopower, which assumes that the state must have “power over life”; rather, he argues,
it is hinged on the “power of life” (“Another Politics” 49). One feature of this logic,
Fassin argues elsewhere, is that within a “humanitarian politics of life” there exists a
dichotomy between those who can save and those who must be saved, what we might
consider the very difference between the bios and zoe (“Humanitarianism” 510-11).
Returning to Agamben, this dichotomy will, by the very nature of its binary
construction, always include the zoe. As he puts it: “If anything characterizes modern
democracy as opposed to classical democracy, then, it is that modern democracy
presents itself from the beginning as a vindication and liberation of zoe, and that it is
constantly trying to transform its own bare life into a way of life and to find, so to
speak, the bios of zoe” (9). In the context of China’s organ donation system, then, the
option of becoming a charitable donor is tantamount to becoming a bios. The zoe,
whose bare life is always at risk of being manipulated by corrupt businessmen, can
now become a bios through a means other than its own commodification. Conversely,
the recipient, who begins as a bios, is always at risk of become a zoe through this
logic of humanitarianism. As one article states, if a patient finds a transplant through
means outside of the system, the patient will not be able to access follow-up care
(“Juanxian”). In other words, in a discourse of ethics that depends on a disavowal of
overt commodification, a person can transition from a bios to a zoe in his rejection of
these principles.
The potential of the zoe to become a bios is perhaps most critical to the future
of discourse on the voluntary organ donation system. In an article that profiles one of
the state’s six hundred “organ donation coordinators,” the most pressing issues at
hand are Chinese citizens’ unwillingness to dispel of the importance of somatic
Melissa Lefkowitz 215
integrity, and their lack of knowledge regarding organ donation in general. The
coordinator cites incidents in which people believed that the agreement to donate
organs necessarily meant that doctors would not treat their loved ones as well once
they arrived on their death beds. The article concludes with the coordinator’s hope
that her child will grow up to regard organ donation as “normal” (zhengchang), just
as her generation had grown to accept cremation (“Zhongguo renti”). What this
article reveals is that through acceding to the logic of this system, one is able to
participate in the logical progression of the state, its modernization, what it ultimately
aspires to in its effort to be a glorious state for a Chinese polity.
Opting in, as one would have it, recalls Paul Rabinow’s concept of
“biosociality,” which he defines as the formation of new “individual identities and
practices” that arise out of scientific truth discourses that exist to help people
“experience, share, intervene, and ‘understand’ their fate” (102). Indeed, China’s
scientific rationalism, which it employs to convey the urgency and necessity of an
increased amount of available bodies for its organ transplant needs, reveals the
direction it plans to take with regard to emergent “identities and practices.” In terms
of people’s individual choice, one should not regard biosociality as an alternative
form of “democracy” or “freedom.” Rather, as Adriana Petryna and Miriam Ticktin
have shown in their respective works on “biological citizenship” in post-Chernobyl
Ukraine and the logic of humanitarianism in contemporary France, opting into a
system that uses biology as a “flexible social resource” (Ticktin 34-35) can have
discriminatory and even debilitating effects. This is not to suggest that the articles I
have discussed thus far are intentionally misleading, which is certainly not the goal
of this current inquiry. Rather, I am suggesting that the biosocial community that the
articles promote will come to fruition at the expense of another truth discourse,
namely that of the importance of somatic integrity.
On May 8, 2012, China Daily ran an article on the arrest of sixteen people who
had been involved in illegal kidney transplant operations in Changzhou, a city located
in China’s affluent Yangtze Delta region. Along with the general information about
the arrest, the article mentioned the 1.5 million: ten thousand ratio, and cited Huo
Feng, dean of the liver transplant center at the General Hospital of Guangzhou
Military Command of the People’s Liberation Army, one of China’s approved
donation hospitals. The article quotes Huo’s comment that “such crimes tarnish the
industry’s image and affect the ongoing effort to set up a national organ donation
system” (Cang and Cao). As this paper has shown, disparate logics exist in a state
that thrives on its authoritarian, neoliberal and humanitarian policies. From the U.S.
media’s perspective, China’s zoe is the prisoner, the political pariah. Yet, the Chinese
216 Concentric 40.2 September 2014
government has other zoes in mind for its Chinese public. Through scandal and
ethical publicity surrounding organ harvesting and donation in China, the zoe is either
a bare body whose life is valued through its monetary surplus or a former bios who
rejects a national system founded on scientific rationalism and charity.
Works Cited
“‘17 sui shaonian maishen’ an 5 ming she’an ren bei tiqi gongsu” (“‘Seventeen-year
Old Teen Sells His Kidney’: 5 Suspects in Case Prosecuted”). Xinhua. 6 Apr.
2012.
28
Apr.
2012.
<http://news.xinhuanet.com/society/201204/06/c_111746223.htm>.
“16 Charged in China’s Biggest Illegal Organ Scam.” China Daily. 01 Mar. 2012. 28
Apr.
2012.
<http://www.chinadaily.com.cn/usa/china/201203/01/content_14732874.htm>.
“5 Charged after Teen Sells Kidney to Buy iPhone.” Xinhua. 6 Apr. 2012. 28 Apr.
2012.
<http://usa.chinadaily.com.cn/china/201204/06/content_14995035.htm>.
Agamben, Giorgio. Homo Sacer: Sovereign Power and Bare Life. Trans. Daniel
Heller-Roazen. Stanford: Stanford UP, 1998.
Anagnost, Ann S. “Strange Circulations: The Blood Economy in Rural China.”
Economy and Society 35.4 (2006): 509-29.
Arendt, Hannah. “The Decline of the Nation State and the End of the Rights of Man.”
The Origins of Totalitarianism. New York: Harcourt, Brace and Co., 1951.
266-98.
Basler, Barbara. “Kidney Transplants in China Raise Concern About Source.” The
New
York
Times.
3
June
1991.
28
Apr.
2012.
<http://www.nytimes.com/1991/06/03/world/kidney-transplants-in-chinaraise-concern-about-source.html>.
Bradsher, Keith. “China Moves to Stop Transplants of Organs After Executions.”
The New York Times. 23 Mar. 2012. 28 Apr. 2012.
<http://www.nytimes.com/2012/03/24/world/asia/china-moves-to-stoptransplants-of-organs-after-executions.html?_r=2&pagewanted=print>.
Brook, Timothy, et al. Death by a Thousand Cuts. Cambridge, MA: Harvard UP,
2008.
Cang, Wei, and Cao Yin. “Police Thwart Illegal Kidney Transplant Gang.” China
Daily. 8 May 2012. 8 May 2012. <http://usa.chinadaily.com.cn/epaper/201205/08/content_15239359.htm>.
Melissa Lefkowitz 217
“China Launches Organ Donation System.” Xinhua. 25 Aug. 2009. 29 Apr. 2012.
<http://news.xinhuanet.com/english/2009-08/25/content_11943516.htm>.
“China to Abolish Transplanting Organs within 3-5 Years.” Xinhua. 22 Mar. 2012.
28
Apr.
2012.
<http://news.xinhuanet.com/english/china/201203/22/c_131483660.htm>.
Cohen, Lawrence. “Where It Hurts: Indian Material for an Ethics of Organ
Transplantation.” A Reader in Medical Anthropology: Theoretical
Trajectories, Emergent Realities. Ed. Byron J. Good et al. West Sussex:
Wiley-Blackwell, 2010. 284-99. Originally published in Daedalus 128.4
(1998):135-66.
“Criminal Justice.” The Dui Hua Foundation website. n.d. 29 Apr. 2012.
<http://duihua.org/wp/?page_id=136>.
Fassin, Didier. “Another Politics of Life is Possible.” Theory, Culture & Society 26.5
(2007): 44-60.
—. “Humanitarianism as a Politics of Life.” Public Culture 19.3 (2007): 499-520.
Foucault, Michel. The History of Sexuality: Volume 1, An Introduction. Trans. Robert
Hurley. 1978. New York: Vintage Books, 1980.
Greenhalgh, Susan. “Globalization and Population Governance in China.” Global
Assemblages: Technology, Politics, and Ethics as Anthropological Problems.
Ed. Aihwa Ong and Stephen J. Collier. Malden: Blackwell, 2005. 354-72.
“Illegal Organ Deals Strike Fear into Chinese Hearts.” Xinhua. 08 June 2011. 29 Apr.
2012.
<http://www.chinadaily.com.cn/usa/china/201106/08/content_12667866.htm>.
“Introduction to the RCSC.” Red Cross Society of China website. 7 Mar. 2014. 18
Aug. 2014. <http://www.redcross.org.cn/hhzh/zh/hsigk/hszjs/>.
“Juanxian qiguan gai fenpei gei shei?” (“To Whom Should We Allocate Organ
Donations?”)
Xinhua.
6
Feb.
2012.
28
Apr.
2012.
<http://news.xinhuanet.com/politics/2012-02/06/c_111489610.htm>.
“Mai shen mai iPhone” (“Sell a Kidney, Buy an iPhone”). Hexun Information
Technology. 27 Mar. 2012. 28 Apr. 2012. <http://tech.hexun.com/2012-0327/139782472.html>.
“Mai shen mai iPhone beihou de ‘wuzhi xingfu’ miwu” (“Fog of ‘Material Happiness’
Behind Sell a Kidney, Buy an iPhone Story”) 27. Mar. 2012. 24 Aug 2014.
<http://cq.cqwb.com.cn/NewsFiles/201203/27/924436.shtml>.
Petryna, Adriana. Life Exposed: Biological Citizens after Chernobyl. Princeton:
Princeton UP, 2002.
218 Concentric 40.2 September 2014
Rabinow, Paul. “Artificiality and Enlightenment: From Sociobiology to Biosociality.”
Essays on the Anthropology of Reason. Princeton: Princeton UP, 1996. 91111.
“The Seven Fundamental Principles.” International Federation of Red Cross and Red
Crescent Societies website. n.d. 18 Aug. 2014 <http://www.ifrc.org/who-weare/vision-and-mission/the-seven-fundamental-principles/>.
Shue, Vivienne. “Legitimacy Crisis in China?” State and Society in 21st-century
China: Crisis, Contention, and Legitimation. Ed. Peter Hays Gries and
Stanley Rosen. New York: Routledge, 2004. 24-49.
Smith, Craig S. “China Resists Efforts to Make Donation of Organs Feasible.” The
New
York
Times.
5
Dec.
2001.
4
May
2012.
<http://www.nytimes.com/2001/12/05/world/china-resists-efforts-to-makedonation-of-organs-feasible.html?pagewanted=print>.
Ticktin, Miriam. “Where Ethics and Politics Meet: The Violence of Humanitarianism
in France.” American Ethnologist. 33.1 (2006): 33-49.
Wines, Michael. “China Announces a System for Voluntary Organ Donors.” The
New
York
Times.
26
Aug.
2009.
28
Apr.
2012.
<http://www.nytimes.com/2009/08/27/world/asia/27china.html>.
“Zhongguo renti qiguan juanxian xietiao yuan – yi ge zhu ren ‘qisi huisheng’ de zhiye”
(“China’s Organ Donation Coordinator: A Career in Helping to ‘Revive the
Dead’”)
Xinhua.
19
Apr.
2012.
28
Apr.
2012.
<http://news.xinhuanet.com/tech/2012-04/19/c_111805519.htm>.
About the Author
Melissa Lefkowitz is a Program Officer at the U.S.-Asia Law Institute at the NYU School of
Law. Ms. Lefkowitz holds a B.A. in Literature and East Asian Studies from New York
University and a master’s degree in East Asian Studies from Harvard University, where she
focused on Sino-African relations, Chinese cultural history, and theories of power and
resistance. Her current research focuses on African migration to China and Chinese media
development in Kenya.
[Received 19 December 2013; accepted 5 May 2014]