作者：鲁慧文
占据中国人口绝大多数的底层人，似乎正在一点一点地失去对自己身体的所有权。
近日，一名十七岁的少年完成了器官捐献志愿登记。当地官员、警察和工作人员登门表彰，镜头里，鲜花鲜艳，笑容灿烂。少年和家人站在一起，大概以为自己做了一件光荣的事。他们也许相信，自己只是提前表达了一份善意；政府给予肯定，社会给予掌声，这便是一种荣耀。
然而评论区里并没有多少掌声。
许多人首先想到的，不是这个少年将来能够救多少人，而是这个少年以后是否安全，毕竟不久前一个在郑州学校体检当中摔倒被保安急切问是否安好的孩子很快就丢失了器官死去了。
这实在是一件很奇怪的事。
在一个正常的社会里，器官捐献本应令人想到善意、医学和生命延续；可在这里，人们看到这样的新闻，却先想到失踪、意外、医院和权力。
这究竟是公众太多疑，还是中共政府早已透支了自己的信用？
宣传者并不回答。
他们只负责把鲜花递到少年手里，把镜头对准那一家人的笑脸，再配上一段温暖的音乐。至于人们为什么恐惧，捐献流程是否透明，未成年人是否真正充分知情，儿童和青少年为啥会无故消失死去并缺少器官，谁来监督器官分配，谁来保证医疗决定不受利益干扰，这些问题通常是不适合出现在镜头里的。
镜头是用来制造感动的，不是用来回答问题的。
我最近还看到两则新闻。一则是日本对涉嫌违法寻求器官移植的人进行追责，另一则是新加坡对违规器官交易采取惩罚措施。评论区里，有人赞美这些政府真正把生命平等和人权平等当回事。
因为在那里，一个有钱人的命，并不天然比穷人的命更值钱；一个有权者的身体需要，也不能自动变成另一个弱者必须承担的代价。
而在我们这里，最常听到的词却是“奉献”。
孩子要奉献，青年要奉献，病人要奉献，穷人更应当奉献。
他们活着的时候奉献劳动，失业的时候奉献忍耐，生病的时候奉献积蓄，死后最好连身体也一并奉献。
至于谁在接受这些奉献，通常是不必问的。
问，就是不善良。
怀疑，就是没有爱心。
要求公开，就是“抹黑”。
于是，一个人的器官，仿佛并不是由他自己支配的，而是暂时寄存在身体里，等到某一天，再由某种更大的需要来接管。
所谓“自愿”，也变得值得推敲。
自愿的背后，是中国大地上无数个丢失孩子的寻亲家庭和很多死去在河水里发现的却少了器官的孩子的身体。
一个成年人，在没有任何压力的情况下，经过充分了解，决定死后捐献器官，这当然值得尊重。但一个十七岁的少年，在官方宣传、学校教育、家庭期待和荣誉表彰之中作出的决定，究竟有多少是真正独立的选择？
当一种选择受到鲜花和掌声的奖励，而另一种选择被暗示为自私和冷漠时，这种“自愿”还剩下多少自由？
真正的自愿，应该包括随时拒绝的权利。真正的安全，是不会因为被大数据匹配就突然消失并失去生命。
一个人不仅有捐献器官的权利，也有不捐献的权利；不仅有帮助陌生人的权利，也有首先保护自己的权利。
如果一个社会只宣传奉献，却不认真保护拒绝，那么它所需要的可能不是志愿者，而是顺从者。如果一个社会，孩子可以随时丢失，活人可以随时在大街上被绑走，每一个底层人就如同羊圈里的“手指羊”一样随时被挑选宰杀，那这不是国家，这是地狱。
中国如果真的想要建立并不断扩大器官捐献登记体系，这本可以是一件推动医学进步的事情。但任何涉及人体、死亡和巨大医疗利益的制度，都不能只依靠道德口号运行。
它需要公开的数据，需要清晰的法律，需要独立的监督，需要可追溯的分配程序，还需要让每一个普通人相信：无论他有没有钱、有没有权、有没有关系，他的生命都不会因为别人的“需要”而被轻视。
遗憾的是，人们看到的往往是宣传和突然的少年消失，却很少看到完整透明的解释。
每年究竟有多少未成年人失踪？
多少人被找回？多少人的尸体在水里被发现？
这些孩子后来去了哪里？
公众需要的不是一句“不要传谣”，而是一套能够经得起核查的答案。
公众需要的是生命的基本权利，是孩子可以安全地上学回家，而不是会突然被匹配，被取器官，被消失，整个底层社会陷入一种巨大的恐惧之中不可自拔。
医院同样如此。
医学原本是救人的，但医院一旦同时成为资本、行政权力和稀缺资源交汇的地方，人们自然会担心：医生面对的究竟是病人，还是指标？手术面对的究竟是生命，还是收益？
器官移植比普通手术更加特殊。它的一端是等待生存的人，另一端却必然连接着死亡。这样的医疗行为，必须拥有比普通手术更高的透明度，而不是更深的神秘。
器官从哪里来？
死亡如何判定？
若这些问题不能被普通公众清楚地了解，那么再多的宣传片，也无法换来真正的信任，反而增加更多更深的恐惧。
有人说，不相信医院和政府，是民众的悲哀。
这话只说对了一半。
民众不信任制度，当然是悲哀；但一个制度若从不努力让自己值得信任，反而责怪民众多疑，那便不只是悲哀，而是傲慢。
一个真正尊重生命的国家，不会急着让孩子宣誓捐献器官，而会先让孩子知道：你的身体属于你自己。
它不会只教孩子如何奉献，也会教孩子如何拒绝；不会只告诉孩子死后可以帮助别人，也会告诉孩子活着的时候，任何人都无权伤害你、支配你、利用你，更不会让太多的孩子突然消失并死去。
国家可以管理医院，可以制定法律，可以建立器官捐献体系，却不能因此成为人体的主人。
否则，中国底层的每一个人，便不过是一具暂时活着的国家资产。
工作时，是劳动力。
缴费时，是纳税人。
生病时，是医疗消费者。
被匹配后，则是可利用的器官资源。
一个人从出生到死亡，仿佛都被登记、编号、分类和使用。只有他自己，反而最没有发言权。
这便是“国有器官”最可怕的地方。
它不一定真的写在法律里，也不一定有人公开宣布。它可能只是藏在一次次宣传、一次次表彰、一次次道德劝说之中，使人渐渐相信：个人的身体并不完全属于个人，必要的时候，个人应当服从更大的安排。
而所谓“更大的安排”，通常从来不需要向个人解释。
我并不反对器官捐献。
我反对的是，在缺乏透明和信任的环境里，将捐献包装成一种必须赞美的道德正确；我反对的是，让尚未成年的孩子站到镜头前，成为制度宣传的样板；我反对的是，普通人的生命问题被要求无条件相信，而有权者却不必接受同等程度的监督；我反对的是，底层中国人的孩子可以随时消失，随时被匹配，随时被拿走作为别人的器官资源。
器官若不再首先属于个人，那么所谓生命权，永远不会在中国这片土地上产生并被尊重。
那位十七岁的少年仍在笑。
鲜花捧在手中，官员站在身旁，镜头记录着一场被命名为“光荣”的仪式。
我只希望，在很多年以后，他依然平安地活着。
而不是让今天的这张照片，成为人们日后不敢回看的东西。
编辑：胡丽莉 校对：周敏 翻译：沈美花
State-Owned Organs
Author: Lu Huiwen
Abstract: Questioning the promotion of organ donation propaganda in an environment lacking transparency and trust, appealing to safeguard individual bodily autonomy, and calling for the establishment of an open, independent, and verifiable organ donation system.
The vast majority of China’s populace—the people at the bottom layer of society—seem to be losing ownership of their own bodies, bit by bit.
Recently, a seventeen-year-old youth completed the volunteer registration for organ donation. Local officials, police officers, and staff members visited his home to commend him. In the camera frame, the flowers were vivid and the smiles were bright. The youth stood alongside his family, presumably believing he had performed a glorious deed. They perhaps believed they were simply expressing an act of goodwill in advance; with the government offering validation and society offering applause, this felt like an honor.
Yet, in the comment sections, there was little applause to be found.
What many people first thought of was not how many lives this youth might save in the future, but whether he would remain safe hereafter. After all, not long ago, a child in Zhengzhou who fell during a school physical exam and was anxiously asked by a security guard if he was alright soon lost his organs and died.
This is truly a very strange thing.
In a normal society, organ donation ought to evoke thoughts of goodwill, medicine, and the continuation of life; yet here, when people see such news, their immediate thoughts turn to disappearances, accidents, hospitals, and power.
Is this because the public is overly paranoid, or is it that the Chinese Communist Party (CCP) government has long since exhausted its own credit?
The propagators do not answer.
They are only responsible for placing the flowers into the youth’s hands, pointing the camera at the family’s smiling faces, and adding a piece of heartwarming background music. As for why people feel fear, whether the donation process is transparent, whether minors are truly fully informed, why children and teenagers vanish without cause and die missing organs, who oversees organ allocation, and who ensures medical decisions are free from financial and political interference—these questions are generally deemed unsuitable to appear in front of the lens.
The lens is used to manufacture emotional touching, not to answer questions.
I also recently saw two news items. One was about Japan holding people legally accountable for suspected unlawful attempts to seek organ transplants; the other was about Singapore implementing punitive measures against illegal organ transactions. In the comment sections, some praised these governments for genuinely taking equality of life and equality of human rights seriously.
Because there, a rich person’s life is not naturally more valuable than a poor person’s life; nor can a powerful person’s bodily needs automatically become a cost that a weaker individual must bear.
Whereas here with us, the word heard most frequently is “dedication” and “self-sacrifice.”
Children must sacrifice; youth must sacrifice; the sick must sacrifice; and the poor, even more so, ought to sacrifice.
They dedicate their labor while alive, dedicate their endurance when unemployed, dedicate their savings when sick, and upon death, it is best if they dedicate their bodies as well.
As for who is receiving these sacrifices, that is generally something one ought not to ask.
To ask is to be unkind.
To doubt is to lack compassion.
To demand openness is to “slander and smear.”
Thus, an individual’s organs seem not to be at their own disposal, but are merely temporarily deposited inside their body, waiting for a certain day when a greater need comes to take them over.
So-called “voluntariness” also becomes something worthy of scrutiny.
Behind this “voluntariness” lie the countless families across the land of China searching for missing children, and the bodies of many dead children recovered from rivers missing their internal organs.
When an adult, under no pressure whatsoever and after becoming fully informed, decides to donate organs after death, that is of course worthy of respect. But when a seventeen-year-old youth makes a decision amidst official propaganda, school education, family expectations, and honorary commendations, how much of it is truly an independent choice?
When one choice is rewarded with flowers and applause, while the other choice is implied to be selfish and indifferent, how much freedom remains in this “voluntariness”?
Genuine voluntariness must include the right to refuse at any time. Genuine safety means one will not suddenly disappear and lose their life simply because of a big data match.
A person has not only the right to donate organs, but also the right not to donate; not only the right to help strangers, but also the right to protect themselves first.
If a society only preaches sacrifice while failing to earnestly protect the right to refuse, then what it requires may not be volunteers, but obedient subjects. If, in a society, children can go missing at any time, living human beings can be snatched from the streets at any moment, and every person at the bottom layer of society is like a “finger sheep” in a pen—picked out and slaughtered at any time—then this is not a country; this is hell.
If China truly wants to establish and continually expand an organ donation registration system, this could originally have been an undertaking that drives medical progress. However, any system involving the human body, death, and vast medical interests cannot function solely on moral slogans.
It requires public data, clear laws, independent supervision, a traceable allocation procedure, and it needs to reassure every ordinary person: regardless of whether they have money, power, or connections, their life will not be treated lightly simply due to someone else’s “need.”
Regrettably, what people often see is propaganda and sudden disappearances of youths, but rarely a complete and transparent explanation.
How many minors actually go missing every year?
How many are recovered? How many of their bodies are discovered in water?
Where did these children go in the end?
What the public needs is not a single line saying “do not spread rumors,” but a set of answers that can stand up to verification.
What the public needs are basic rights to life—that children can safely go to school and return home, rather than being suddenly matched, harvested of their organs, and made to disappear, leaving the entire lower strata of society trapped in an inescapable sense of deep terror.
The same applies to hospitals.
Medicine was originally meant to save lives; but once a hospital simultaneously becomes a place where capital, administrative power, and scarce resources intersect, people naturally worry: is the doctor facing a patient, or a quota performance metric? Is the surgery facing a human life, or a financial yield?
Organ transplantation is far more unique than ordinary surgery. One end connects to people waiting to survive, while the other end inevitably connects to death. Medical practices of this nature must possess a higher level of transparency than ordinary surgeries, rather than deeper secrecy.
Where do the organs come from?
How is death determined?
If these questions cannot be clearly understood by the general public, then no amount of propaganda films will earn true trust; instead, they will only fuel deeper and broader fear.
Some say that it is a tragedy for the populace to disbelieve the hospitals and the government.
This statement is only half right.
It is indeed a tragedy when the public distrusts the system; but if a system never strives to make itself trustworthy and instead blames the public for being overly suspicious, then that is not merely a tragedy, but sheer arrogance.
A nation that truly respects life would not be in a hurry to have children swear oaths to donate organs; rather, it would first let the child know: your body belongs to you.
It would not merely teach children how to dedicate themselves, but also teach children how to say no; it would not merely tell children that they can help others after death, but also tell children that while they are alive, no one has the right to harm you, control you, or exploit you—and certainly, it would not allow so many children to suddenly disappear and die.
The state can manage hospitals, enact laws, and establish organ donation systems, but it cannot thereby become the master of the human body.
Otherwise, every person at the bottom layer of China is nothing more than a temporarily living state asset.
When working, they are labor power.
When paying fees, they are taxpayers.
When sick, they are medical consumers.
Once matched, they become usable organ resources.
From birth to death, a person seems to be registered, numbered, categorized, and utilized. Only they themselves have the least say.
This is precisely the most terrifying aspect of “state-owned organs.”
It may not necessarily be written explicitly into law, nor does anyone need to announce it publicly. It may simply lurk behind repeated propaganda, repeated commendations, and repeated moral persuasions, gradually inducing people to believe that an individual’s body does not belong entirely to the individual, and that when necessary, the individual ought to submit to the “greater arrangement.”
And the so-called “greater arrangement” usually never needs to explain itself to the individual.
I am not opposed to organ donation.
What I oppose is wrapping donation into a mandatory moral correctness that must be praised, within an environment lacking transparency and trust; what I oppose is putting underage children in front of the camera to serve as propaganda models for the system; what I oppose is demanding that ordinary people unconditionally trust life-and-death matters, while those in power do not have to undergo an equivalent level of supervision; what I oppose is that the children of ordinary Chinese people at the bottom of society can vanish at any time, be matched at any time, and be taken away at any time to serve as someone else’s organ resource.
If organs no longer belong first and foremost to the individual, then the so-called right to life will never emerge or be respected upon this land of China.
That seventeen-year-old youth is still smiling.
Holding flowers in his hands, with officials standing beside him, the camera records a ceremony named “glory.”
I only hope that many years from now, he will still be alive and well.
Rather than letting today’s photograph become something people dare not look back upon in the future.
Editor: Hu Lili
Proofreader: Zhou Min
Translator: Shen Meihua
