China Is Risking the Lives of Political Prisoners by Denying Them Medical Care

Dissident activist Chen Xi entered Xingyi Prison in Guangxi in January 2012 to serve a 10-year sentence. The previous month, he had been convicted of “inciting subversion of state power” for writing articles about human rights and democracy. This wasn’t Chen’s first time in jail. He’d already spent a total of 13 years in prison, including three for participating in the 1989 pro-democracy movement. So to some extent, he was prepared for what lay ahead. But this prison term would be different.

Within a month, he had contracted frostbite on his hands after prison guards refused to give him warm clothes and blankets during the unusually cold winter. After two years, Chen began to suffer from chronic enteritis, a treatable inflammation of the digestive tract normally caused by contaminated food or drink. But Chen didn’t receive treatment. In December 2013 he began to have frequent bouts of severe diarrhea. When his wife visited him in mid-2014, he was extremely weak due to dehydration and fever, had lost a considerable amount of weight, and was in a poor mental state. By December of that year, Chen was psychologically distressed. By then, he had been suffering from untreated diarrhea for a year and had been repeatedly placed in solitary confinement. The prison has refused to grant him medical parole and reportedly told Chen’s wife it never would, despite its inability or unwillingness to treat him.



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Disturbingly, Chen’s case is not an outlier. Dozens of political detainees and prisoners have reported being deprived of adequate medical treatment. These cases raise the question of what kind of treatment Nobel Peace Prize Laureate Liu Xiaobo received before his death in July 2017 due to complications from liver cancer. Chinese security agents and propaganda officials went into overdrive before and after his death, attempting to paint a picture that Liu received the best available medical care. However, during Liu’s seven years at Jinzhou Prison in Liaoning Province, authorities knew that Liu had hepatitis B, a disease that put him at greater risk for liver cancer. Yet, Liu’s cancer was so advanced when he was granted medical parole and moved to a hospital that no surgery, chemotherapy, or radiation therapy could be performed, according to his wife, the poet Liu Xia.

Chinese law mandates that prisoners and individuals held in detention facilities receive prompt medical care; however, the reality is often far removed from the law. Deliberately depriving prisoners of medical care is a life-threatening form of torture, and appears to be commonly used against political prisoners on China. Many of these cases follow a similar pattern, starting with a decline in health from existing conditions or new injuries emerging due to torture or ill-treatment, denied access to adequate and prompt medical care, and a refusal to approve applications for medical bail or parole. Family members worry that the government will simply let their loved ones die behind bars; the death of China’s most famous political prisoner in police custody only strengthens that fear.

Another pressing case of deprived medical treatment is that of rural women’s rights activist Su Changlan. Su was detained in 2014 after posting social media messages in support of the Occupy Hong Kong pro-democracy protests. Authorities in Guangdong’s Foshan City arrested and charged Su with “inciting subversion of state power,” accusing her of trying to “overthrow the socialist system” with her articles and comments on WeChat. Su suffers from hyperthyroidism, which can be fatal if not treated. In custody, she has suffered from complications from a lack of treatment, including heart arrhythmia, trembling hands, swollen eyes, weight loss, and incontinence. Su told her lawyers in meetings throughout 2015 and 2016 about the poor or non-existent medical care she had been receiving, as well as the poor hygiene and living conditions.



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For more than two years, authorities repeatedly denied her lawyers’ applications to secure her release on medical bail. In March 2017, Su was found guilty and sentenced to three years in prison. Su’s health continued to dangerously deteriorate after her conviction, and she now reportedly suffers from possible kidney failure and is having difficulty speaking. Her husband, who visited her on June 2017—the first time that officials allowed him such a visit—told journalists, “Her health is much, much worse than it was before.” Su’s family fears her life is in danger and she won’t receive better treatment until she is released in October 2017.

The risk of death from deprived medical care is very real. On March 14, 2014, human rights activist Cao Shunli died after being deprived of medical treatment for over six months in a Beijing detention center. Police seized Cao, who had several manageable health conditions, in September 2013 to prevent her from traveling to Geneva to testify to the U.N. Human Rights Council about the human rights situation in China. Cao had a liver condition that she had managed in the past, but guards reportedly confiscated medication that she had with her. While Cao was held in a detention center, her health began to deteriorate, but authorities refused to approve her lawyers’ requests for medical bail. It was not until she was practically in a coma that bail was approved, and Cao died from organ failure only 22 days later. Other individuals who challenged the government and have died after being deprived of medical care in custody include petitioner-activists Chen Xiaoming and Duan Huimin in the mid-2000s, and more recently Tibetans Goshul Lobsang and Tenzin Delek Rinpoche.

The international community has spoken out about deprivation of medical treatment as a form of torture used against China’s political prisoners. U.N. human rights experts, in calling on China to provide adequate medical care for activist Guo Feixiong in August 2016, felt that, “His public profile as a human rights defender seems to have been the cause and aggravating factor for the denial of appropriate medical care and ill-treatment.”

Chinese President Xi Jinping has promised to “govern the country according to the law,” but the pattern of deprived medical care shows a disregard for the lives of human rights defenders and a lack of rule of law. Legislation requiring “prompt medical treatment” are not implemented, and other regulations and rules are deficient because they don’t contain legal guarantees that doctors in prisons or detention facilities can make independent medical decisions without interference from either law-enforcement or Chinese Communist Party (C.C.P.) officials.

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Under the Regulations on Detention Facilities, detainees are only guaranteed a medical examination upon entering the detention facility. A request for treatment outside the facility must be approved by the head of the detention center, allowing for arbitrary decision-making in “politically sensitive” cases. The new draft Detention Center Law doesn’t contain any new language that would ensure prompt, impartial, and comprehensive medical treatment, exposing the government’s failure to act to end this disturbing trend. Though prisoners receive periodic medical checks, in practice exams are only required to be done once a year, and they may not be comprehensive or timely enough to detect health problems.

Securing release for medical reasons is also difficult. China’s Criminal Procedure Law allows for detainees and prisoners to receive medical bail or parole due to “serious illness.” However, the scope of what constitutes “serious illness” under detailed measures released in 2014 is extremely restrictive and requires some prisoners to endure six months of failed treatment before they can be eligible. Some Chinese lawyers who take on “politically sensitive” cases have reported that C.C.P. bodies, not medical professionals, must approve applications for medical release.

China has obligations under international law to ensure prisoners and detainees have access to prompt and adequate medical care, including seeing a doctor of their choice. Since 1988, China has been party to the Convention Against Torture, which bans torture and cruel, inhumane, and degrading treatment. In December 2015, the U.N. Committee Against Torture raised concern over deaths in Chinese custody as a result of a lack of prompt medical care. A year prior, two other U.N. committees, on economic, social, and cultural rights and on women’s rights, called on China to ensure women in detention and human rights activists are provided with adequate health care in all circumstances, in respect of China’s treaty obligations.

China’s fellow members on the U.N. Human Rights Council should pressure the government to cooperate with the Council’s own independent human rights experts, who have highlighted concerns over the deprivation of medical care to human rights defenders. Such experts should be allowed, as some have in the past, to independently visit China’s prisons and detention centers to report on the standard and care of medical treatment. Other governments can and should continue to forcefully and publicly call on China to abide by its international obligations on torture and human rights. China’s respect for its responsibilities under international law is a matter of global concern.

As Dostoevsky famously wrote, “The degree of civilization in a society can be judged by entering its prisons.” In China, as seen in the cases of Chen Xi, Su Changlan, Cao Shunli, and so many others, the government refuses to behave in a civilized manner when it tortures prisoners of conscience by depriving them access to adequate medical treatment.