When the Romans fed Christians to lions in the arena, afterward, they did not sell the bodies as lion food in supermarkets. But the Chinese communists have figured out how to do it. That’s the shocking insight in Jan Jekielek’s new book, "Killed to Order."
The ugly question behind all of this is not hard to understand. How does a transplant system produce organs in days or weeks when patients in the United States wait months or years?
In a follow-up interview after a speaking engagement at the Trump Kennedy Center on Monday, Jekielek pointed me to what he sees as one of the hardest numbers to wave away. Researcher Ethan Gutmann, he said, “under oath defended the number 60 to 100,000 transplants per year… and that’s a low bound.”
And the system, if that estimate is even close to right, is not shrinking. During the event, Jekielek pointed to the growth in transplant infrastructure itself, noting that “there were 146 hospitals… now there are 200 hospitals” capable of performing these procedures.
That is not what a handful of bad actors looks like. It is capacity at scale. It is a system. And it raises the question most people would rather not follow to its conclusion: what kind of apparatus can sustain that kind of volume at that kind of speed?
Jekielek’s book does not dance around the answer. It describes “a vast enterprise” that has systematically sourced organs from living prisoners of conscience and other targeted groups.
And the case it makes is not built on one lurid anecdote. It is built on a pattern. Investigators have long pointed to the mismatch between official donation numbers and transplant volume, then asked the obvious next question: how do you keep meeting demand that fast? One of the most disturbing answers in the book is what researchers have called “execution by organ procurement,” meaning the act of removing the organ is itself what causes death.
If that still sounds impossible, the details do not get easier to dismiss. The book references accounts in which detainees are subjected to repeated medical testing while in custody, not for their own care, but to assess organ compatibility. In some cases, according to those accounts, “teams of surgeons remove… organs from people who are still alive, and then the bodies are incinerated.”
It is no longer about policy or even human rights as they are usually discussed. It is about process.
Jekielek put it plainly during our interview.
“The crime scene is an operating room… scrubbed clean every time.”
That reality helps explain why this has stayed on the margins, despite years of reporting, congressional testimony, and independent investigation. If the crime scene is wiped clean every time, the evidence does not remain: it builds. Piece by piece. And over time, the pattern stops looking like coincidence and starts looking like design.
At the event, that accumulation was the point. Rather than relying on a single shocking claim, the discussion moved step by step through the logic, from transplant wait times to hospital capacity to documented inconsistencies in official data. By the time it circled back to the central allegation, the question had shifted. It was no longer a question of whether the claim sounded extreme. It was whether anyone in the room could come up with a more plausible explanation.
Read More: Is China More Fragile Than We Realize?
Actor Rob Schneider’s role in the discussion made that shift visible. He reacted to the evidence as it was presented, mirroring what much of the audience was coming to terms with in real time. The initial disbelief gave way to a quieter realization that, taken together, the pieces are difficult to reconcile with a purely voluntary system.
Jekielek is careful about how far he pushes the claim, but he is not vague about where it points. While Falun Gong practitioners have long been identified in reporting as primary victims, he warned that the system, if it exists at scale, would not stay limited to one group for long.
“I’m genuinely worried that they’re looking for new groups to add to this machine of death,” Jekielek said in our follow-up interview.
The book points to Uyghurs and other persecuted populations as targets within a system that turns repression into a resource.
That possibility does not stop at China’s borders. It puts Western institutions in focus, including medical and academic partners who have worked alongside these systems. It also raises an uncomfortable reality about incentives. Access to China for research, reporting, or business creates pressure. And that pressure cuts in one direction: do not pursue the stories that might jeopardize that access. Jekielek was blunt when I asked him. “They’re afraid to touch it.”
The reason is straightforward. Credible reporting on this carries consequences, especially for organizations that rely on continued access to China’s institutions and markets. “If they report on this credibly, they will lose that.”
That gap between the severity of the allegations and the level of sustained attention is not accidental. It is not just an evidentiary problem. It is psychological and institutional. And yet, that is starting to shift. Jekielek told me reactions have changed as more information has come out. “Most people I talk to these days are horrified.”
The claims outlined in "Killed to Order" are not just disturbing. They are difficult to place in any familiar framework. They force a confrontation with something profoundly wrong existing in plain sight, sustained not just by secrecy but by disbelief. If even part of it is true, the comparison isn’t rhetorical. A system exists that turns human bodies into a resource, and unlike the Romans, this time, the world is still doing business with it.
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