So how did PRC security authorities inflict brain death—and only brain death—on humans in a repeatable and reliable way, while preserving the rest of the body for successful organ procurement? There are obviously no known published studies detailing experiments on this problem anywhere in the world. If the PRC medical establishment were to stay at arm’s length from the actual executions, then this challenge would have to be overcome by the security apparatus.

The only other country we know of that even tried something like this and wrote about it was Taiwan. In 2011 Taiwanese researchers discussed a very similar process to the quotes above from China about partial execution: “The bullet penetrating the temporal bone of skull will not reach the brainstem, so a direct brainstem death could not occur.” A bullet to the head will cause intracranial hemorrhage, they write, and this could possibly cause brainstem death. But “such a means is indirect, imprecise and unreliable.” The danger, from a strict transplant outcome perspective, would be accidentally causing the donor to suffer cardiac death—and the heart would then be wasted.

The question then is how PRC security and medical authorities resolved this dilemma. We don’t think they did. Our research presents a large amount of evidence for the alternative: Rather than execution-by-brain-death being mastered and refined by security authorities, the act of execution was joined with the act of heart removal, and was carried out by surgeons on the operating table.