China will begin to phase out organ donation from executed criminals next year, as it moves towards a voluntary system, a government expert said. In an interview in the World Health Organization’s Bulletin, Wang Haibo, of the Ministry of Health, agrees that “an organ transplantation system relying on death-row prisoners’ organs is not ethical or sustainable”. Despite the existence of a black market in organs, China has banned the sale of organs.
Although his words were appropriately optimistic about the success of a new system for allocating organs, Mr. Wang said that there are some formidable obstacles. About 1.5 million people wait for organ transplants annually, but only 15,000 register for donation in all of China, according to China Youth Daily.
The first of these is Chinese cultural norms. Although the head of China’s transplant policy, Jiefu Huang, told the media that, ”What lags behind is not the tradition or moral status of Chinese people; it’s our system,” Mr Wang constantly refers to social inertia.
The second is suspicion of corruption. Citizens need to be reassured that their organs will not be sold on a black market.
The third is lack of enabling legislation. In other countries, brain death is enough to declare a person dead and to remove vital organs. However, there is no law defining brain death. Only 9% of organs come from brain dead patients.
“I have been asked many times by our international colleagues: ‘How can China do organ donation after death without brain death legislation?’ That is exactly the research question that needs to be addressed in the new system. It is not customary – in terms of our culture, law and medical practice – to take brain death as the definition of death in China. Members of the public want organ donation to save lives, but they also want to be sure that, when this involves organ procurement after death, that their loved one is definitely dead.”
Legal clarity may also not motivate potential donors. As Mr Wang said, “even with legal recognition of death determination on neurological criteria or brain death legislation, there is no guarantee of the success of donation in terms of public willingness to donate.
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