In for penny, in for pound on organs

Editorial | Mar 20, 2017
Over the years, the government has been putting a lot of effort into promoting organ donations.

What's the situation now?

Around 240,000 people have signed up to donate organs after death, which is slightly more than 3 percent of the population. While this is better than before, the response is still disappointing. New thinking is clearly needed.

All along, Hong Kong has pursued an "opt-in" approach, under which people are asked to say "yes" to organ donations.

In some countries, an "opt-out" policy is adopted - meaning people are assumed to be willing donors unless otherwise stated.

Health chief Ko Wing-man yesterday raised the idea, saying the government is looking into this, and may soon consult the public.

That's a sound idea and should be the way forward. However, Ko must act cautiously because the SAR - despite its international outlook - remains a conservative community, where cultural norms regarding death remain traditional and many want to keep their body whole for the after-life.

It will be essential to communicate with the community fully if the taboo is to be overcome. Legislation to formalize an "opt-out" policy would help, but can't fundamentally change the social bias.

Speaking after a public event, Ko said a decision will be made before the end of the current administration's term.

He correctly noted the controversial nature of the issue, that even if the consultation is to start during the remaining few months, the legislative work will be for his successor to take up.

According to Hospital Authority figures, 180 patients died while waiting for liver, heart or lung transplants over the past five years. In other words, there could have been fewer deaths if the local Chinese community had been more receptive to the idea of donating organs.

However, it will require more than a law to change attitudes. Perhaps, Spain is the world's most outstanding example on organ donation, and can be used by Hong Kong as a reference, as it seeks the way forward.

Spain has a population of 46 million - about six times more people than Hong Kong. In 2016, Spain harvested a total of 4,818 donated organs - about 105 per one million people. That marked a dramatic rise from a few decades ago. Spain's donations in 2016 included 281 hearts - 28 times that of the SAR during the period.

In addition to the "opt-out" policy, Spain has a 500-member coordination team to identify potential donors at early stages. Hong Kong has a similar team formed by nine coordinators. The SAR is smaller in size, and doesn't need a team as large as Spain's, but it certainly helps if there are more coordinators.

Spain also starts promoting organ donation early in education, and because of this, the people there are mostly open-minded about donating organs after death.

The "opt-out" policy alone can't solve all the problems facing organ donation here, but it would surely be a good start.



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