From July 1 it will be mandatory for all organ transplant
operations in China to be discussed with and approved by a medical
science and ethics committee.
The measure is part of a new regulation that will play a vital
role in banning the sale of organs and putting a stop to practices
that violate the ethics and medical standards of organ transplants,
officials said.
This is the first time a Chinese health authority has set up a
special committee and taken measures to help regulate organ
transplants, Mao Qun'an, spokesman of the Ministry of Health,
said.
The ministry will set up a state-level committee of experts in
management, medical treatment, nursing, pharmacy, law and ethics to
guide the country's work, Mao said.
Medical institutes and hospitals at various levels will also be
required to organize their own committees to approve all organ
transplants.
A key task of the committee is to ensure that the organs used
for transplants are voluntarily donated instead of being sold or
randomly taken from people, Mao said in an exclusive interview with
China Daily.
Sources claimed that at least 2 million patients in China need
organ transplants each year, but only 20,000 transplants can be
carried out because of the shortage of donated organs.
At the same time, there are too many hospitals performing organ
transplants, and many of them are not qualified to do so.
Managers of many small hospitals invite doctors from other
hospitals to carry out one or two organ transplants and then claim
they are able to provide the service in order to attract more
patients.
There are currently 500 hospitals in China conducting liver
transplants. There are only 100 hospitals performing the same
operation in the United States.
The shortage of donated organs and the lack of supervision of
hospitals have led to many viewing transplant surgery as a cash
cow, Huang Jiefu, vice minister of health, told recently.
Many people have been enticed to profit from this situation by
offering their organs for sale.
In many hospitals, those patients with money or connections to
managers or doctors have greater sway and more chance of obtaining
an organ sooner.
For example, while thousands of Chinese people are waiting in
line for operations, many foreigners have successfully gotten organ
transplants in recent years. Experts said that this is primarily
because they have more money.
In western Europe a kidney transplant costs US$173,000, while in
China patients pay between 40,000 yuan (US$4,800) to 60,000 yuan
(US$7,200) more affordable for foreigners from developed countries,
but a heavy burden for most Chinese people, 80 percent of whom have
no medical insurance, official sources noted.
Mao said that the new committee will supervise the application
process for organ transplants to ensure that available organs are
given to the people who need them most according to the waiting
queue, rather than who can afford the highest price.
Well-known actor Fu Biao, who died from liver cancer last year,
had two liver transplants in 2004 and 2005, but they only extended
his life for a few more months.
Mao said that there is little point in transplanting organs to a
cancer patient at the terminal stage and it is a waste of an organ
to do so.
The July 1 regulation also brings a set of medical standards for
organ transplants in an effort to guarantee medical safety and
prevent the waste of limited organs.
Only Class-3A hospitals, China's top-ranking comprehensive
hospitals, can apply for registration if they have doctors with
clinical organ transplant qualifications, the related transplant
equipment, a good management system and a medical ethics
committee.
The measure is aimed at preventing unqualified hospitals from
performing organ transplants. Medical institutions wanting to carry
out transplants will need to register with provincial-level health
departments, he noted.
Shanghai Changzheng Hospital did 181 kidney and 172 liver
transplants in 2005. Of these, nearly 30 had bad outcomes and were
done by unqualified doctors, according to Shanghai-based Life
Week magazine.
The new regulation stipulates that medical institutions must get
written agreement from the donors or their relatives before the
transplant, regardless of whether the donors are ordinary citizens
or executed criminals. And the donors are authorized by the
regulation to refuse the donation at the last minute.
Many experts were expecting the regulation to recognize or
approve the concept of brain death in China to solve the problem of
organ shortage, but this was not the case. No law or regulation in
China currently accepts the concept of brain death, the moment at
which a transplant is best performed.
The traditional Chinese attitude towards death, considered to be
the moment when a person's heartbeat and breathing cease, is also a
big obstacle to the promotion of organ donation.
With no law or regulation about organ donation in China, people
often feel confused and uncomfortable about donating organs.
As a result of this lack of legal guidance on organ donation,
many applications including those from executed criminals have been
refused in many places.
(China Daily May 5, 2006)