Huang Jiefu, China?s vice minister of health believes that China must enact a law on brain death. Experts assigned the task of examining the issue by the Ministry of Health have now finished the first draft of the diagnostic standards for defining brain death in line with China?s actual conditions. At present, they are soliciting opinions of people from all walks of life.
Huang disclosed this important information during a recent television interview. This is the first time for an official of the Ministry of Health to publicly express support for a brain death law since Chinese medical experts first appealed for such legislation in 1986.
By the end of 2000, among 189 member countries of the United Nations, 80 have accepted a standard for brain death, and such a concept now represents the developing trend of advanced civilization in the bio-medical field. China must speed up the enactment of the relevant legislation, said Huang.
According to him, the diagnostic standard for brain death has been clearly set since the 1980s. However, doctors cannot pronounce on brain death of patients because there is no legislation to protect them. With China?s entry into many international organizations, including the World Trade Organization and the World Health Organization, as well as much economic development, it is very important for it to now enact a brain death law in order to play a larger world role in scientific fields.
Huang said the legislation would be a breakthrough in the concept of death, which has lasted for thousands of years. However, the diagnosis of brain death involves human life, so that, in order to guarantee the diagnostic standard is scientific and practical as well as feasible, Chinese experts have emphasized learning from the successful experiences of other countries and the latest achievements in the international study of brain death.
The legislation is a new subject for China?s judiciary circles. With the influence of tradition and religions, it takes some time for Chinese people to accept the new concept of death. Therefore, Huang Jiefu emphasized that the two concepts -- the stopping of the heartbeat and brain death -- can co-exist. People could define death through one or both, allowing the process to develop gradually.
During the period of transition from the traditional concept, related departments including Chinese Medical Association and China Physicians Association should be well prepared for the following aspects: to make sure of a strict diagnostic standard for brain death; and to check up on technical standards as well as the management procedure. The legislation of brain death can be carried out only under this premise.
As a doctor, Professor Huang Jiefu specially pointed out that brain death is different from the human vegetable condition (where a person is physically alive, but mentally inert). He said, most of people will stop breathing and their heart will cease beating first at the end of their life, but in five percent of cases, people will appear to firstly suffer irreversible loss of all brain functions, due to, say, brain injury and brain tumor as well as cerebrovascular disease etc, which is brain death.
According to Huang, the brainstem of the human vegetable is normal. Their coma is caused by severe damage to the brain cortex or in a sudden inhibition status. Therefore the patients can continue to breathe freely with a heartbeat and brainstem reaction. A few may wake up some day.
He cited a research report in Britain of 16 scholars who had clinically diagnosed 1,036 people suffering brain death. Although they did all they could to help, none of these patients returned alive. The expense for trying to rescue one brain dead patient per day is 10 even 100 times more than for an ordinary patient.
Confirming the concept of brain death and implementation of the brain death law can terminate ineffective medical rescue efforts in proper time and reduce the meaningless consumption of medical resources. ?Of course, the legislation of brain death is not only for saving resources; people can die with more dignity by the abandonment of ineffective rescue.?
Huang said the brain death law would also be conducive to promoting the medical development of organ transplant and enable thousands of patients to have the chance for revitalization. At present, the transplant of heart, liver and kidney in China has reached a certain level in clinical experience. Due to the lack of the legislation on brain death, however, the quality of organ supplies is not as good as other countries. The normal procedures covering organ resources are affected and disturbed. Due to suspicion over the origin of organ suppliers, the scientific research and achievements China has made in the clinical organ transplant field are not recognized by the world. Related papers cannot be published and some hostile forces may use the issue to circulate rumors and distort the truth.
He concluded that the legislation of brain death was a very serious and cautious work. It is not due to the requirement of the Ministry of Health or doctors but due to the requirement of social development. He believed that China would speed up the legislation and fulfill the important task with joint efforts from all aspects.
(china.org.cn by Wang Qian, August 29, 2002)
