Government expounds on cross-boundary organ transplant mutual assistance mechanism and organ donation registration
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All lives are priceless and equally precious. Cadaveric organ donation is an act of selfless dedication to rekindle others' lives. The spirit and mechanism of cadaveric organ donation in the medical profession of Hong Kong and around the world has all along hinged on two major principles, namely altruism and utilitarianism. Altruism is an act of unconditional giving, arising from self-initiation without any exchange for reward. While decisions made by donors voluntarily and independently shall be given absolute respect, neither the donors nor their family members should expect any return from the decision made. On the other hand, the goal of utilitarianism shall be to maximise the overall good.
The prevailing legislation and mechanism governing the donation, allocation, and transplantation of cadaveric organs in Hong Kong work on the above two major principles. The public can make a registration with or withdraw from the CODR according to their own will. For the deceased who have not registered with the CODR, they may still donate their organs after death to rekindle others' lives, as long as they have clearly expressed their wish for donation to medical staff or family members when they were alive. However, donors or their family members cannot designate any specific recipients or request any identity screening of the recipients. The identity of the recipients will not be made known to the family members of the donors beforehand. This mechanism is to ensure that no beneficial interest nor discrimination would exist between donors and recipients.
Taking reference from the successful experience of the very first cross-boundary organ transplant case last year, the Health Bureau (HHB) and the Hospital Authority (HA) are exploring the setting-up of a standing organ transplant mutual assistance mechanism with the Mainland. The mechanism being considered is a second-tier mutual assistance allocation mechanism which can be activated immediately once suitable patients cannot be identified for any organ donated in either side of the two places and matching was unsuccessful in the local allocation system for the relevant organ. The Hong Kong Special Administrative Region (HKSAR) Government is actively examining the proposed mechanism with relevant Mainland authorities to align the technical requirements, criteria and operational procedures, and to ensure that such organ donation is conducted under the principle of benefitting patients with the greatest need in a legal, fair, equitable and safe manner. It is hoped that the mechanism can be put in place as early as possible. The relevant mechanism will allow donated organs in Hong Kong and the Mainland be better utilised when no suitable recipients can be identified in the respective place, thus achieving the greatest benefit for the greater good and giving patients currently on the waiting list an extra chance to live a new life.
The Government noticed that a small number of individuals distorted the virtue and altruistic value of devotion in organ donation on the Internet recently by promoting the idea that organ donors should scrutinise the identity of the recipients and even urging others to withdraw from the CODR. The HHB expresses regret towards such act which completely goes against the spirit of selfless love in organ donation. Some individuals also wantonly vilify the constructive significance of the proposed establishment of a standing mutual assistance mechanism for transplant by the two places, undoubtedly despising the inseparable ties between citizens of Hong Kong and the Mainland as well as various selfless acts of assistance in the past including cases of organ donations from the Mainland in saving the lives of Hong Kong patients. These individuals disregard completely the well-being of the patients awaiting organ transplants in the two places, and have the development of organ donation and transplant as well as the allocation system for transplant in the Mainland misinterpreted. As a matter of fact, the nation has made remarkable achievements worldwide in human organ donation work in recent years, while the China Organ Transplant Response System (COTRS) is also highly recognised by the World Health Organization and The Transplantation Society.
Hong Kong has been adopting an "opt-in" system for cadaveric organ donation. Since its establishment in 2008, the registration number of the CODR has kept growing, from 45 150 in 2009 to more than 357 000 at present, reflecting strong support for organ donation from the general public. The Department of Health (DH) recently observed some abnormalities in the figures relating to withdrawal filed via the website of the CODR. During the five-month period from December 2022 to April 2023, a total of 5 785 withdrawal applications were recorded, which is significantly higher than that recorded in the past. However, it is eventually found that over half of the applications, viz. 2 905 applications, are invalid ones from persons who have either never opted in for the CODR or made repeated attempts of withdrawal. In February alone, the percentage of invalid withdrawals was as high as 74 per cent. It cannot be ruled out that a small number of people have intentionally made withdrawal attempts with the aim of disrupting the representativeness of the CODR and increasing the administrative burden on government personnel. The HKSAR Government strongly condemns such utterly irresponsible behaviour. As for the 2 880 valid withdrawals during the same period, the reasons for such number being far higher than before are diverse. The HHB and the DH value every registration and respect individual autonomy in decision-making, and will actively step up the promotion of and education efforts in organ donation mechanisms and spirit. Nonetheless, it is worth noting that there were 5 091 new registrations during the same period, implying a net growth in CODR registrations after all with the support from the general public on organ donation. The Government appeals to members of the public to keep supporting the selfless and generous act of organ donation in saving lives, and not to let a small group of people with ulterior motives to jeopardise the hard-earned atmosphere in support of organ donation over the years.
The HHB, together with the DH and the HA, will continue to make every effort in promoting organ donation on various fronts in collaboration with community partners, including: (1) establishing an institution-based network with signatories of the Organ Donation Promotion Charter and supporters to promote organ donation and encourage members of the public to register with the CODR; (2) launching public education through talks and seminars; (3) setting up promotion booths and organising promotion activities to encourage citizens' registration in the CODR; (4) arranging publicity through various channels, such as radio, newspapers and the Internet; (5) continuing to drive online participation of members of the public via the dedicated Facebook page entitled "Organ Donation@HK"; and (6) production of promotional materials for distribution in various occasions and events.
The Government will continue its efforts in promoting organ donation by fostering more public education and promotion through a multi-pronged approach in a bid to build a receptive and respectful culture for organ donation, thereby more patients waiting for organ transplants can be given a new lease of life. The Government once again urges citizens to give their strong support to organ donation by registering with the COCR (www.codr.gov.hk).
Ends/Monday, May 22, 2023
Issued at HKT 13:48
Issued at HKT 13:48
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