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EDITORIAL: Transplant policies need revision
The Cabinet took action this week to bolster the chances of people whose lives are dependent upon an organ transplant and to bar the trade in organs. Both moves were long overdue, but now it is up to the legislature to pass the changes into law. It should do so as soon as lawmakers return from their recess on Feb. 20.
The proposed amendments to the Human Organ Transplantation Act (人體器官移植條例) will allow people to donate kidneys to non-family members, require those who go overseas to procure an organ transplant to provide details of their operation to the Ministry of Health and Welfare and outlaws the brokering of or profiting from organ donations. Another proposed change would speed up the actual transplant procedure by eliminating the need to get the ministry’s prior approval for each kidney transplant operation.
The Taiwan Organ Registry and Sharing Center Web site shows that 8,332 people are waiting for a transplant, 6,275 of whom are waiting for a kidney. There are 1,155 people on the liver list, 154 on the heart list and 62 waiting for a new pancreas.
However, the Web site says that an average of 150 donors are found annually, with only about 300 organ transplants each year, meaning people could wait for years for a kidney or other organ to become available.
The center, health authorities and others have worked for years to overcome cultural barriers and encourage more people to sign up to donate their organs after their deaths.
A survey conducted by the center last year found that 70 percent of respondents were willing to donate their organs after they die, but only 1 percent have made the effort to have their consent listed on their National Health Insurance cards.
However, even when donors are willing, sometimes their families are not and the Medical Care Act (醫療法) still requires hospitals to get the consent of a dead donor’s family before harvesting the person’s organs. This shows that more education is needed.
At present, the law bars donations from living donors who are not related to the patient. Eliminating this restriction will open the way for more donations to be made. While the Cabinet’s decision this week is laudable, it did not go far enough. Taiwan remains in a gray area when it comes to harvesting organs from convicted prisoners and, through omission, encouraging people to participate in questionable transplant operations abroad by allowing the National Health Insurance system to cover the cost of post-transplant treatment and medication.
A majority of Taiwanese who do go overseas to receive a transplant go to China — accounting for 88.6 percent of all overseas transplants from 2000 to 2011 — where reports of illegal or unethical harvesting of organs are rife.
The legislature in November last year passed a legally binding resolution requiring the then-Department of Health, now the Ministry of Health and Welfare, to require major medical institutions and physicians to register the country where organs were source and information on the hospital and doctors where a transplant is carried out when organ recipients return to Taiwan and apply for postoperative health insurance coverage. This will help the authorities determine exactly where in China the donated organs are coming from and could aid international efforts to end the practice of harvesting organs from dead inmates or others who did not consent to such actions.
There is still much work for the Cabinet and the legislature to do to help improve Taiwan’s organ transplantation infrastructure and ethics.
source: Taipei Times
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