1. Background
Hong Kong organ transplants are the same as in other countries and regions, with thousands of people waiting every day for organ transplants. Living death and donation of the body are the main ways of organ donation. Unlike other countries and regions, there is a lack of voluntary living donations in Hong Kong, so body donation is currently the main method of organ transplantation in Hong Kong.
As the social care level improves, organ transplantation can extend the lives of end-stage organ failure patients. Even though Hong Kong has a high level of organ transplantation, the real constraint on organ transplantation is the very low rate of organ donation. The number of donated organs is far less than expected each year.
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For example, 2,318 people were waiting for kidney transplants in Hong Kong as of June 30, 2019, but in the first half of the year only 21 were donated. Looking back over the past decade, a total of 74 kidney donations per year and at least 59 cases have occurred. This means that every year, less than 3 percent of people have a chance to be reborn.
Hong Kong's organ donation rate ranks behind the world's developed countries and regions, according to IRODaT's report. Just 6.7 people donate organs per million people. In addition, in Spain, the number one, 48 per million people donated organs. This number is about eight times Hong Kong's figure.
So, what is the cause of the very low rate of organ transplantation in Hong Kong? What is the way to encourage people in Hong Kong to donate organs and in the following empirical observations, I will describe the three main reasons in depth and provide appropriate solutions.
2. Consequences
Because in Hong Kong there are fewer cases of organ donation than those waiting for transplants. It causes every patient to take a long time to wait for a suitable transplant organ. They need to know that if a person gets ill, he or she needs immediate care, otherwise it might be life-threatening.
It takes 51 months for a patient with organ failure to wait for a kidney, according to the Hospital Authority. Waiting for a liver takes 42 months. Waiting for a heart will take 21.7 months. Waiting for a lung would take 9.27 months. The longest, 352 months, almost 20 years are waiting for treatment. Is it true that every patient must wait twenty years for an organ transplant? It's impossible to answer. Survival rates will decrease year after year for patients without organ transplants. Even if after several years the organ is transplanted, the risk of postoperative complications increases. A patient can be killed by serious complications.
At the same time, when waiting for an organ transplant, patients need to take a large variety of drugs or procedures to slow down organ failure. These drugs and therapies can have side effects and take a great deal of time. A person with kidney failure, for instance, must be on hemodialysis three days a week, each taking four to five hours. It may also cause nausea, cramps, and headaches after hemodialysis.
Lastly, the cost of each drug and routine treatment for an ordinary family is a significant burden. And most organ failure patients are unable to work long hours, resulting in loss of income for them. Only with the help of family and friends, they can continue treatment.
3. Root cause
1. Hong Kong people's traditional ideology.
Hong Kong is a Chinese place to live. In thought, philosophy, etiquette and even behavior are profoundly affected by traditional culture, and obviously the practice of organ donation has a huge influence. Respect for the family, especially the wishes of the elders and the concept of the integrity of their remains, that is, the 'remaining of the whole body,' are of great importance.
If a family member dies and does not report organ donation, most members of the public will not be willing to donate the organs of the members of the deceased family, believing that they will be considered disrespectful.
Most people's thoughts are affected by Chinese terms, such as Confucianism's 'Our bodies, every hair and skin we receive from our family, and we must not attempt to harm or injure them. This is the beginning of filial piety,' otherwise 'parents ' filial piety' influences the desire to donate organs.
2. Under the influence of Chinese ethics and different religions
On the religious level, the majority of religions endorse and promote organ donation, and because of those views, only a few groups are unfit for organ donation. For example, Buddhism's secret sect, because hours after death can't touch the deceased's body after death, it can't meet the conditions for organ donation.
3. Misunderstandings about the donation process
People have had little access to relevant information in their daily life or training courses in the past. Therefore, people do not have a deep understanding of organ donation and do not have a clear understanding of the process of organ donation, relevant organ donation organizations, application registration procedures, etc. As a result, they have reservations about organ donation and are not actively involved in it, leading to a decline in the desire to donate.
In this respect, the academic and marketing shortcomings are not as strong as they should be, and their inability to achieve the desired results is closely linked to the production of time-to-time. Many high school students claim that previous classes have failed to raise awareness of organ donation and are not aware that they can enroll there as donors. Some members of the public consider themselves too young to be too young or do not need to consider organ donation (the public is not aware that there is no age limit for organ donation) which may be the reason why many students or members of the public have thought about donation but have not taken action to register as donors. The lack of public awareness of organ donation also makes them concerned that medical staff will not do their best to treat donors, make donations indecent, register data security is inadequate, or can not be canceled after registration.
4. Affected by the organ donation system
The rate of donation of organs depends not only on the public's attitude, but also on the functioning of the entire mechanism and the matching of manpower and resources. In the opinion of the respondents, the current system of organ donation registration is poorly designed and not convenient for the public, which reduces their chances of participating in the scheme. Nevertheless, due to insufficient personnel and equipment in public hospitals, in particular the lack of beds in the intensive care unit, medical staff (such as the Organ Transplant Liaison Coordinator and nurses in the Intensive Care Unit) have too much work to do, likely to miss potential donors and eventually lose any usable organs.
4. Solution
1. Increase effective participation channels to encourage active registration
Opt-out is generally effective in increasing the rate of donation of bodies and organs, based on international experience, but the measures are controversial. Most respondents assume that to enforce the policy rapidly, Hong Kong does not have the necessary social conditions. The study suggests first enhancing the current registration system by offering more and more accessible participation networks. In addition to promoting registration, most respondents (including young people) believe that an 18-year-old person has the independent ability to decide whether to donate their own organs after death. While Hong Kong people are 18 years of age to register as voters, the government suggested that when citizens receive 18 adult identity cards, provide relevant information to donate organs while body, and form will provide three free options to 'attend,' 'not to participate' and 'not to decide;' all applicants will apply three free options, once again by referring them to the health department of immigration. On the one hand, it will increase active channels of participation in the program, and on the other, it will encourage applicants to focus on their essential civic obligations.
The government is also currently holding flyers on organ donation at mobile blood donation stations, transportation department, immigration department, and health department. Many members of the public, however, say that when donating blood, obtaining their driving licenses or passports, they did not receive the leaflets. Despite the fact that organ donation leaflets are now accessible in a number of hospitals, further collection places could be added, such as 41 public hospitals, all private hospitals, and even clinics for private practice. At the same time, the study suggests that, in addition to distributing promotional leaflets, a voluntary identification alternative as an organ donor may be added to the blood donation or driving license application form, passport and other documentation to provide more opportunities for the public to demonstrate their willingness to participate in the scheme.
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