Organ donation: Opt-in or opt-out?

May 05, 2017 17:07
Despite the recent surge in the number of organ donors in Hong Kong, their number, in terms of their ratio to the city's population, is still far smaller than those in developed countries. Photo: CNSA

A recent case in which a dying mother was saved by a liver donor has fueled intense discussions in Hong Kong.

Tang Kwai-si, 43, suffered from an acute liver failure but her daughter could not donate her liver because she was a few months short of the legal age.

Then a 26-year-old woman, surnamed Cheng, came forward and donated two-thirds of her liver to keep Tang alive before doctors at the Queen Elizabeth Hospital performed a second transplant for Tang a week later by using a liver donation from a dead patient.

Cheng, who was a complete stranger to Tang's family prior to the donation, told media she thought it was worthwhile to donate her liver to extend another person’s life, even for just a week before the second donation became available.

The public lauded Cheng for her noble act, which she willingly did without asking anything in return.

What she did required great conviction to "do the right thing no matter what the outcome might be”.

An unexpected phenomenon resulted from the case-a surge in the number of people who put their names on the Centralized Organ Donation Register set up by the Department of Health.

The number, which increased by several hundreds in early April, saw an increase of more than 1,500 within a week after the case was reported.

However, the surge took the total to only more than 250,000, and that number, in terms of its ratio to the city's population, is far smaller than those seen in developed countries.

It suggests that Hongkongers, in fact, are not quite generous when it comes to organ donations.

Although they are always ready to offer their help, it seems they would rather see others donate their organs to save lives than do it by themselves.

This raises one issue: Which system is better in getting consent for organ donation before one dies?

There are two options: opt-in, which requires explicit consent from a would-be donor, or opt-out, in which non-refusal to donate organs is deemed as consent.

Personally, I am in favor the latter.

The opt-out system is based more on one’s willingness to help, while opt-in is tantamount to requiring one to make a sacrifice to some degree, and for ordinary people, this is never easy, even from the point of view of public policy.

This article appeared in the Hong Kong Economic Journal on April 29

Translation by Taka Liu

[Chinese version 中文版]

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