China is phasing out its reliance on executed prisoners for donated organs, but an architect of the country's transplant system said Friday that ingrained cultural attitudes are impeding the rise of donations among the general population.
Almost all donated organs in China used to come from executed prisoners. A growing proportion now come from ordinary people, but the government is seeking to eliminate prisoner donations altogether.
However, former vice health minister Huang Jiefu said Friday that there was little hope of changing a requirement that family members give consent before organs are donated, even if a person had expressed a desire to donate.
"China is a Confucian society. It's strongly hierarchical and the family's concerns usually trump those of the individual," said Huang, presently a leader of the national legislature's top advisory body. An objection from even one family member can block a donation, he said.
Chinese have traditionally held that a person's body should be interred intact, and while such attitudes are gradually changing, they remain strong among older Chinese. At the same time, China is cutting down on its reliance on executed prisoners for organs — a practice that Huang called "profit-driven, unethical and violating human rights." Critics have long claimed that standard safeguards were often ignored in the case of obtaining organs from prisoners who may have been pressured to donate.
The use of prisoners' organs was also seen as causing an artificial shortfall in the number of organs available by impeding the promotion of donating among the public as a whole. China suffers from an acute shortage of available organs and Huang said only about 10,000 of the 300,000 Chinese suffering from liver disease will be able to receive transplants. He hopes to raise that number to 100,000 over time. Another 1 million people suffer from kidney ailments, but many can be sustained for lengthy periods on dialysis machines.
China considers the number of annual executions a secret, but most observers estimate the number at 6,000-8,000. It isn't known what proportion of those executed agree to donate their organs.
However, 5,009 liver and kidney transplants performed last year used organs from executed prisoners, out of a total of 7,882 such operations, according to the Health Ministry. By contrast, 2,960 of 2,997 liver transplants performed in 2005 used organs from executed prisoners.
Huang reiterated a projection that reliance on prisoners will be eliminated within about two years of the launch of the nationwide donor network in February.