BEIJING, April 28 (Xinhua) -- The question of what
constitutes death is at the center of a medico-legal debate in China with
important implications for organ transplants, a senior health official said on
Saturday.
In April, China issued its first regulation on human
organ transplants, aimed at banning organ trade in any form and regulating the
country's huge organ transplant market. It will go into effect on May 1.
The new organ transplant regulations are a milestone
in China's health sector, but the legal framework remains incomplete, vice
minister of health Huang Jiefu told a press briefing, pointing out that new
legislation on "brain death" is needed.
He said the development of human organ transplants
requires a wider medical definition of death besides the traditional notion of
cessation of heartbeat.
"Fifteen minutes at most after the cessation of
heartbeat and breathing, organs are irreparably damaged and can no longer be
harvested for transplants," said Huang, a liver transplant specialist, who
completed his postdoctoral research at the University of Sydney, Australia.
Most western countries stopped using cessation of
heartbeat as a sign of death before organ removal in 1968. Instead they use the
concept of "brain death", the criteria for which include absence of brain-stem
reflexes, no evidence of breathing and total lack of consciousness.
Organs can be successfully harvested from a person
who is brain dead but whose heart and lungs are kept functioning by machines.
However, the traditional Chinese view that "life goes
on until the last breath and until the heart stops beating" has held back the
introduction of legislation on brain death even though academics have been
urging the promulgation of such a law since the 1980s.
Chinese medical experts say that if the law was
amended to allow organs to be removed from people declared "brain-dead", organ
supply would increase significantly.
China has been carrying out organ transplants for
more than 20 years and is the world's second largest performer of transplants
after the United States. But there is a terrible shortage of organs. Official
statistics show that while 1.5 million patients need organ transplants each
year, only 10,000 can find organs.
Most organs are donated by ordinary citizens at their
death who have voluntarily signed a donation agreement.
As China's human organ transplant regulations do not
recognize brain death, it is currently illegal to take organs from a brain-dead
patient for transplant purposes, Huang previously said.
Huang, who has long advocated the recognition of
brain death, said an academic seminar planned for the second half of the year
will examine the concept of brain death, which is widely misunderstood by
ordinary Chinese.
"China will seek to change people's traditional views
and -- in a context of worldwide shortage of organs -- encourage a humanitarian
spirit of helping each other," Huang said in an earlier interview in March.
"The country will probably establish a range of death
criteria covering brain activity, breathing and cessation of heartbeat and allow
people to choose the criteria that seem most appropriate to them," he said.
Huang gave no more details of the legislation but
stressed that the drafters will ensure the doctors who pronounce "brain death"
are not the ones responsible for organ transplants.
Recognition of brain death is part of a package of
criterion the ministry of health is drawing up to implement the human organ
transplant regulation, Huang said.
Most of the criterion will be completed in three to
five years, he said, adding that a manual on liver transplant, the first of its
kind, will be released in this August, followed by the manual on kidney
transplant.
On Saturday, the health ministry also announced that
the first batch of more than 160 medical institutes have been granted the
licence to transplant human organs.
About 600 hospitals and clinics have applied, the
ministry said.