The “Chinese Mode” of organ donation and transplantation
In 2007, the State Council promulgated the Regulations on Human Organ Transplantation, the first law of organ transplantation in China. This law has led China’s organ transplantation onto the trajectory of law-based regulation, signifying the beginning of China’s organ transplantation reform. China’s organ transplantation has accomplished remarkable achievements through the arduous reform over the past ten years. Being adhered to WHO’s guiding principles on human organ transplantation and based on Chinese cultural tradition and the socio-economic conditions, we have created a scientific and ethical system of national organ donation and transplantation. This system, promoting sound development of organ transplantation, with the social responses and admiration both domestically and abroad, is called “Chinese Mode” by WHO.
The “Chinese Mode” has six features
A nationwide system
China’s organ transplantation reform is in-depth in cultural, legal and medical perspectives under the guidance of the Party Central Committee and the State Council, with the participation of National Health and Family Planning Commission, the Red Cross Society of China and other government departments. For instance, at the end of 2013, the General Offices of the Central Committee of the Communist Party of China and the State Council jointly issued the Instructions on Party Cadres’ Leading Role in Promoting Funeral and Interment Reform. It encouraged party cadres to take the lead in donating organs and bodies after death. In the light of the purport of “Rule by Law” on the Fourth Plenary Session of the Eighteenth CPC Central Committee, on December 3, 2014, the Government announced that from January 1, 2015, China would stop obtaining organs from executed prisoners and ensure the voluntary donation from the citizens is the sole legal source of human organs, to realize a successful transition of the transplantable organ sources in China; Mainstream media guided by the Publicity Department of the Central Committee of the CPC widely reported and popularized organ donations, profoundly impressed the public by the stories of “Gifts of Life” and transformed social traditions at the same time; Meanwhile, National Health and Family Planning Commission, the Ministry of Public Security, the Ministry of Transport, Civil Aviation Administration of China, China Railway Corporation and the Red Cross Society of China constructed a green channel for human organs transport; Ministry of Public Security is responsible for cracking down on the criminal acts of organ trafficking.
Legal framework
The Regulations on Human Organ Transplantation was issued in 2007, Amendment (VIII) to the Criminal Law of the People’s Republic of China was issued by the Supreme People’s Court in 2011 criminalizing trafficking of human organs, and Interim Provisions on Human Organ Procurement and Allocation was issued by National Health and Family Planning Commission in 2013. The above are all the strenuous effort to regulate the organ transplantation. Furthermore, when the policy of donation after citizen’s death (DCD) was initiated in 2010, more than thirty supportive documents were issued by the Red Cross Society of China and National Health and Family Planning Commission and the new version of Law of the People’s Republic of China on the Red Cross Society was implemented in May, 2017.
Regulatory authorities
Organ transplantation and donation are administrated by National Health and Family Planning Commission with the Red Cross Society of China as the third party. They established National Organ Donation and Transplantation Committee which consists of five administration branches: organ donation, organ procurement and distribution, the medical system for organ transplantation, organ registration after transplantation and organ transplantation supervision. These five branches are composed of health and family planning administrative departments of all levels, Red Cross offices of all levels, China Transplantation Development Foundation, Chinese Hospital Association, Chinese Medical Association and Chinese Medical Doctor Association as well as medical institutions of organ donation; China Organ Donation Administrative Center and organ donation coordinators, China Organ Transplant Response System (COTRS), and Organ Procurement Organization (OPO) are the key components of this system.
Criteria for human organ donation
According to the world criteria for defining “DBD” and “DCD”, China has developed its own 3-class criteria for human organ donation after death (donation after brain death, DBD - China’s Class I criteria; donation after cardiac death, DCD—China’s Class II criteria; donation after brain and cardiac death, DBCD—China’s Class III criteria). Moreover, some thoughtful donation procedures designed with the element of Chinese tradition culture are widely accepted by the donor. Thus, the standard of technical support and the quality of deceased donor organs can be maintained. As for the living organ donation, donation among relatives is strictly and cautiously performed.
Humanitarian assistance policy
China’s organ donation policies stick to the principle of safeguarding people’s rights and interests, and of voluntary and free of payment donation. The policies are based on China’s social security, with an aim to highlight the warmth and love of a socialist family. Although the social economy varies from place to place in China, the cost of rescue and medical care for donors are reduced or free of charge normally. At the same time, the families of donors as well as disadvantage recipients are provided with humanitarian assistance. Donor’s families are given honors and awards to witness the renewal of donor’s life. Meanwhile, great efforts have been made to gradually incorporate the medical services of organ transplantation into the national basic medical insurance.
Humanistic spirit
Organ transplantation is a life-saving medical service, reflecting the civilization and progress of the whole society. Organ donation carries forward the compassion, mutual assistance, love and other virtues. After the relevant policies and guidelines are formulated with the spirits of “trust” and “anti-evil”, organ transplantation becomes an open, just and transparent social medical service with mutual social dependence, embodying the socialist core values and promoting the traditional virtues of China in organ donation.
Through the “China—International Organ Donation Conference” held in October, 2016 in the Golden Hall, Great Hall of the People, Beijing and the Summit on Organ Trafficking and Transplant Tourism sponsored by the Pontifical Academy of Sciences of Vatican in February, 2017, China has demonstrated the eye-catching “Chinese Mode” to the world and it has entered the global arena of organ transplant and participated in codifying the world transplant development summit statement. China will be dedicated to providing a high-quality transplantation service for the people and making a due contribution to the development of world organ transplant as a political power.
Acknowledgements
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