HANOI; The Ministry of Health has clarified that a draft amendment to the Law on Human Tissue and Organ Donation, Removal and Transplantation, and Body Donation does not encourage children to become donors, but seeks to establish a legal framework that safeguards their best interests while allowing suitable cases of donation not covered by current legislation to be considered.
The draft amendment, submitted to the National Assembly (NA) for review, has attracted interest from lawmakers, experts and the general public.
In response to differing views on a proposal to allow people under 18 to register as tissue and organ donors, the ministry issued a clarification of the draft regulations on Friday.
The Department of Medical Services Administration, the agency leading the drafting process, said the draft law was guided by the overarching principle of safeguarding the best interests of children.
It aims to create more opportunities to save the lives of children with serious illnesses, particularly those requiring tissues or organs of a size or anatomical characteristics that are difficult to obtain from adult donors.
The proposed provision also respects the wishes of people under 18 and their families to donate, including their desire to donate after death so that life can continue through other patients.
The draft law distinguishes between donations by people under 18 while they are alive and donations after their death.
The two cases are different in nature.
First, while they are alive, donors under 18 would be allowed to donate regenerative tissues, such as haematopoietic stem cells, to treat family members only when no other suitable adult donor is available.
Those aged 15 to 18 would be allowed to donate to family members, while those under 15 would be permitted to donate to their biological parents and siblings.
Child donors must be in good health, receive independent counselling and obtain consent from both the child and their parent or guardian.
The draft law continues to strictly prohibit the removal of kidneys, liver, heart, lungs or any other healthy organs from living people under the age of 18.
Second, after death, the retrieval of tissues or organs may be considered only after the child has been declared brain-dead or dead following circulatory arrest by an independent expert council, has registered or expressed a wish to donate before death, and has obtained the consent of their parent or guardian.
People under 18 may register as donors with written consent from their parent or guardian. They may change or withdraw their registration at any time.
Associate Professor Dr Nguyen Lan Hieu, director of Hanoi Medical University Hospital, said he knew many children in the final stages of heart or kidney failure who were waiting for organ transplants.
Many children do not live long enough to receive a suitable organ, partly because current law does not allow people under 18 to register as organ donors after death.
Meanwhile, transplanting organs from adults into children presents significant challenges because of differences in the size of organs and blood vessels, Hieu said.
According to the doctor, young people, especially children, need information appropriate to their age, the right to express their opinions and protection from undue pressure.
However, while it is important to listen to children, their opinions should not be treated as absolute, and their age and educational background should not be overlooked.
“Listening to children does not mean burdening them with decisions that exceed their capacity; yet, protecting them does not mean stripping them of their right to speak,” Hieu said.
“Expanding the pool of organ donors to save children is essential. The humanistic value of such a policy lies not only in the number of children saved, but also in how we uphold the dignity and best interests of each individual child,” he said.
Responding to concerns about the illegal trade in human tissues and organs, including those from children, the drafting agency said the draft law explicitly prohibits the buying and selling, coercion, theft or brokering of human tissues and organs. It also forbids the exploitation of guardianship, alternative care or adoption arrangements to obtain tissues or organs from children. Those who violate these provisions may face criminal prosecution in accordance with the law.
The tissue and organ transplantation process must be co-ordinated through a national registration system and a fair waiting list.
The identities of living donors must be verified, and they must undergo evaluation by an independent advisory council.
Procedures for determining brain death or death following circulatory arrest must be conducted independently and objectively to prevent conflicts of interest and any actions that could falsify the results.
People are encouraged to notify the police or other competent authorities immediately if they encounter any signs of brokering, buying or selling human tissues or organs.
The draft law is currently undergoing further refinement based on feedback from NA deputies and the public.
The objective is to ensure the legislation is rigorous and humane, providing life-saving opportunities for patients while offering the strongest possible protection for the rights and interests of children. — VNS
