The System Construction Study On The Organ Donation In China

BackgroundOrgan transplantation arose from in the 1950s and it was a historic breakthrough in the field, with it saving countless lives of patients in organ failure, close to death.The earliest organ transplantation operation happened in 1960 in China, which was completed by famous Urology specialist, Jieping Wu,with cadaveric donor renal. In 1980s, organ transplant technology developed rapidly and we can complete transplantation operation of vital organs such as islet, spleen, bone marrow, testes. From 1993 to 2002, China’s transplantation operation increased by an annual of more than 1000.Meanwhile, China’s human tissue transplant, xenotransplantation research, transplantation immunology research and immune drug development all made great progress. According to National Health and Family Planning Commission (NHFPC),in recent years annual number of organ transplants in China has been more than 8,000, especially in 2013, reaching 9116, behind the United States, ranking second in the worldHowever, we still had many problems in the area of organ donation and transplantation. Firstly the system construction about organ donation and transplantation has been weak, which couldn’t achieve system guarantee for donation. Secondly due to various constraints, people were lack of organ donation will. Thirdly organ donation management department and hospitals, have been lack of mature operation mechanism, which has been hard to promote the organ donation of the general. These problems cause low organ donation rate in China, for example, we can finish about 10 thousand organ transplantation operations one year, but still about 300 thousand patients waiting for the operations. In 2010, the general organ donation rates were 0.03 per million populations (PMP). Compared with other countries, China is one of the lowest organ donation rates in the world, such as Spain 37 for PMP. Thus, through research, we would try to understand the public’s organ donation will, increase the public organ donation rate, change the existing organ donation and transplantation the mechanism, and improve the construction of legal system for organ donation.In recent years, China has made some achievements in improving organ donation rates. In May 2007, the State Council promulgated The Human Organ Transplantation Regulations, which makes China’s organ donation onto legal way. However the regulation hasn’t clear and normative rules about organ donation and distribution. In March,2013, on the basis of pilot work, the NHFPC and the Red Cross Society of China started the human organ donation nationally. In Sep 1,2019, the Human Donation Organ Acquisition and Allocation Regulation was implemented, which required the qualified organ transplant hospitals to carry out China Organ Transplant Response System (COTRS).And the acquired organ must be distributed in the system, none outside.After the fruitful work, we make progress in the field of human organ donation. In 2013, our PMP only were 0.03, which soared to 0.63 in 2013. Moreover it reached 1.2 in 2014. Until Aug 19,2015, the total donated organs were 1590 in the 2015. It would has been estimated that PMP would reach 2. In the short five years, the figure is 40 times more than 2010.To sum up, this study has the following:1. Which questions are there in the organ donation law system construction?2. Which questions are there in the organ donation procedure?3. How to increase organ donation rate with incentives.Research MethodsAccording to the research purpose, the research methods are as following: Literature research method. Through collecting and collating other countries’ regulations about organ donation, contrasting the donation regulations at home and abroad, we may know the deficiencies on donation construction, the field need to be strengthened, and the measures need to be adopted in the future. Through studying the working mechanism of OPO and organ donation coordinator, the study analyzes emphatically OPO working mechanism and organ donation procedure. And from the angle of process reengineering, we try to realize the management effective of improving organ donation mechanism, thereby increase of organ donation rates.Experts’interviews. Through the interviews with law experts who have participated in writing The Human Organ Transplantation Regulations, we know the legislative purpose and effect to be achieved of establishing organ donation and transplantation. Meanwhile, through several rounds of exchanges, the study determine the basic framework and focus areas of system construction. The experts’proposals have been brought into the paper’s theory, further improving the structure of the paper.Questionnaire. Through 632 random sampling people’survey about organ donation and awareness, we know ordinary people’aspirations and apprehensions about organ donation, also ideas about incentives.Comparative method. Based on the difference of domestic and international legal systems, we analyze how to learn from foreign system and style of organ donation, in order to promoting the development of organ donation in China. And the paper also gives corresponding legislative proposals about how to make a national organ donation law.Result1. Constructing organ donation law system with Chinese characteristicsChina is lack of the regulation about regulating donation, which result in the state of disorder of donation work. So constructing organ donation law suitable for China may safeguard the public’rights of informed consent, as well as the right to life and health rights and interests, regulate the donation law order, establish accountability mechanisms for violations of public rights and interests, and promote our donation onto legal way.2. Realization of reconstruction of the organ donation process managementFinishing the organ donation process reengineering, we may improve the donation efficiency, optimize donation program, and realize the transition focus on public interest.3. Building a series of organ donation incentive mechanism suitable for the public’ expectation.Organ donation is a kind of altruistic behavior, combined with other countries’ incentives, through the construction of protection of rights with organ donors; we can give motivation to donors in health insurance, specified organ donation, medical expenses relief, and honorary title, cleaning up donors’ concerns, raising the public’s donation rates.Conclusions and RecommendationsBy comparing states’ organ donation laws, according to China’s current conditions, especially through interviews with experts and the public about organ donation awareness and readiness questionnaire to get the understanding and awareness of this issue, we constructed the organ donation system, as well as the organ donation process suitable for China’s medical industry characteristic. In accordance with the relevant experts’ research and demonstration, we adjust and perfect the framework, in order to contribute to increased public willingness to donate organs, improve the efficiency of organ donation, and promote the development of organ donation in China.The perfect organ donation system can effectively protect the interests of organ donor, and motivate the public’wishes of organ donation. The authority in accordance with the system also effectively manages the donation and establish friendly situation into multiparty interaction.Policy suggestions on organ donation:1. According to China’s national conditions, considering the public’s awareness of organ donation and acceptance, strengthening legislation forward-looking, meeting the need of current donation, also focusing on the further development of future donations, we may set up a set of organ donation system suitable foe China’s reality.2. Determining responsibilities of the various parties in organ donation, focusing on playing the leading role of the OPO, we hope to be people-oriented in the donation process management, strengthening the construction of units, increasing the transparency of information, implementing the flat management structure, improving the efficiency of donations.Innovation and LimitationInnovation:1. Compared with other countries’ organ donation system, combined with China’s conditions and people’recognition and acceptance, the paper tries to build the donation law system suitable for China, achieving a new breakthrough in organ donation. Parts of this study were published in BMJ. Also, we compiled a new law named China Law on Organ Donations (draft), see Appendix.2. Based on SWOT theory, compared with American citizens’organ donation system, we analyze internal strengths and weaknesses, and external opportunities and challenges about donation system. This is the first application with SWOT theory in organ donation analysis.3. The time we built the relevant mechanisms of organ donation was short. As promoting our donation, there still were a lot of problem, such as too long donation procedure, not meeting the public right to know, and poor security mechanism, which strongly limited development of donation in China. So this is the first application of BPR theory in the field of organ donation, through project preparation, project implementation and project evaluation, redesigning the present donation procedure.LimitationOrgan donation for the Chinese is a whole new thing, and most people are misunderstanding on this issue. So realizing the acceptation from awareness of the public’s organ donation is a long-term process. The legal system construction, workflow management and incentive measures of organ donation are only more important sides influencing public donation. Moreover, according donation, new problems arise quickly, and the paper can’t cover anywhever. So, the new problems will be new direction next step.