Serious doubts have been raised as to whether an amendment made in 2011 to the Human Organ Transplantation Act (人體器官移植條例) requiring that a potential donor’s consent be recorded on his or her National Health Insurance (NHI) card legally justifies a hospital’s removal of a deceased patient’s organs without their family’s consent.
The Organ Procurement Association (OPA) on Saturday held a round-table discussion aiming to incorporate opinions and views expressed by all sides and to dispel doubts concerning the act.
Medical and legal experts, a Department of Health official and members of the public were present at the meeting to discuss ways to improve the law aimed at boosting the number of organ transplants.
Article 6 of the act states that doctors are not allowed to remove organs from a donor’s body if the deceased has not left their documented consent or the most immediate family members do not consent.
The former, the law states, has to be registered on the donor’s NHI card and the document be scanned and saved in the central database.
The registration of the documented consent on the NHI card has become legally binding, the association’s Web site said, which is different from the private expression of willingness seen by the previous registration system.
The amendment has given rise to various questions because some say that it seems to grant overriding power to the donor’s wishes even in the face of their family’s refusal.
An organ donation promoter said the lack of clarification on the government’s part would make the promotion and solicitation of organ donations disputable and even immoral, considering that Taiwanese are often bound by the tradition of maintaining the wholeness of their body.
Yang Hsiu-I (楊秀儀), an associate professor of health care law at National Yang-Ming University, said Article 6 has to be accompanied with further mechanisms, such as measures to make sure that the registered donor’s decision was made after careful deliberation and a discussion with their family.
Yang said that the Human Organ Transplantation Act cannot override the Medical Care Act (醫療法), which requires that hospitals seek the consent of a patient’s family before undertaking an operation.
“Organ removal operations are, without doubt, operations,” Bureau of Medical Affairs Director Hsu Ming-neng (許銘能) said.
Lee Ming-Che (李明哲), a physician at Buddhist Tzu Chi General Hospital, said that in practice it is almost impossible for doctors to remove the organs of a deceased patient without the consent of the patient’s relatives.
“However, the amended act can act as a legal basis for doctors to notify family members of the deceased donor’s wish and inquire about the potential organ donation,” Lee said.
However, the most important step should be made by the registered donor to share and discuss their wishes with family, Yang said.
“The government can also lessen the impact on the family members of the donor by allowing registered donors to leave personal messages for their relatives about organ donation on the consenting document,” he added.
“By making their family members understand and respect their wish to become an organ donor through a personal message, the donor becomes a successful promoter of donation,” Yang said.