Organ transplant technology in Taiwan has been mature and of an international standard for some time.
However, because the number of organ donations is well below demand, those who need organ transplants have not enjoyed these technological advances.
To address this long-standing problem, Department of Health Minister Yaung Chih-liang (楊志良) recently suggested that organ donation legislation be amended so that unless people explicitly state that they do not want to donate organs, their consent will be assumed.
In general, Taiwanese still consider the concept of a complete corpse at death as important. If the absence of explicit rejection of organ donation is rendered equivalent to donor consent, it would amount to stealing.
It would also be difficult to pass such a law. In practice, utter confusion would ensue if large numbers of Taiwanese were to rush to sign a statement denying access to their organs. So there are better methods that we can apply.
We could start by teaching children that it is admirable to save a life through organ donation, thus offering an alternative to the view that completeness of a corpse is important.
We could also employ a method similar to that used at accredited hospitals in advanced cardiac life support, making it a requirement that a proportion of doctors in each department have training in brain death verification, a skill that neurologists acquire as part of their specialist training.
Amending the Organ Transplant Act (人體器官移植條例) is the most practical option.
To prevent the disadvantaged from privately selling their organs, Article 12 of the Act states that donors should not receive compensation for donating organs.
The intentions of this article are honorable, but the effect is to limit the number of organs available for transplant.
FUNERAL COSTS
Thus, to encourage people to donate organs, Article 10.1 states that the central health authority shall pay funeral costs for the families of the deceased who donate organs and that the benchmarks for this should be decided by the health authorities.
Article 15 then states that the family of the deceased who donated an organ should be publicly recognized by the applicable special municipality, city or county government and that poorer families should receive funeral subsidies.
Obviously, when these laws were made, legislators wanted to have some way of offering reparations to the families of organ donors. They therefore decided to name these payments “funeral costs” to rationalize the reality that a family would get paid for the organs of the deceased.
Central, city and county governments issue these funds, but it is not mandatory for them to do so.
At present, the maximum amount that the central government can issue is NT$100,000, regardless of the number of organs donated.
At the local government level there are no such measures, save for a partial waiver for funeral fees in Taipei City. In other words, the subsidies that ought to be offered by city and county governments exist only in name.
Talking about subsidies seems to negate the goodwill that donating organs entails. However, we must remember that most of those who meet the criteria for organ donation are relatively healthy and young. They are therefore less likely to have substantial assets to pass on, and their sudden demise can a have a big financial impact on their families.
If we place ourselves in their position, maybe the knowledge that their organs may help other human beings could bring them happiness as they prepare to leave this world.
Still, they would be very worried about their family in their absence. Under such circumstances, can we claim that it is inappropriate and even greedy to use organs to provide financial support to those left behind?
In addition, patients who cannot wait for organ transplants in Taiwan may be forced to go to China, where human rights are violated and medical standards are lower. Such patients are willing to spend NT$1 million to NT$1.3 million for organs of unknown source and quality, with less-than-ideal follow-up treatment and the risk of ongoing disputes.
This shows that patients are primarily concerned with their health, quality of living and their lives as opposed to money, of which many of these patients have enough to spend.
USER PAYS
Therefore, the minuscule subsidies in the Organ Transplant Act do not only fail to improve the long-standing problem of a lack of organs, they also run counter to the universal principle of user pays.
Taiwan’s organ donors and their relatives, patients who need transplants, the medical community, the Bureau of National Health Insurance and the government will always lose out under this regime.
To increase practical benefits for organ donors and those waiting for organ transplants and to increase the number of sources for organs, Article 12 of the Act, which states that donors should not receive remuneration, needs to be reassessed.
Kao Ko-pei is vice superintendent at Chutung Veterans Hospital.
TRANSLATED BY DREW CAMERON
The return of US president-elect Donald Trump to the White House has injected a new wave of anxiety across the Taiwan Strait. For Taiwan, an island whose very survival depends on the delicate and strategic support from the US, Trump’s election victory raises a cascade of questions and fears about what lies ahead. His approach to international relations — grounded in transactional and unpredictable policies — poses unique risks to Taiwan’s stability, economic prosperity and geopolitical standing. Trump’s first term left a complicated legacy in the region. On the one hand, his administration ramped up arms sales to Taiwan and sanctioned
The US election result will significantly impact its foreign policy with global implications. As tensions escalate in the Taiwan Strait and conflicts elsewhere draw attention away from the western Pacific, Taiwan was closely monitoring the election, as many believe that whoever won would confront an increasingly assertive China, especially with speculation over a potential escalation in or around 2027. A second Donald Trump presidency naturally raises questions concerning the future of US policy toward China and Taiwan, with Trump displaying mixed signals as to his position on the cross-strait conflict. US foreign policy would also depend on Trump’s Cabinet and
The Taiwanese have proven to be resilient in the face of disasters and they have resisted continuing attempts to subordinate Taiwan to the People’s Republic of China (PRC). Nonetheless, the Taiwanese can and should do more to become even more resilient and to be better prepared for resistance should the Chinese Communist Party (CCP) try to annex Taiwan. President William Lai (賴清德) argues that the Taiwanese should determine their own fate. This position continues the Democratic Progressive Party’s (DPP) tradition of opposing the CCP’s annexation of Taiwan. Lai challenges the CCP’s narrative by stating that Taiwan is not subordinate to the
Republican candidate and former US president Donald Trump is to be the 47th president of the US after beating his Democratic rival, US Vice President Kamala Harris, in the election on Tuesday. Trump’s thumping victory — winning 295 Electoral College votes against Harris’ 226 as of press time last night, along with the Republicans winning control of the US Senate and possibly the House of Representatives — is a remarkable political comeback from his 2020 defeat to US President Joe Biden, and means Trump has a strong political mandate to implement his agenda. What does Trump’s victory mean for Taiwan, Asia, deterrence