The General Assembly of the Legislative Council yesterday (5 May) debated and unanimously passed a non-binding Members' Bill on the implementation of organ transplant cooperation with the Mainland. During this period, officials and lawmakers pointed the finger at the unusual number of applicants for canceling organ donation in recent days, criticizing them for being "shameful and cold-blooded" and "anti-China and chaotic Hong Kong", stirring up contradictions between the two places. Although it is illegal and unreasonable to incite members of the public to maliciously cancel registration, it cannot be ruled out that some members of the public still have doubts about the organ donation distribution mechanism and the level of transplant medical treatment in the mainland. In addition to politicizing the "cancellation of donations", those who govern Hong Kong should also strive to explain and dispel public doubts. Hong Kong 23 interviewed Ming Wai Kit, a Hong Kong public health expert who is familiar with mainland medical care, to explain the development of organ transplantation in the mainland and put forward feasible suggestions for cross-border organ transplantation.

Policy Analysis Series on Members' Motions

Recently, there has been a controversy in the society about cross-border organ transplantation cooperation. (Visual China Image)

Politicians are sentimentally expressing
unhelpful policy lobbying

Since the successful transplantation of the Mainland heart organ in December, the Hong Kong government has actively promoted the cooperation mechanism of cross-border organ transplantation. However, the Health Bureau (CARE) revealed on Monday (12 May) that of the 5,22 applications for organ donation cancellation that had increased sharply in recent months, more than half (5785,2905) were invalid applications that had never been registered or cancelled repeatedly, and the rate of invalid cancellation in February alone was as high as 2%. Questioning attempts to disrupt the representativeness of the central roster and increase the administrative burden on the government, Chief Executive Lee Ka-chiu strongly condemned the sabotage of the system and called for police to intervene in the investigation.

Two days later (5 May), the Legislative Council General Assembly debated the non-binding motion on "Implementing Organ Transplant Co-operation with the Mainland" initiated by Lam Che-yun, a member of the medical and health sector, urging the Government to cooperate with the Mainland as soon as possible in implementing cross-boundary organ transplantation. The chamber then became a arena for officials and parliamentarians. In his opening and concluding remarks, Director of the Medical and Health Bureau, Lu Zhuomao, repeatedly criticized some people for spreading rumors and falsifying with ulterior motives, smearing the development of organ transplantation in the country, and attempting to create contradictions. Members of parliament such as Chan Kin-po in the insurance sector, Lin Xinqiang in the legal sector, Ge Peifan of the Democratic Alliance for the Betterment of the Democratic Initiative, and Lee Tsz King of the New People's Party also denounced inciting others to cancel organ donation as harmful to others and self-detrimental and shameful and cold-blooded, and even described their organized and premeditated provocation of contradictions between the two places as "anti-China and chaotic Hong Kong".

Officials and legislators have attacked in droves, seemingly treating all those who have cancelled organ donations as "anti-China and chaotic Hong Kong" elements. Although it is illegal and unreasonable to incite members of the public to maliciously cancel registration, it cannot be ruled out that some members of the public still have doubts about the organ donation distribution mechanism and the level of transplant medical treatment in the mainland. However, except for Lin Zhexuan and Lo Chong Mao, who tried to explain the organ transplant system and development in the mainland by citing scriptures, the statements of other Hong Kong rulers seem to be emotional and do not help policy lobbying. Looking through the online discussion messages, it is not difficult to find that some netizens are more concerned about the fairness, justice and legality of organ distribution, and express their distrust of the cross-border organ transplant cooperation mechanism with statements such as "donating organs to wealthy and senior officials in the Mainland" and "donating organs will be used for trading". This is obviously due to a lack of understanding of the development of organ transplantation in the mainland.

The Hon Lam Cheol-hyun initiated the non-binding motion on "Implementing Organ Transplant Co-operation with the Mainland", urging the Government to cooperate with the Mainland as soon as possible in implementing cross-boundary organ transplantation. (Profile picture)

The mechanism for continuous improvement
of regulations is quite mature

Assistant Professor Ming Wai Kit, Department of Infectious Diseases and Public Health at City University of Hong Kong, is familiar with the development of healthcare in the Mainland. In an interview with Hong Kong 01, he mentioned that the State Council promulgated the first organ transplant law, the Human Organ Transplantation Regulations, in 2007, and in the next 16 years, the relevant laws have been continuously improved, and a set of organ transplantation mechanisms with a legal basis, organization and distribution system has been formed. He explained that the "Computer System for the Chinese Allocation and Sharing of Human Organs (COTRS)", which began operation in 2011, and the "Regulations on the Administration of the Acquisition and Distribution of Human Donor Organs (Trial)" issued by the state in 2013, explained that the former ensures that organs are scientifically allocated according to the data of all donors and recipients; The latter requires provincial health administrative departments to set up a number of human organ acquisition organizations (OPOs) under the leadership of the National Health Commission, which are responsible for the donation of organs in the region, and a team of coordinators is responsible for and supervises the identification, assessment, maintenance and transport of organs. Since 2015, the mainland government has stopped obtaining organs from executed prisoners, and voluntary donations from the public are the only legal source of organ transplantation.

Layers of regulations and mechanisms ensure that organs are from legal sources and distributed fairly and justly, and no institution or individual may distribute or trade organs outside the system without authorization. Mr Ming added, "The distribution system contains detailed information on donors and recipients, and in the event of organ trafficking and unauthorized distribution, it will be handed over to relevant agencies and departments for investigation and prosecution." He described that the country's organ transplantation operation mechanism is quite mature, such as the Notice on Establishing a Green Channel for the Transport of Human Donated Organs issued in 2016, and the National Health and Family Planning Commission has established a set of green channels for organ transport with the Ministry of Public Security, the Ministry of Transport, the Civil Aviation Administration, and the Railway Corporation to assist the rapid and orderly operation of donated organs between different provinces and cities.

According to statistics from the Chinese Organ Donation Management Center, as of the end of May this year, the cumulative number of registered organ donation volunteers and entity donations in China was as high as 5.625 million and 4,5. By comparison, as of the end of April this year, Hong Kong's central organ donation register was only 4,35. Mr Ming believes that in addition to the huge number of donors in China, if Hong Kong is included in the Chinese Organ Allocation and Sharing Computer System (COTRS), Hong Kong's waiting organ patients have a greater chance of matching with suitable organs and prolonging their lives.

Lu visited Beijing in March this year and met with the vice chairman of the China Organ Transplant Foundation and other responsible persons to understand the current situation of organ transplantation development in China and explore the establishment of a permanent organ transplantation cooperation mechanism. (Information Services Department)

The inclusion of higher
numbers is three tricks to remove doubts

However, Mr Ming also understood that some members of the public had concerns about the cross-boundary organ transplant co-operation mechanism and suggested that the Government should work in three ways to dispel public concerns.

In terms of system, the co-operation mechanism implemented by the Health Bureau follows the existing registration and distribution systems of the two places, and sets up a second-tier allocation mechanism on top of this - the organs of the two places are matched locally, and cross-border organ mutual aid is initiated after it is found that there is no suitable waiting list, but some members of the public still have many concerns. Mr Ming suggested that the government could improve the transparency of organ donation, and that the current anonymity system for organ donation can indeed avoid illegal activities such as organ trading and elite trading. However, if donors or their families and recipients are allowed to meet and get to know each other five or ten years after organ transplantation, it can highlight the preciousness of human life, meet human spiritual needs, and promote organ donation."

Organ donation is always voluntary, and the donor's consent and knowledge are essential to establish a long-term cooperative mechanism. Mr Ming said, "Is it possible to add the option of donation to the donor area on the organ donation card? Are you willing to donate organs for local, national or global use? Because organ mutual aid can not only cooperate with countries, but also in the future, it is possible to carry out organ mutual aid with different countries and regions in Asia, and even join the global distribution system. For waiting patients, there is a greater possibility of transplantation. 」

In addition, the government also needs to do a good job of public education. Mr Ming believes that at present, the public's participation in organ donation is purely out of kindness, but Hong Kong has always been a Chinese society, and the traditional Chinese cultural concept of "leaving the whole corpse" is deeply rooted, and more publicity and education are needed to make the public aware of the value and significance of organ donation.

Ming Weijie believes that the government can establish a long-term cooperation mechanism based on the transparency of the mechanism, donation cards and public education, and dispel public doubts.

"North wind and sun"
who is more convincing

Hong Kong's return to the motherland is about to mark its 26th anniversary, but for various reasons, some citizens still do not know much about the country's development, or even have some misunderstandings and prejudices, so they are more likely to be incited by people with ulterior motives and fall into justice. However, instead of "pulling, locking and investigating" at every turn, and treating the public as "anti-China and destabilizing Hong Kong", should the HKSAR Government also deeply reflect on how it can enhance their understanding of the current situation of the country? And how can we truly improve the cross-border organ donation and transplantation cooperation mechanism, so that more citizens can help their compatriots, and how much more citizens in need can get help from the state?

During the debate on the motion, Election Committee member Tse Wai-chun mentioned the story of the "North Wind and the Sun" in Aesop's Fables.

At one point, the north wind and the sun were arguing about who was more capable. They happened to see a man walking by, wearing a cloak. They said who could get that person to take off that cloak, even if he was more capable. So, the north wind blew desperately. Unexpectedly, the harder he blew, the more the man wrapped himself in a cloak. In the end, North Wind had no choice but to give up. Then, when the sun came out to dry, the man immediately took off his cloak. So, North Wind had to admit defeat. The parable of the story is that instead of fully controlling the other person, it is better to let go and make the other person happy.

Tse uses this story as a metaphor for the excessive criticism of some officials and parliamentarians - relying on strong winds alone will only be counterproductive, so why not use the warmth of the sun to convince the public?