Confucian beliefs hindering organ donation in China

Government and international health agencies are facing a unique problem in securing organs for transplantation in China. The reason: the ancient Confucian system of philosophy still followed in the country.

According to a report in Bloomberg, between 6,000 and 9,000 transplants are being conducted in China each year, a fraction of the roughly 300,000 needed, according to government data.

This is because many Chinese believe that an intact body is needed in the afterlife, and medical workers and volunteers seeking donors usually face a protracted battle with extended families. “The body, hair and skin are received from the parents and one dares not harm them,” says one Confucian teaching.

The report quotes Gao Xinpu, deputy director of the medical affairs department at the China Organ Donation Management Center, which helps train coordinators and operates under the Red Cross Society of China. Xinpu says that in China, prior consent by the donor doesn’t constitute legal permission. In practice, the system requires written consent from all living members of the immediate family, including parents, adult children and spouses.

Xinpu also says that only 1.2 out of every million Chinese became organ donors last year. The comparable number in the US is over 20.

The Chinese government launched a nationwide organ donation system as recently as February 2013, before which organs were donated through local programmes or arranged case by case. In 2014, about 1,700 people contributed organs through the programme.

But as the Bloomberg report notes, the rising incidence of chronic diseases such as liver cancer in China along with a government drive to end a controversial practice of using executed prisoners’ organs means that this number is too small to fulfill the required number of transplants.