[VIEWPOINT]Give the gift of life to others“Your job is very noble, but it must be very tough” is the first thing most people say when they see my business card. When I started the country’s first organ donation drive in January 1991, the Confucian idea of treating body parts as given by the parents pervaded the nation, and even medical and religious personnel said it would take at least 10 years for the movement to take root.
When the survivors of a brain dead patient agreed to donate all usable organs in June 1992, for the first time in Korea, no hospital was equipped for the job. All of the organs could have been donated, but only the kidney and the cornea were transplanted. The case, however, was instrumental in changing Koreans’ views on organ donation. The number of donors continued to increase, and in 1999, there were 162 organ donors. In 1992, six people donated their bodies through the Korean Organ and Tissue Donor Program, and the number grew to 130 in 2001.
Until the law on organ transplants went into effect in February 2000, brain death was not recognized as legal death. Despite the donors’ noble intentions, an organ transplant was an illegal procedure done by some brave doctors.
But even the law was too strict regarding the control and supervision of organ donations and transplants, unlike foreign precedents, and so the number of patients who agreed to donate organs in case of brain death fell to 36 in 2002.
Many patients with failing organs have decided that the chance of getting a transplant is very slim in Korea no matter how long they wait, and so they are traveling to China to get the organs they need. According to a knowledgeable source, four to five patients register at the airport every week to travel abroad to get organ transplants. However, generally only liver-transplant candidates register. If those who go abroad for kidney transplants are taken into account, the total would be considerably larger.
The government revised the law so that donated corneas are transplanted at the hospital where the cornea was received, and hospitals are given priority to transplant one kidney from brain dead organ donors they find. Thanks to these incentives, the number of donors began to increase again, but it is still not enough to boost the organ donation movement.
The legislation certainly has had positive effects. Before the law was enforced, each brain dead patient gave organs to 2.6 people on average, but after the legislation, each donor gave organs to 4.6 other patients. By maximizing the positive effects and correcting the shortcomings, the government needs to encourage more organ donations and transplants.
The most urgent task is to establish a system where people can easily access organ donation information and get registered as a donor. Thanks to the cornea donation drive by a television network, more than 20,000 people have agreed to donate their corneas as of the end of April. The number far exceeds last year’s 8,500 newly registered donors.
People’s perceptions of organ donations should be changed through constant public ad campaigns, and the government should introduce a system that allows people to indicate they are organ donors on their identification cards.
Secondly, the procedure of deciding brain death needs to be modified. It makes no sense that the Brain Death Decision Committee made up of non-specialists makes a decision when it requires medical expertise. Instead, it would be more appropriate to follow the foreign system, where at least two neurologists or neurosurgeons who are not involved in organ transplants determine whether brain death has occurred, and then the committee can review the decision posthumously according to the law.
Thirdly, the system itself needs to change. As the rate of organ donations has increased, a central agency needs to take charge of distributing organs, moderating between organizations and keeping statistics, while hospitals perform operations and manage organ donors and receivers. Non-profit groups should focus on public relations and finding brain dead patients. These civic groups should be designated as independent organ procurement organizations and increase their efforts to get people to sign up as organ donors.
By operating a brain dead patient registration system or educating trustworthy medical personnel to consult with the patients and survivors on organ donation just like they do in some developed countries, we can increase the rate of organ donation even more.
Lately, Koreans have been focusing on living well. But we need to get ready for dying well, too. Organ donation can turn death into life and make the end of our lives beautiful.
* The writer is the secretary general of the Korean Organ & Tissue Donor Program. Translation by the JoongAng Daily staff.
by Choi Seung-joo
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