An Overview on Attitudes Towards Organ Donation in Hong Kong

Despite rising patient needs, transplant activities in Hong Kong have been limited by the lack of cadaveric donors. While the number of patients waiting for renal transplant rose by 250% from 1994 to 2004, the number of cadaveric kidney donations has remained the same (44 donations in 1994 and 2004). In the past, the view of a traditional Chinese culture on the preservation of an intact body was an important reason limiting organ donation. In recent years, the public has become more open towards organ donation. This paper describes and reviews the changes in public attitudes on organ donation over the past decade in Hong Kong, as well as the current status. A review of published surveys on public attitudes was conducted. Reasons given by relatives, during bedside interviews by transplant coordinators, for refusing or consenting to donate organs are recorded in the Renal Registry of the Hong Kong Hospital Authority (Renal Registry). The interview data for 1996-2004 were also analyzed. Willingness to donate organs ranged from 28.5% to 60.3%. From data recorded in the Renal Registry, preservation of the intact body accounted for 49% of the refusals in 1996, and 33% in 2004. In contrast, unwillingness to decide because the deceased had not expressed his/her wish to donate during life (2% in 1996; 15% in 2004) and lack of consensus within the family (2% in 1996; 26% in 2004) emerged as important reasons for why relatives refused to donate in recent years. From the bedside experience of transplant coordinators, traditional beliefs regarding the preservation of an intact body have gradually been changing. Relatives not knowing the wish of their loved ones and a lack of consensus amongst family members have emerged as important reasons for refusing to donate organs. Hong Kong needs to consider innovative ways to encourage and allow individuals to express their wish as to whether or not they would like to be organ donors, for example, by storing such data on the new Hong Kong identity cards.