Asian and Middle Eastern countries have developed noticeably different yet generally comparable legal approaches to organ and tissue donation from minors. According to a correspondent from the Vietnam News Agency, China, Japan, India, Thailand, and Israel have special regulations aimed at preventing coercion, abuse, and the commercialization of donation. Despite varying details, all five jurisdictions prioritize protecting the donor's rights, minimizing the risk of pressure on the child, and strictly controlling the medical and legal conditions of the procedure.
China: Total Ban on Living Extractions in Persons Under 18
On May 1, 2024, the Regulations on Human Organ Donation and Transplantation came into effect in China, explicitly prohibiting organ extractions from living persons under the age of 18. Article 36 of the document establishes that extracting organs from a minor or a living person without their consent may lead to criminal prosecution. At the same time, post-mortem organ donation from a deceased minor is permitted under legal, medical, and ethical conditions, including family consent. The procedure strictly prohibits coercion during donation campaigns and any forms of financial reward.
Japan: A Combination of Individual Will and Family Consent
Japan employs a mechanism that combines an individual's personal expression of will with family consent. The Organ Transplantation Law stipulates that individuals aged 15 and older can register their desire to become a donor after death. For children under 15, post-mortem donation is also possible if the child has not left a statement of refusal and the family agrees. Since July 17, 2010, amendments allow organ extractions from children under 15 following the determination of brain death based on family consent. At the same time, the right of refusal is protected for all ages: if the deceased previously expressed a desire not to be a donor, the family cannot overturn this decision.
India: Medical Exceptions and Judicial Practice
In India, organ and tissue donation from minors is regulated by the Transplantation of Human Organs and Tissues Act (THOTA) of 1994 and subsidiary rules of 2014, which restrict such donations but allow exceptions in special cases. According to a VNA correspondent in New Delhi, the procedure requires medical indications, supporting documents, and approval from a competent authority. Courts have reviewed cases where 17-year-old adolescents donated a portion of their liver to their fathers, highlighting the need for a thorough assessment of the donor's condition, risks to them, and the feasibility of finding a suitable adult donor. Post-mortem donation is considered based on the determination of brain death and the consent of parents or guardians.
Thailand: Distinguishing Between Organs and Tissues
In Thailand, donation conditions vary depending on the type of tissue and the method. Living organ donation requires voluntary participation, full information about risks, compliance with health requirements, and the absence of any compensation. Post-mortem eye donation is regulated differently: the Thai Red Cross Eye Bank accepts donors starting from two years of age, provided there is cooperation and written family consent. This approach demonstrates that tissue donation conditions cannot be applied uniformly to organ donation.
Israel: The Adi Card and Family Court Control
In Israel, individuals aged 17 and older can register and receive an Adi organ donor card, expressing their wish to become a donor after death, in accordance with the Organ Transplantation Law of 2008. However, if a registered individual dies before turning 18, organ extraction is governed by special rules for minors. According to a VNA correspondent in Tel Aviv, living donation from a minor is reviewed by the Family Court based on the opinion of the Central Council for Organ Evaluation for Transplantation, and parental consent is not the sole basis for the procedure. Israel also strictly prohibits organ trafficking and uses monitoring mechanisms to protect children from pressure.
A comparison of the experience of the five countries shows that, despite differences in specific regulations, establishing a mechanism for organ and tissue donation among minors requires a clear distinction between living and post-mortem donation, specific age requirements, medical indications, and clearly defined powers for regulatory authorities. According to VNA correspondents, this exact combination of legal, medical, and ethical restrictions forms the basis of protecting children's rights in the field of transplantation.
