Australian Government Urged to Consider ‘Opt-Out’ Organ Donation

December 13, 2018 Updated: December 13, 2018

Australia’s federal government is considering steps to automatically register all Australian residents as organ donors, unless they opt-out.

The government’s Inquiry into Human Organ Trafficking and Organ Transplant Tourism proposed the measure to help reduce lengthy wait times for organ donations in order to deter patients seeking organ transplants from turning to the international organ market as a transplant tourism.

In the report entitled Compassion, Not Commerce: An Inquiry into Human Organ Trafficking and Organ Transplant Tourism (pdf), the Human Rights Sub-Committee leading the inquiry recommended the Australian government should conduct “further investigation of other countries’ donation programs, including opt-out organ donation programs to determine whether such a program could be appropriate for the Australian health system.”

If the opt-out system is adopted, residents who do not wish to be registered as organ donors would have to declare this wish to authorities.

In September 2018, there were 1,423 people on the wait list for an organ transplant in Australia. More than 70 percent of these patients were waiting for a kidney transplant.

However, the demand for organs is higher than the available supply, with wait times varying from six months to four years. One in three Australians (8 million) are registered as organ donors, according to Australia’s Organ and Tissue Authority.

Australia Urged to Ratify Convention on Organ Trafficking

The sub-committee urged the Australian government to sign and ratify the 2014 European Convention against Trafficking in Human Organs. The groundbreaking convention aims to facilitate co-operation at national and international levels on preventing organ trafficking, and signing it would ensure Australia has a zero-tolerance policy for organ trafficking crimes and the entities that facilitate these practices.

“Australia has an obligation to demonstrate leadership as a notable organ-importing jurisdiction, and now has the opportunity to do so through accession to the Convention,” the report said. “Existing Australian legislative and policy approaches could do more to address the transnational problem [of human organ trafficking].”

China Keeps Organ Trafficking Under Wraps

In the People’s Republic of China, most organ trafficking crimes are committed in a state-sanctioned system where organs are sourced from prisoners of conscience including Christians, Tibetans, Uyghurs, and Falun Dafa adherents.

According to Ethan Gutmann, investigative journalist and co-author of a 2016 investigative report on the Chinese Communist Party’s (CCP’s) organ harvesting crimes, “There is an indisputable mound of information at this point showing that Chinese transplant volumes are significantly higher than anything that Beijing has claimed.”

The CCP has tried to suppress discussion of the controversial subject and, in many countries like Australia, Chinese consulates have threatened any discussion of reports of large-scale forced organ harvesting from political prisoners would damage bilateral relations. The CCP’s official execution figures remain a state secret.

The sub-committee criticized the behavior of patients paying to travel overseas to receive a commercial organ transplant as “unethical” and “medically hazardous.”

“Transplant tourism poses clear health risks to donors, including risk of infection, diminished physical capacity, and complex psychological harm, including mental illness and emotional trauma,” the report said. “Donor participation in transplant tourism may lead to social or economic harm or exploitation, including financial hardship associated with poor health outcomes resulting from organ removal.”

Transplant Tourism Poses ‘Serious Health Risks’ to Patients

The report also said transplant tourism can pose serious health risks to the recipients of such organs, including “elevated risk of bacterial, viral and fungal infection, graft failure, and death.”

The inquiry recommended publishing information on human organ trafficking and transplant tourism on relevant Australian government websites, including the Department of Foreign Affairs and Trade’s, and country-specific pages of nations where human organ trafficking is known or suspected to occur.

It also recommended setting up a multilingual public health education program that addresses the legal, ethical, and medical risks associated with transplant tourism.

“[The proposed program] includes a stream for educating front line staff such as medical professionals about how to best identify possible cases of organ harvesting and … to educate Australians who were born in, or have family associations in, countries where human organ trafficking is known or suspected to occur,” the report said.

Physicians Support Discussing the Risks of Transplant Tourism

Medical professionals like transplant physicians are also encouraged to engage with patients on the many risks involved in traveling for major surgery, a move the Royal Australasian College of Physicians supports.

“The Royal Australasian College of Physicians supports producing guidance and educational resources for potential organ recipients, and for transplant physicians, regarding the personal health and social dangers of transplant tourism,” the report said.

Human Body Exhibit Faces Regulatory Scrutiny

The inquiry also responded to allegations that human cadavers displayed at the internationally touring Real Bodies exhibition may belong to prisoners of conscience from China. It recommended the Australian government work with state and territory governments as a “matter of priority” to ensure any human tissue imported into Australia for commercial purposes has verifiable documentation, showing consent from the donor or next-of-kin.

“The concerning circumstances raised by the allegations of the killings of prisoners of conscience in China, during the period this human tissue was sourced, illustrate the importance of that documentation,” the report said. “It is not desirable for human tissue, regardless of its source, to be brought to Australia without appropriate documentation of free, informed, and specific consent.”

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Before the year 2000, organ transplantation in China was a relatively niche medical treatment.