Čína: Ďalšie škandály napriek reformám transplantácie orgánov | Medicínske právo
              

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Čína: Ďalšie škandály napriek reformám transplantácie orgánov


 | 30.9.2013 | komentárov: 346

Čína zavádza nový národný systém darovania orgánov a transplantácií. Lekárska agentúra tvrdí, že reformami sa realizujú politické zmeny, ale nedávne škandály a nedostatok transparentnosti podnietilo otázky verejnosti – či avizované zmeny budú v konečnom dôsledku úspešné.

Obrazok Red Cross Society of China (Čínsky Červený kríž)  bol poverený ministrom zdravotníctva, aby riadil chod systému darovania orgánov. Má pozíciu dozorcu nad všetkými procesmi spojenými s darcovstvom orgánov, ich sprostredkovaním a alokácie v systéme v súlade s platnou legislatívou. Čínsky Červený kríž sa však opäť dostal do problémov, keď bolo v júli tohto roka zverejnené, že niektoré jeho sekcie si pýtali od nemocníc vykonávajúcich transplantáciu orgánov sumu 100,000 RMB (16,300 $) za každú úspešnú donáciu orgánu organizovanú prostredníctvom nich. V auguste denník People's Daily oznámil, že koordinátor, ktorý pracoval pre pobočku Červeného kríža v Shannxi hrozil rodine kriticky zraneného pacienta, že mu odoberie prístroje podporujúce dýchanie, ak budú naďalej odmietať darcovstvo jeho orgánov v prípade smrti na následky zlyhania srdca. Koordinátor, Liu Linjuan, povedal rodine, že za predpokladu, že budú ochotní darovať orgány "môžeme vám dať 100,000 RMB. Nie viac."

Odkedy sú v Číne možné  transplantácie orgánov, drvivá väčšina orgánov určených na transplantáciu bola odobraná odsúdeným väzňom, často bez ich súhlasu. Čínska vláda prisľúbila postupne eliminovať takéto neetické a politicky nekorektné praktiky do augusta roku 2015. Pilotný program týkajúci sa darovania orgánov bol spustený pred troma rokmi. Zatiaľ tento rok (podľa oficiálnych štatistík), podiel transplantovaných orgánov odobratých odsúdeným klesol pod 54 % a darovanie orgánov z tiel mŕtvych darcov v celkovej populácii vzrástol na 23 %. V súčasnosti je pravdepodobné, že vláda bude robiť ďalšie kroky k naplneniu vyššie avizovaného cieľa.

1. septembra vstúpila do platnosti „The Provisions on Human Organ Procurement and Allocation.“ Podľa novelizovanej právnej úpravy, musí byť každý darovaný orgán zaznamenaný v systéme „the China Organ Transplant Response System“, skrátene COTRS. Nemocniciam, ktoré tak neučinia, budú odobrané transplantačné licencie. COTRS, vytvorený podľa vzoru USA, je počítačový systém ktorý rozdeľuje orgány do katetogórií na základe urgencie a času strávenom na čakacej listine. Teoreticky vzaté, nemocnice a lekári by už nemali mať vplyv na rozhodovaní – kto bude príjemcom konkrétneho darovaného orgánu. Podľa Huang Jiefu, vedúceho „transplant office at the National Health and Family Planning Commission“, systém je navrhnutý tak, aby rozdeľoval orgány donorov spravodlivo a transparentne. Medzitým, Čínsky Červený kríž a organizácie pre zásobovanie orgánov v každom zo 165-tich akreditovaných transplantačných nemocníc, boli  poverené propagáciou darcovstva orgánov, hľadaním potenciálnych darcov a koordinovaním procesu darcovstva, ak by sa našiel potenciálny darca.
Huang tvrdí, že unikátne navrhnutý systém zabezpečuje vierohodnosť, že program darcovstva bude široko a akceptovaný čínskou spoločnosťou. Zatiaľ čo v súčasnosti je iba jedna tretina darovaných orgánov prerozdeľovaná prostredníctvom tohto systému, Huang verí, že systém bude úplne implementovaný do roku 2014. No ak bude COTRS pokračovať v trende škandálov a očividných nedostatkov, bude to prakticky ťažšie realizovateľné.

Svetová zdravotnícka organizácia (the World Health Organization) a Transplantačné združenie (the Transplant Society) schvaľuje úsilie čínskej vlády zdokonaliť systém darovania orgánov; avšak v systéme by mali byť minimalizované nejasnosti, aby sa zaručilo, že orgány budú spravodlivo prerozdelené a aby získala dôveru verejnosti. Predchádzanie škandálom je taktiež kľúčom k ochrane a udržianiu systému, ktorý závisí od ochoty účastníkov spolupracovať.

Spracoval: Mgr. Lukáš DERCO
Foto: freedigitalphoto.net

Použité zdroje
1) http://www.theatlantic.com/china/archive/2013/09/will-chinas-organ-transplant-reforms-really-work/279567/
2) http://www.who.int/bulletin/volumes/90/11/12-031112/en/




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