(SCMP; September 23, 2002)
China's struggle to get to grips with Aids becomes more worrying by the day. The latest from the mainland is that hospitals are forcing patients to sign waivers stating that they will not sue for damages in the event of contracting HIV or hepatitis through tainted blood transfusions.
It would be difficult under the best of circumstances for a nation of 1.3 billion people to control the spread of such a deadly disease. But this is a nation that is reforming its economy, and its society, at a startling pace. Issues such as patients' rights in the event of tainted blood transfusions are still being dealt with on a case-by-case basis, sometimes in the courts, sometimes in the court of public opinion.
It would therefore be immature to jump to conclusions about why mainland hospitals are engaging in such a palpably unjust practice. Hong Kong had to deal with the suffering of Aids patients infected by tainted blood transfusions from public hospitals as recently as 1985. Our mainland counterparts do not have anywhere near as sophisticated a medical establishment. Blood is being tainted at mainland hospitals not because people responsible for its donation and screening are inherently sloppy; it is because the entire health-care system is in the throes of far-reaching reform. Controls and standards are more difficult to maintain.
The bigger picture is daunting. As China moves towards a market-oriented economy, hospitals are being asked to fend more for themselves financially. At the same time, new legislation has been implemented that makes it easier for patients to sue hospitals for malpractice. Faced with such a rock and a hard place, and given that their blood-screening methods are not foolproof, what are hospital administrators to do?
What they should do is forget about the waiver forms. These are obviously not going to hold up in a court of law, and all they achieve is to intimidate people into avoiding medical treatment. Instead, medical authorities need to find a common ground between the rights of patients and the realistic duties of hospitals. And until blood-screening systems really do become '100 per cent clean', hospitals must be held liable for tainted blood transfusions. Questions of compensation levels should be left for the courts to decide.
