Hong Kong health care and hospitals

Peace at last for mourning parents? Hong Kong officials consider change in fetus law to allow burial of stillborns

Meetings among lawmakers, concern group and authorities centre on options to either remove regulatory roadblock or relax limitations on public cremators and burial sites

PUBLISHED : Saturday, 12 May, 2018, 10:04pm
UPDATED : Saturday, 12 May, 2018, 11:30pm

Hong Kong’s health authority is considering legislative amendments to resolve a long-standing issue that has added to the tears and heartbreak of parents dealing with a miscarriage before the 24th week of pregnancy.

Under existing laws, a fetus in this situation cannot be properly buried or cremated as it is not categorised as a stillbirth but instead as “medical waste”. Jeremy Tam Man-ho, one of the two lawmakers leading a group of parents in meetings with official departments, said government representatives for the first time promised to consider and seek legal advice on two options of reform.

“The first way involves the amendment of several ordinances, including the Births and Deaths Registration Ordinance, and others concerning food and environmental hygiene,” Tam said.

“The other way is to expand the definition of ‘human remains’ to cover ‘fetal remains’ [in the Cremation and Gardens of Remembrance Regulation].”

Nowhere to go on Ching Ming: Hong Kong parents struggle to mourn stillborn babies

A spokesman for the Food and Health Bureau confirmed it was “working in earnest” to consider “options for legislative amendments”, but did not disclose further details.

The latest meeting last week was the second in a series of sessions set up between senior officials from the bureau, the Hospital Authority, lawmakers Tam and Fernando Cheung Chiu-hung, as well as members of the Little Baby Concern Group.

Founded in May, the concern group has been calling on the government to abandon the current practice of sending unclaimed miscarried fetuses to landfills as medical waste.

The talks follow two high-profile cases in 2014 and 2017, when Prince of Wales and Princess Margaret hospitals refused to certify two babies miscarried under 24 weeks – one of them was only a day short of the mark – as stillbirths. This made it impossible for the parents to properly inter their lost babies.

On the first possible method of reform, authorities would have to overcome several regulatory roadblocks centred on the controversial definition of stillbirth.

In Hong Kong, only a fetus miscarried after the 24th week is recognised by the Hospital Authority as a stillbirth. And, only a certified stillbirth can be cremated and buried in public facilities. Burying an uncertified stillborn child could result in a fine of HK$2,000 (US$255), or six months in jail.

Hope for Hong Kong couple stuck in bureaucratic battle over attempt to bury baby lost in miscarriage

The authority said the 24-week mark was based on guidelines by the Hong Kong College of Obstetricians and Gynaecologists. College spokesman Yu Kai-man said this followed internationally recognised medical experience.

A fetus miscarried before the 24th week is classified as an abortus, which is considered “medical waste”. That means that whether the remains are claimed by the parents they must be handled by licensed facilities instead of ordinary funeral services.

At present Hong Kong’s only burial site for claimed abortuses is located in Holy Cross Catholic Cemetery in Chai Wan. Called Angel Garden, the site including some 200 places was opened last summer under a special permit from the Food and Environmental Hygiene Department.

Abortuses that are unclaimed are sent to a landfill for disposal.

The second option being considered would allow public cremators and burial sites to handle abortuses. Tam said it would be appealing because it covered fewer ordinances.

Cheung Tak-hong, chief of obstetrics and gynaecology at Prince of Wales Hospital, backed this option on a radio programme last month, saying that medical sector would not recommend changing the 24-week mark.

I hope the government can understand that it won’t cost them much and it would give parents great comfort
May Tse Mei-yee, Little Baby Concern Group

Little Baby Concern Group convenor May Tse Mei-yee supported the idea.

“It’s fine if the government chooses the second option,” she said. “What matters most is the result.”

Tse argued more burial sites were needed because the current one at the Catholic cemetery seldom served non-believers. She said the Hospital Authority should provide more support to parents in such situations.

The group also recommended that unclaimed abortuses be separated from medical waste and cremated collectively, then buried at the Wo Hop Shek Public Cemetery in Fanling.

“I hope the government can understand that it won’t cost them much and it would give parents great comfort,” Tse said.

“Undersecretary for Food and Health Chui Tak-yi mentioned humanity at the meetings and said legislative amendments were necessary. I hope he was not just paying lip service.”

A Hospital Authority spokesman said it was “reviewing the application procedures” and “planning to provide some guidance” to parents on viable options for handling abortuses legally.

Expansion of its grief team would be subject to manpower, the spokesman added.