Editorial | Hong Kong must take a sensitive approach to boost its organ donation rate

At present, Hong Kong has an opt-in policy, under which residents sign up to indicate that they wish to become organ donors after death. Even then, it does not necessarily mean that their wishes will be followed if doctors face resistance from the family of the deceased.

This reflects cultural sensitivities about keeping the body of a loved one intact. The result is one of the lowest organ donation rates among developed economies. Director of Health Ronald Lam Man-kin has suggested restarting the debate on switching to a mechanism under which everyone would be assumed to be a donor unless they opted out. But this has prompted warnings of a political backlash. A 2017 Census and Statistics Department survey showed that only 34 per cent supported an opt-out policy and that they may not easily understand such a system. By August, more than 400,000 out of 7.5 million residents had registered as organ donors. But only around 30 deceased organ donors were recorded last year, about four per million population, compared with 52.6 in Spain in 2024.

Lawmaker Rebecca Chan Hoi-yan, political assistant to former health minister Ko Wing-man, has called for more efforts to persuade people to opt in as donors. Organ donation came into focus when patients made urgent pleas, but the government needs to make it a regular part of public education. Dr Chau Ka-foon, honorary president of the Hong Kong Transplant Sports Association, said, “It is essential to change people’s mindsets before we consider an opt-out mechanism”. The city needs a more effective organ donation rate, it must uphold respect for cultural sensitivities surrounding death, and it should embark on a sustained public education campaign about the social benefits of voluntary organ donation.