Lawmakers discussed the revised Law on Donation, Removal and Transplantation of Human Tissues and Organs and Donation and Recovery of Cadavers at the first conference of full-time National Assembly deputies on the afternoon of Sept. 29.

The draft law proposes adding several circumstances in which human tissues and organs may be donated.

Under one provision, people aged 15 to under 18 would be allowed to donate regenerative tissue while alive to treat a family member when no suitable adult donor is available, provided they have received counseling and both the donor and their legal representative have given consent. Blood and blood-component donations would be excluded.

Tran Thi Hoa Ry, a National Assembly deputy from Ca Mau, said the policy should be approached cautiously because minors are a group requiring special legal protection.

Trần Thị Hoa Ry
National Assembly deputy Tran Thi Hoa Ry. Photo: National Assembly Media

She noted that while family relationships can provide the basis for an altruistic donation, they may also create psychological and emotional pressure on the donor.

For that reason, Ry argued that consent from a legal representative alone would not be sufficient. More importantly, the law must establish the donor’s independent wishes and intentions.

She proposed that the draft law clearly specify three conditions. First, the minor must give direct and voluntary consent and have the right to change their decision before tissue donation or removal takes place.

Second, donors must receive comprehensive, age-appropriate information and counseling about the benefits, risks and potential consequences.

Finally, an independent assessment and monitoring mechanism should be established to ensure that donations are not the result of coercion, pressure or conflicts of interest within the family.

“For minors, the principle must be that the donor’s interests and safety come first, even when the purpose of the donation is to save a family member,” Ry emphasized.

Addressing the same issue, Truong Ho Hai, a National Assembly deputy from An Giang, said the term “family member” was too broad and should be narrowed specifically to biological siblings.

Trương Hồ Hải
National Assembly deputy Truong Ho Hai. Photo: National Assembly Media

Hai said children under 15 could still potentially donate tissue to treat malignant blood disorders, leukemia and bone marrow failure, conditions requiring a very high degree of clinical compatibility. The highest compatibility rates are found among biological siblings, he said.

He cited the hypothetical case of a six-year-old child with acute leukemia whose only compatible donor is a 10-year-old biological sister. Collecting bone marrow, cells or other regenerative tissue would not cause permanent harm to the sister but could represent the younger child’s only chance of survival.

In such a case, Hai argued, a minimum donor age of 15 could deprive a pediatric patient of a chance to survive even when a compatible donor is available.

The lawmaker cited practices in the United States and Europe, where children may donate tissue or stem cells to biological siblings provided independent medical and psychological assessments are conducted and consent is obtained from a legal representative.

He proposed allowing children under 15 to donate regenerative tissue while alive, but only to biological siblings and with the consent of their parents or guardians. Independent psychological and medical assessments should also be required to ensure the child’s best interests, he said.

Donors’ wishes after death should be respected

Speaking later, Ly Anh Thu, a National Assembly deputy from An Giang, expressed agreement with the views of the two lawmakers.

Lý Anh Thư
National Assembly deputy Ly Anh Thu. Photo: National Assembly Media

On respecting a person’s wish to donate after death, Thu said the draft law did not clearly establish the legal validity of wishes expressed verbally.

She proposed revising the provision to state: “For a person aged 18 or older who has registered to donate body parts after death, the removal of body parts shall be carried out within the scope of the registered donation and in accordance with other conditions stipulated by law. Medical examination and treatment facilities shall be responsible for notifying, explaining and coordinating with the donor’s family.

“If the person has not registered as a donor, their wish to donate before death must be expressed in writing or recorded in a file in the presence of a witness who has no related interests. The removal of body parts must receive written consent from a family representative.”

Thu said such clear provisions would help medical personnel act promptly, respect donors’ wishes and protect families against potential disputes.

Ry also raised concerns about a provision in the draft law allowing the recovery of a cadaver when the deceased person’s last place of residence cannot be identified and a death certificate has been issued by the commune-level People’s Committee where the person died, even if that individual had not registered to donate their body.

She urged careful consideration of the provision because it directly concerns the principle of voluntary consent.

“If a person did not register to donate their body while alive and did not express consent verbally or in writing, the inability to determine their last place of residence cannot be regarded as grounds for assuming that they consented to body donation,” Ry said. “An unidentified place of residence is an administrative management issue, not an expression of a person’s intention to donate their body. Legally, these are two fundamentally different matters.”

She said the law would lack consistency if, on the one hand, it established that the donation and removal of human tissues and organs and the donation of bodies must be based on voluntary consent, while on the other hand it allowed the recovery of a body without evidence of the deceased person’s voluntary wishes.

Ry called for the legal, ethical and practical basis of the provision to be clarified.

Tran Thuong