On October 21, 2026, Health Minister Dao Hong Lan presented to the National Assembly a draft amendment to the Law on Donation, Removal and Transplantation of Human Tissues and Organs and Donation and Recovery of Cadavers.

One of the proposed changes would allow people under 18 to donate certain types of tissue while alive in exceptional circumstances, or to donate tissues and organs after brain death or circulatory death.

As part of the legislative process, the ministry's Medical Services Administration conducted an online survey from October 12 to 21. Questionnaire No. 02 was designed for children aged seven to under 18 and was distributed primarily through healthcare facilities.

Respondents included children of healthcare workers and relatives of patients.

On October 22, a representative of the administration confirmed that the questionnaire contained nine questions and that children had been given guidance before answering.

There is nothing inherently wrong with consulting children. Both the United Nations Convention on the Rights of the Child and Vietnam's Law on Children recognize their right to express views on matters affecting them.

However, the convention also requires that children's opinions be given due weight according to their age and maturity.

The age of seven is not an unfamiliar threshold in Vietnamese law. In divorce proceedings, for example, courts must consider the wishes of children aged seven and older when determining which parent they would prefer to live with.

But these are two very different situations.

A seven-year-old may know whether they want to live with their mother or father because both are familiar figures in their everyday life. Organ donation, brain death and the medical risks associated with tissue removal are far more abstract concepts, often beyond anything a child has personally experienced.

A child may understand that donating organs is a good thing because it can save another person's life. But whether that understanding extends to the medical realities is another question.

What is the difference between donating tissue and donating an organ? What are the health implications of donating tissue while still alive? Is brain death the same as being in a coma? Can someone refuse to donate?

These are difficult questions even for adults.

Research cited by the American Academy of Pediatrics (AAP) suggests that many children aged around 12 to 15 can understand and reason about medical information in ways approaching those of adults, provided the information is explained appropriately.

Even so, their decisions remain susceptible to emotional influences and pressure from family members and others around them.

Seven-year-olds can therefore participate in policy consultations, but their responses cannot reasonably be assessed in the same way as those of 17-year-olds.

What needs to be established is whether the Ministry of Health used different questions for different age groups, checked whether children understood what they were being asked, and analyzed responses separately according to age.

How questions are framed can shape children's answers

Another concern is the composition of the survey group, which consisted mainly of healthcare workers' children and patients' relatives.

These children may have been relatively easy to reach, but they cannot be assumed to represent Vietnamese children as a whole.

Children with seriously ill relatives, or those frequently exposed to hospital environments, may view organ transplantation differently from children who have never encountered the subject.

The way questions are explained and presented is equally important.

For example, if a child is asked, "Would you want to help a seriously ill family member stay alive?", many would probably say yes.

But the answer might change if the question were framed differently: "Would you agree to doctors removing some tissue from your body, requiring you to undergo a medical procedure and potentially exposing you to health risks, to save a family member?"

Both questions concern helping to save someone's life. Yet their wording creates very different impressions of what that help would involve.

That is why the number of children who agreed or disagreed is not enough. It is also necessary to know precisely what they were asked and how the issues were explained to them.

Vietnam needs more donated organs

According to the Global Observatory on Donation and Transplantation (GODT), 173,727 solid-organ transplants were performed worldwide in 2024, with approximately 70% using organs from deceased donors.

The observatory also recorded 2,372 deceased organ donors under the age of 18 across countries that submitted data.

In Vietnam, figures released by the Ministry of Health show that approximately 91.4% of organ transplants rely on living donors, while just 8.6% use organs donated after brain death.

Although the statistical methods are not entirely comparable, the figures illustrate Vietnam's continued heavy dependence on living donors.

Revising the law to expand opportunities for life-saving treatment, particularly for children with serious illnesses, is therefore an important undertaking.

But expanding organ donation also requires public trust. Any legal provisions involving children must be clearly explained to avoid misunderstandings and unnecessary anxiety.

Without access to the complete questionnaire and survey results, it would be premature to conclude that consulting children from age seven was inappropriate.

At the same time, there is not yet enough information to assess how reliable the findings may be.

The Ministry of Health should make Questionnaire No. 02 publicly available, along with the number and ages of participating children, the criteria used to select respondents and the guidance provided before they answered.

More importantly, the ministry should explain how the survey findings will inform the legislative process.

Will children's responses be analyzed separately by age group? Will the findings be considered alongside medical research and studies of child development and psychology?

It is also essential to distinguish between three separate matters: allowing children to express views on public policy, allowing them to state their wishes regarding organ donation after death, and permitting them to donate certain tissues while alive.

These are fundamentally different issues and cannot be assessed using the same criteria.

Organ donation is an act of generosity that can save many lives. Efforts to improve the legal framework supporting transplantation deserve serious consideration.

However, when children are involved, the central question is not simply whether they agree or disagree. It is whether they genuinely understand what they are being asked.

Seven-year-olds have the right to be heard. Adults, in turn, have a responsibility to ask questions appropriately, explain the issues clearly and ensure that children's answers are not interpreted as expressing more than they actually understand.

An Hai