Department of Critical Care Medicine and Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea.
Department of Medical Education, Ewha Womans University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Apr 6;35(13):e94. doi: 10.3346/jkms.2020.35.e94.
In 1999, the Organ Transplantation Act legalized organ donation from brain-dead patients. As a result of the government's continued efforts, the number of brain-dead donors steadily increased from 2002 through 2016. However, the number has declined since 2017. This paper examined the possible reasons behind the decline in brain-dead organ donation.
This investigation was an analysis of published data from the Korea Organ Donation Agency annual reports from 2013 to 2018.
The number of brain-dead organ donors in Korea rose steadily until 2016, declined in 2017 for the first time since 2002, and then dropped sharply in 2018. Although the number of brain-dead potential organ donors increased between 2017 and 2018, the number of eligible donors decreased, suggesting that patient families rejected the brain-death determination process and brain-dead organ donation. Statistics gathered during identification of brain-dead potential donors and actual donations confirm that rejection or withdrawal of consent by the family has increased. During the same period when donation from brain- dead patients decreased, five events occurred: 1) compensation for donor families was abolished; 2) an incident of mistreatment of a brain-dead donor's remains occurred; 3) the Life-Sustaining Treatment Act was enacted, providing a legal procedure whereby families of brain-dead patients could forgo life-sustaining treatment; 4) residents' work week was limited to 80 hours; and 5) the Labor Standards Law was amended.
Fewer eligible donors in spite of an increase in brain-dead potential organ donors suggests that reduction in these donations resulted mainly from factors associated with family consent. Among such factors, implementation of the Life-sustaining Treatment Act appears to be most important. Abolition of family compensation and the incident in which a brain-dead donor's remains were mistreated may also have influenced family consent.
1999 年，《器官移植法》使脑死亡患者的器官捐赠合法化。由于政府的持续努力，脑死亡供体的数量从 2002 年到 2016 年稳步增加。然而，自 2017 年以来，这一数字有所下降。本文旨在探讨脑死亡器官捐献减少的可能原因。
本研究分析了 2013 年至 2018 年韩国器官捐赠管理局年度报告中的已发表数据。
韩国脑死亡器官捐献者数量在 2016 年之前稳步上升，2017 年首次出现下降，2018 年急剧下降。尽管 2017 年至 2018 年脑死亡潜在器官捐献者数量有所增加，但符合条件的捐献者数量却有所减少，这表明患者家属拒绝了脑死亡判定过程和脑死亡器官捐献。在脑死亡潜在供体识别和实际捐献过程中收集的统计数据证实，拒绝或撤回家属同意的情况有所增加。在脑死亡患者捐献减少的同期，发生了五起事件：1）取消对捐献者家属的补偿；2）发生一起脑死亡捐献者遗体受虐待事件；3）《维持生命治疗法》颁布，为脑死亡患者家属提供了放弃维持生命治疗的法律程序；4）居民每周工作时间限制为 80 小时；5）《劳动标准法》修订。
尽管脑死亡潜在器官捐献者数量增加，但符合条件的捐献者数量减少，这表明这些捐献减少主要归因于与家属同意相关的因素。在这些因素中，《维持生命治疗法》的实施似乎最为重要。取消家属补偿和脑死亡捐献者遗体受虐待事件也可能影响了家属的同意。
