The "Healthy China 2030" Planning Outline proposes the main health indicators for 2030. "Integrating health into all decision-making" is one of the main contents of Healthy China, not only to integrate health into health policies, but also to integrate health into economic, cultural, ecological and social decision-making. Integrating health issues into these decisions naturally involves health ethics. Among them, a large number of medical ethicists take the maintenance of public health fairness and justice as their own responsibility, pay equal attention to introduction, absorption and innovation and development, devote themselves to the cause of medical ethics with Chinese characteristics, and serve the cause of "big health" and "healthy China".
At the beginning of the new year, we have the honor to talk to Professor Li about the challenges and opportunities faced by organ donation and transplantation in China in recent years. What kind of innovative measures and suggestions did the research team led by Professor Li make in this regard?
Li Enchang, editor of Xi'an Jiaotong University, practicing traditional Chinese medicine physician, distinguished professor of the Center for Health and Bioethics of Wenzhou Medical University, the first executive director of the Health Ethics Professional Committee of the Chinese Ethics Society, and a distinguished researcher of the Press and Publication Research Center of Xi'an Jiaotong University, a special researcher of the Applied Ethics Research Center of the Chinese Academy of Social Sciences, the editor-in-chief of the Yearbook of Chinese Medical Ethics and Bioethics, the executive director of the Bioethics Branch of the Chinese Society of Natural Dialectics, and the deputy director of the Medical Ethics Society of the Shaanxi Medical AssociationHe is a member of the editorial board of many journals such as Chinese Medical Ethics, Chinese Journal of Social Medicine, and Medicine and Philosophy. Deputy to the Sixth People's Congress of Shaanxi Province. He has been engaged in medical ethics, medical humanities research and editing and publishing research for a long time, presided over and participated in four provincial and national research projects, and a number of research results have been approved by the leaders of the People's Republic of China. He has published more than 130 articles in journals in China, the United Kingdom, the United States, etc., of which more than 10 articles have been included in SCI and SSCI; published more than 100 articles in the reporting category; Won 4 provincial and ministerial awards; Editor-in-chief and co-editor of more than 30 books and books; He has won more than 20 awards for outstanding editor-in-chief and outstanding editor in national universities and Shaanxi Province. He has long been interested in and researched the ethical issues related to organ donation and transplantation.
Research Interests: Health Ethics, Bioethics, Social Medicine.
Interview highlights:
Moderator:Professor Li, you are a senior expert in medical humanities and social sciences in China, who has been engaged in ethical research for many years, especially in the field of organ donation. Prof. Lee En-chang:First of all, thank you for the interview and the opportunity to present the research results of the project.
In August 2018, I won the project of "Construction of Ethical System of Human Organ Donation", which is the fourth related project I obtained after years of hard work after completing three social science projects on the theory and ethics of organ donation in provinces and cities. After review, this is also the only topic of organ donation ethics research in the national social sciences so far.
When I was studying Chinese medicine in school in the late 70s, I became interested in medical humanities and began to pay attention to medical ethics and medical ethics. In the early 80s of the last century, because of the publication of articles on medical humanities attracted the attention of the academic community, he was transferred from the primary medical unit to Xi'an Medical University to engage in medical editing, and in 1984, he and his colleagues first founded the journal "Chinese Social Medicine". In 1987, he founded the journal Chinese Medical Ethics with his colleagues, and served as the editorial director and full-time deputy editor-in-chief of the journal for 20 years. During this period, in addition to editorial work, he has systematically engaged in the research of medical humanities and social sciences such as bioethics, medical ethics and health ethics, put forward the concepts of political health, economic health, scientific health, and healthy society, published hundreds of articles, and edited more than 30 monographs. It has been more than 40 years. In recent years, the reason why I chose the challenging and relatively niche issue of human organ donation ethics as my research direction in recent years is not only because of my professional sensitivity, but also because of my sense of responsibility as an ethical person.
Human organ donation has a high degree of ethical sensitivity, and the international academic community attaches great importance to the study of organ donation ethics. China's organ donation work has its own unique national conditions, as well as a tortuous development process, which constitute the difficulties and particularities of China's organ donation ethics research. The huge contradiction between the demand and supply of organs calls for innovative development in the ethical research of organ donation. I deeply feel that I must overcome difficulties, mobilize and lead all the members of the research group, do a good job in the research plan, complete the expected research goals, and build an ethical system for organ donation. Due to the foundation of the previous three topics and the background of international and domestic research on the ethics of organ donation, this study was carried out in strict accordance with the research plan, and after several years of efforts, important results have been achieved in some fields. Relevant articles have been published in well-known international and domestic journals, and the following is a brief introduction to some of the landmark achievements of the research work.
1. The results of the questionnaire survey on the knowledge, belief and practice of organ donation among Chinese citizens
In order to do a good job in research, we invited the internationally renowned health statistics expert, Professor Wang Duo** of the Liverpool School of Tropical Diseases in the United Kingdom to give guidance, and cooperated with colleagues from Xi'an Jiaotong University, Zhengzhou University and Hangzhou Normal University to formulate a questionnaire on the knowledge, belief and practice of organ donation for Chinese citizens on the basis of repeated investigation and research, and after 5 rounds of pre-investigation a year, and interviewed more than 50 experts and relevant personnel, repeatedly revised the stereotype, and organized personnel to implement it conscientiously. The questionnaire survey and analysis of Chinese citizens' knowledge, belief and practice on organ donation mainly achieved the following two results:
To assess the level and determinants of the public's willingness to donate organs.
Method:We conducted a population-based cross-sectional study of 4261 participants in China. The primary outcome was about the willingness to donate organs. Logistic regression models are used to determine the factors that influence the willingness to donate organs.
Results:Overall, this study showed a 47 percent of participants willing to donate their organs45%。Women are more likely than men to donate organs; Participants with experience in organ donation, organ transplant patient care, and volunteering in related activities were more willing than those without these experiences.
Conclusion:The willingness of the public to donate organs in China is not high. Geography, gender, experience of organ donation-related activities, care for organ transplant patients, and volunteering for related activities were independently related to participants' willingness to donate organs. To assess the level of awareness, attitudes and willingness of the Chinese public to donate organ donation, and the conclusions, knowledge and attitudes were positively correlated with the willingness of the Chinese public to donate organ donation. Knowledge of the concept of brain death and transplant procedures may help increase the willingness to donate organs.
2. The basic concept of constructing an ethical system for organ donation
This is the core of the research on this topic. The essence of constructing an ethical system of organ donation with Chinese characteristics is to build an academic system, discipline system and discourse system of organ donation ethics with Chinese characteristics, and the establishment of iconic concepts is its core. This research puts forward the concept of "donating life", which is expected to become one of the basic views of the ethical system of organ donation with Chinese characteristics. Its core content is that the past view of life believed that human life has the unity and inseparability of the whole and the part. The emergence of organ donation technology has changed people's understanding of the relationship between the part and the whole of life, and the human body has become partially separable from the whole and indivisibility of the past, that is, the independent organs and tissues of the human body out of the body, under the protection of modern science and technology, can exist as an independent life unit for a certain period of time, providing conditions for it to enter the human body from one human body to another, so that it can be separated from the body of the body that is about to pass away, transplanted to another body, and constitute a new body of life. This kind of new life formed by donation can be called "donating life", and the concept of life formed by this should be called "donating life". The emergence of donated lives has profoundly changed the traditional way of reproduction and rescue of life. Traditional life is produced by heredity and reproduction, and human life is obtained by parental copulation.
Today, it is possible to transplant a dying life and give it a new lease of life. This kind of life rebirth and acquisition, based on the premise of organ donation of other living organisms, as a new way of life acquisition and life rebirth, changes the way of human life continuation, this reborn life belongs to the receptor from the main consciousness, but in terms of the integrity of reconstituted life, it produces a new life form of a new you have me and I have you, which is a win-win situation of altruism and self-interest, and provides a new way and method for human life salvation and life continuation, and has rich ethical and moral connotations. It also has great social value. There is no doubt that the emergence of this kind of life is based on social relations, and the society's understanding of its value is of decisive significance to whether it is recognized and supported by policies and laws, and whether it is produced. It has brought a huge impact and challenge to the traditional social and cultural concepts of mankind, and people's understanding of it has just begun, and it is necessary to strengthen its multidisciplinary and multi-field research in order to better understand it, support it, and make it orderly, standardized and harmless to others, so as to better benefit human life, health and long-term well-being.
3. Research on family factors and willingness to donate and humanistic care for donors' families
Through field research, it is found that family factors have a great impact on organ donation, and some suggestions are put forward, suggesting that family factors should be the focus of organ donation ethics research, and advocating humanistic care for organ donation families.
Fourth, the first to put forward the medical insurance card and the donation card in one, has been promoted in Wenzhou City.
At present, tens of thousands of people have achieved the integration of the two cards. The Chinese Human Organ Donation Management Center attaches great importance to and supports this, and specially holds a meeting to promote it to the whole country, and Mr. Lin Jianfeng, the main member of the research group, was interviewed by ** TV station and made a special introduction.
Fifth, cultivate talents
Through the establishment of a team, investigation and research and related publicity activities, a group of student backbones such as Huang Junting and Liu Wei have been trained, and Huang Junting has won the title of "The Most Beautiful College Student" by the Central Propaganda Department and the Ministry of Education and the "Seventh National Post Learning Lei Feng Model" by the Central Propaganda Department.
Moderator:On December 14, 2023, the "Regulations on Human Organ Donation and Transplantation" was promulgated, which clarified that organ donation and transplantation should adhere to the principle of "people first, life first", and emphasized that organ donation and transplantation, a great love and good deed in the world, is not only related to the life and health of the people, bioethics and social fairness, but also an important symbol of the development of national medicine and the progress of social civilization. In particular, the revised regulations state the importance of strengthening the ethics of donation and transplantation. With that in mind, can you share your thoughts and specific suggestions with readers based on your and your team's research? Prof. Lee En-chang:Well, the promulgation of the "Regulations on Human Organ Donation and Transplantation" has absorbed many beneficial results of academic research in recent years, summed up the mature experience in organ donation work, and marked that China's organ donation cause has entered a new stage. Of course, there is a lot of work to be done on how to implement the Regulations, but strengthening the construction of the ethical system of organ donation still plays a pivotal role. I would like to share some views on how to strengthen this work
1. Continue to promote the construction of an ethical system for human organ donation with Chinese characteristics
First of all, I would like to talk about why the construction of organ donation ethics is very important, and why it is necessary to build organ donation ethics with Chinese characteristics. Because ethics is decisive in justifying a job or a cause. If there is no ethical argument and defense, this matter will lack moral rationality, and it will be untenable in terms of morality, that is, "immorality" and "lack of morality", and naturally it will not be recognized by people's ethics and morality, and people will not support this work from the bottom of their hearts at the moral level, and it will become "water without a source" and "a seedling without roots", and it will naturally be impossible to talk about the formulation of relevant policies and laws. China's organ donation work has gone through a tortuous road, and today's organ donation situation is not easy to come by, and the country plays an important role in it. In 2013, when China's organ donation work was getting off to a difficult start, I cooperated with Professor Bai Ning of Harbin Medical University to focus on the important role of the state in organ donation from an ethical perspective, that is, to study the ethical legitimacy and importance of national advocacy, and clearly put forward that national advocacy is the key to doing a good job in organ donation. The revised "Regulations on Human Organ Donation and Transplantation" clearly states that "the state encourages deceased organ donation", which fully reflects this point. In the future, many ethical issues will still arise as the relevant work continues, and it is necessary to continue to strengthen research in this area.
2. Use socialist ethics to guide the innovative construction of the ethical system of human organ donation
Regarding the construction of the ethical system of human organ donation in Chinese, we have put forward such a basic concept as "donating life", but it is far from enough. It is also necessary to combine the practice and development of organ donation to construct a series of ethical concepts of organ donation, which are connected to each other and logically united to form a series of theoretical systems to support and promote organ donation.
The construction of China's ethical system for human organ donation should not only respect international consensus, abide by the relevant norms formulated by the World Health Organization, but also have Chinese innovation and experience, and contribute Chinese wisdom to the world. To achieve this, the guidance of socialist ethics plays a fundamental role.
We have always said that philosophical and social science theoretical research must be combined with China's national conditions. One of the major national conditions for the construction of an ethical system for organ donation with Chinese characteristics is the socialist direction of moral construction.
The "Implementation Outline for the Construction of Civic Morality in the New Era" promulgated by the Communist Party of China is a programmatic document guiding the moral construction of all walks of life in China, and the construction of an ethical system for human organ donation should not be an exception.
The "Outline" clearly points out: "Adhere to the Marxist moral outlook and socialist moral outlook, advocate communist morality, take serving the people as the core, collectivism as the principle, and love the motherland, the people, labor, science, and socialism as the basic requirements, and always maintain the socialist orientation of civic moral construction." ”
When talking about the connotation of social morality, the "Outline" points out that "promote the practice of social morality with civility and courtesy, helping others, caring for public property, protecting the environment, and abiding by laws and regulations as the main content, and encourage people to be a good citizen in society".
From here, it can be clearly seen that "serving the people as the core, collectivism as the principle" and "helping others for pleasure" are the directions and principles that should be adhered to in the ethical and moral construction of human organ donation in China. These directions and principles have opened up space for the ethical and moral construction of organ donation, and provided valuable theoretical resources and guidance. Therefore, for ethicists, it is a mission of ethicists to construct ethical concepts and theories of organ donation that conform to the principles of socialist morality on the basis of insisting on voluntary and unpaid.
Objectively speaking, organ donation and transplantation, as a new scientific and technological social existence, will inevitably grow into new social relations, and the establishment of such social relations must follow certain ethical principles, and in China, these moral principles must not only follow the principles of socialist ethical and moral construction, but also must conform to the general internationally recognized ethical and moral principles of the industry. And the formation of these must be done through theoretical innovation. For the majority of scholars engaged in applied ethics research, this is not only a challenge, but also an opportunity for theoretical innovation, and I hope that more ethicists will devote themselves to this profession.
Speaking of which, I am reminded of a poem I wrote at the end of the project, the New Year of 2024 has also arrived, and I would like to take this opportunity to dedicate it to those engaged in organ donation research and work, as well as to the general reader:
Editor-in-Charge |Zhang Shanshan Contributing Editor |Wu Yue
Edit |Meng Jun, Liu Hezhi Data** lshareforlifeFor life, convey beauty
The Chinese Human Organ Donation Management Center sincerely invites you to register as an organ donation volunteer. Here's how to register:
WeChat registration:
Follow *** Chinese human organ donation", click "Volunteer Registration" to register.
**Registration:
Log in to the official website of the Chinese Human Organ Donation Management Center** (www.).codac.org.cn) to register.
Authorized Registration:
Shi Zhi receive, Zheli Office, Jinxin Office, online State Grid.
On-site registration:
Go to your local Red Cross organ donation administration or registration station to register in writing.