When the State Controls the Body: Organ Donation, Human Rights, and the Price of Trust in Việt Nam

An examination of medical ethics, human rights, and government accountability.

Organ and tissue donation is among the most profound acts of human generosity. It can offer a second chance at life to people facing life-threatening illnesses, and medical advances have made it possible to save countless lives through the voluntary donation of human tissues and organs.

But when a government establishes laws governing the donation, removal, and transplantation of parts of the human body, the discussion cannot end with the humanitarian purpose of saving lives. We must also ask: Who has the authority to make these decisions? Who supervises that authority? Who protects the donor? And, most importantly, who is held accountable when that power is abused?

A law is not inherently humane simply because it is introduced in the name of humanity. Its legitimacy depends on whether it protects the rights, dignity, and safety of every individual through transparent, independent, and enforceable safeguards.

These questions deserve serious attention as Việt Nam considers amendments to its law governing the donation, removal, and transplantation of human tissues and organs.

What Is Việt Nam Proposing?

Việt Nam is moving to revise its 2006 Law on Donation, Removal, and Transplantation of Human Tissues and Organs, which took effect in 2007. Among the most debated provisions are proposed changes that would allow individuals under the age of 18 to donate tissue.

According to explanations released by Việt Nam’s Ministry of Health in October 2026, the draft would permit minors who are still living to donate certain regenerative tissues, such as hematopoietic stem cells, under narrowly defined circumstances.

Under the proposal, individuals aged 15 to under 18 could donate regenerative tissue to family members when no suitable adult donor is available. Children under 15 could donate only to their parents or biological siblings, subject to the same condition.

The Ministry of Health has also emphasized that the draft does not permit the removal of healthy organs, including kidneys, livers, hearts, or lungs, from living minors. The proposed safeguards include medical eligibility requirements, independent counseling, and consent from both the child and the parent or legal guardian.

These distinctions matter. The proposed donation of regenerative tissue by a living minor is not the same as the removal of a major organ. Nor should living donation be confused with donation after death, which involves a different set of medical and legal considerations.

The ministry’s explanations deserve to be represented accurately. Nevertheless, the existence of safeguards in a draft law does not, by itself, establish that those safeguards will be effective in practice.

The central question is not only what the law permits today, but also who will interpret, enforce, supervise, and potentially revise those limits in the future.

Another issue drawing public attention is the proposal to seek the views of children between the ages of 7 and under 18 on organ and tissue donation.

There is nothing inherently wrong with asking children for their opinions. Children have the right to express their views on matters that affect them, provided the process is appropriate to their age and level of maturity.

However, when the subject involves their bodies, health, and personal autonomy, the method of consultation must be examined carefully.

Why was the age of seven selected? How were the questions written? Were they explained in neutral, age-appropriate language? Were children given enough information to understand what donation involves? Was participation entirely voluntary? What role did parents or legal guardians play? What measures were in place to prevent pressure from adults, schools, or other authority figures?

Perhaps most importantly, how will the results be used in the legislative process?

A child expressing an opinion is not the same as a child providing informed consent to a medical procedure involving their body. These are fundamentally different matters and must never be treated as interchangeable.

At a press briefing on Oct. 27, 2026, the Ministry of Health addressed public concerns surrounding the proposed amendments. The World Health Organization (WHO) also emphasized that donation involving minors should be considered only under exceptional circumstances and with strict protections.

WHO stressed the importance of age-appropriate information, independent counseling and assessment, and a child’s right to refuse or withdraw consent. It also emphasized the need to protect minors from family pressure, coercion, and exploitation.

On Oct. 28, WHO described the draft as broadly consistent with its principles and international experience while recommending further improvements to ensure that children’s consent is genuinely voluntary and informed.

That assessment deserves to be acknowledged. But alignment with international principles on paper does not automatically eliminate the risks associated with implementation. The final law, its accompanying regulations, and the actual operation of its safeguards must still be examined.

The Issue is Not Organ Donation. It Is Public Trust

Public concern about the proposed amendments should not be mistaken for opposition to organ donation itself.

Donating tissue or an organ to save another person’s life is a deeply admirable act. But the nobility of that purpose cannot replace the legal protections owed to the donor.

At the heart of this debate is a broader question: How much confidence can the public place in the institutions responsible for making decisions involving the human body and human life?

According to Freedom House’s “Freedom in the World 2026” report, Việt Nam remains a one-party state with significant restrictions on freedom of expression, the press, and civil society. The report also raises concerns about judicial independence.

In an environment where independent journalism, civil society oversight, and judicial accountability face significant limitations, the ability to scrutinize government decisions becomes especially important.

If misconduct occurs during the donation or transplantation process, can citizens demand a genuinely independent investigation? Can those responsible be held accountable without political interference? Can donor families obtain relevant medical records and information about the procedures performed? Will independent experts be permitted to examine the evidence and reach conclusions without pressure?

These are not abstract questions. They become especially serious when the individuals involved are children, patients, people experiencing financial hardship, or others who may be vulnerable to pressure from family members or society.

The World Health Organization’s “Guiding Principles on Human Cell, Tissue, and Organ Transplantation,” endorsed by the World Health Assembly in 2010, provides an important international ethical framework.

Principle 4 establishes a general prohibition on removing cells, tissues, or organs from living minors while recognizing narrowly defined exceptions that are permitted under national law. Principle 11 emphasizes transparency and accountability in transplantation systems while requiring the protection of donor and recipient privacy.

Independent oversight is therefore not an obstacle to medical progress. It is an essential part of ethical medicine.

People should not have to wait until someone becomes a victim before they are allowed to question the accountability of those in power.

International Warnings Cannot Be Ignored

Concerns about the potential abuse of organ donation and transplantation cannot be discussed without acknowledging serious allegations and investigations involving other countries.

In China, the China Tribunal, an independent tribunal chaired by British barrister Geoffrey Nice, published its full judgment in March 2020. The tribunal concluded that forced organ harvesting had taken place in China for years on a significant scale and identified Falun Gong practitioners as one of the principal sources of organs.

It is important to be precise about the nature of this finding: the China Tribunal was an independent investigative tribunal, not an international court with compulsory jurisdiction. Its conclusions should be described accordingly.

On June 14, 2021, United Nations human rights experts publicly expressed alarm over credible information they had received concerning allegations of forced organ harvesting from detained members of minority groups in China. The groups identified included Falun Gong practitioners, Uyghurs, Tibetans, Muslims, and Christians.

The experts called for investigations and independent monitoring. Their statement was a serious warning about allegations requiring investigation, not a judicial ruling that independently established each one.

These cases demonstrate why transparency, independent investigation, and international scrutiny matter whenever human organs and vulnerable populations are involved.

There is also a wider regional concern involving human trafficking and organized criminal networks.

On June 30, 2025, INTERPOL reported that, as of March 2025, traffickers had exploited victims from 66 countries in online scam centers. According to the organization’s analysis, 74% of the victims covered by the data had been taken to centers in Southeast Asia.

These findings illustrate how cross-border criminal networks can exploit vulnerable people. However, it is important to maintain a distinction: evidence of human trafficking for online scam operations does not constitute evidence of forced organ harvesting. These are separate crimes and must be investigated using separate evidence.

Likewise, the material discussed in this article does not establish that the government of Việt Nam operates a forced organ-harvesting program comparable to the practices that the China Tribunal concluded occurred in China.

It would be irresponsible to accuse one country of crimes simply because similar concerns have been documented elsewhere. But it would be equally irresponsible to dismiss the need for safeguards merely because we have yet to establish a comparable abuse.

The principle is straightforward: We cannot use wrongdoing in one country as proof of guilt in another. But neither should the absence of confirmed wrongdoing become an excuse to reject preventive oversight.

Every country developing an organ transplantation system has a responsibility to prevent coercion, exploitation, and abuse before they occur.

Why International Oversight Matters Now

The World Health Organization’s involvement in discussions about Việt Nam’s proposed amendments is an important development. Its public statements recognize the humanitarian potential of transplantation while emphasizing that the interests and protection of donors, particularly children, must remain paramount.

However, international endorsement of broad policy principles should never be interpreted as a guarantee that every risk has been eliminated.

Ethical standards must be translated into concrete procedures. Those procedures must be independently reviewable, and there must be meaningful consequences when violations occur.

The COVID-19 pandemic demonstrated how public health issues can raise difficult questions about transparency, access to reliable information, the disclosure of data, and international cooperation. The broader lesson is that we must address matters affecting human life and public welfare through credible evidence, verifiable information, and accountability.

The same principle applies to organ and tissue transplantation.

Countries with advanced transplantation systems and international medical partnerships should pay attention not only to whether an organ transplant successfully saves a patient’s life, but also to whether the donated organ or tissue was obtained legally and ethically.

A responsible transplantation system must be able to demonstrate that donors were not coerced, deceived, exploited, or treated merely as instruments for someone else’s benefit.

No humanitarian objective can justify sacrificing the fundamental rights of the person providing the donation.

One person’s life cannot be protected by violating another person’s human rights.

For that reason, Việt Nam must address several matters openly as it moves forward with its proposed legislation.

• First, legislative transparency must be guaranteed. The government should publish complete versions of the proposed amendments, clearly explain significant changes, and disclose the scientific, medical, and legal reasoning behind provisions involving minors.
• Second, the process of consulting children must be transparent. Authorities should explain why particular age groups were selected, how participants were recruited, how questions were formulated, whether participation was voluntary, and how the responses will be used. Children must receive neutral, age-appropriate explanations rather than information designed to influence their answers.
• Third, a child’s right to refuse must be protected. Any donation of living tissue from a minor should necessitate independent counseling, an evaluation of medical risks, and explicit protocols to ensure that the child’s refusal or withdrawal of consent is honored. Parental permission must never become a substitute for the child’s own willingness.
• Fourth, conflicts of interest must be prevented. The assessment of a potential donor should be independent of the interests of the recipient, the transplant facility, and anyone who may benefit from the donation. Medical decisions must be guided by the donor’s welfare, not by pressure to secure a transplant.
• Fifth, independent and verifiable oversight must be established. The public should have access to appropriate aggregate data on donation and transplantation activities, while the privacy of donors and recipients remains protected. There must also be reliable procedures for complaints, independent investigations, and meaningful action when someone identifies misconduct.

These are not demands that undermine the humanitarian purpose of organ donation. They are safeguards that protect the credibility of the medical profession and preserve public confidence in transplantation.

Human Life Cannot Depend on Promises Alone

Organ donation is an act of humanity. But a legal system governing organ donation can earn public trust only when it protects the autonomy, safety, and dignity of every donor in practice.

That responsibility is even greater when children are involved. Minors do not possess the same legal capacity and level of maturity as adults, and they may be particularly vulnerable to pressure from parents, relatives, medical professionals, or other authority figures. A decision involving their bodies may have consequences that extend far beyond the moment when they provide consent.

For a country where freedom of the press, civil society oversight, and judicial independence face significant restrictions, questions about the supervision of government power deserve even greater public scrutiny.

Those who draft, approve, and enforce the law have a responsibility to demonstrate that the protections they promise are not merely words written into legislation but safeguards that function effectively in real life.

Transparency must come before the demand for trust. Independent oversight must come before the exercise of authority. Accountability must exist before official assurances can be accepted as genuine protection.

A government’s good intentions are not a substitute for institutions capable of preventing and investigating abuse.

Ultimately, the human body is not an unlimited resource for the state to manage. A person’s life, bodily integrity, and dignity must never depend solely on the goodwill of those who hold political power.

And one question remains:

When decisions concerning the human body are placed in the hands of government authorities, who will protect the people if the very institutions entrusted with that responsibility violate the limits established by law?