China’s legislature said the nation’s law should be updated so that brain-dead patients can be legally recognized as dead — a controversial topic that has been debated in the country for nearly two decades.

The National People’s Congress confirmed its stance on the issue to financial news outlet Caixin on Friday. Brain death is the “diagnosis and confirmation of death based on the irreversible cessation of functioning of the entire brain, including the brainstem,” according to an agreement on the usage of the term from a 2012 international forum co-sponsored by Canadian Blood Services and the World Health Organization. But in China, a person’s death is legally recognized only after several vital conditions are met: The heartbeat has stopped, breathing is no longer spontaneous, blood pressure has dropped to zero, and the pupils have dilated. However, the heartbeat may persist when a patient’s body is supplied with oxygen via mechanical ventilators, even if the brain is dead.

In the Caixin report, China’s legislative body said it supports the establishment of either a new law or a “dual standard” of interpretation for the existing law on death, which would grant family members the right to determine the status of a patient’s life in the case of irreversible heartbeat cessation or brain death.

Chen Jingyu, a member of the congress and vice president of Wuxi People’s Hospital, has been one of the most vocal supporters of formulating a law on brain death. He presented proposals at the annual government meetings in both 2015 and 2016 but was turned down both times. “The public doesn’t agree on brain death,” the congress said in a statement explaining the rejection. In March of this year, Chen again proposed legislation during the annual sessions of the national congress as well as the Chinese People's Political Consultative Conference.

Last month, a special committee of the national legislature responded to Chen’s latest proposal, saying that it’s necessary for the country to specify the legalities of brain death. “Now there are no barriers in technical regulations on implementing clinical death judgement,” the National People's Congress Education, Science, Culture, and Public Health Committee wrote in their statement. “But compared to the conceptual knowledge of the medial field, the public’s perception on death is still limited to a considerable degree to the death of the heart.”

Currently, over 100 countries and regions in the world have laws regarding brain death. Chen said China’s medical standards for brain death are in line with the international community but that legislation is still urgently needed.

“Legislation for brain death is not just about organ transplantation,” he told Caixin, addressing the widespread public perception that brain death laws only concern organ harvesting by doctors. “There are still many family members who ask doctors to treat brain-dead patients until their hearts stop beating, which consumes a lot of medical resources and burdens families financially.”

Editor: Bibek Bhandari.

(Header image: A medical device displays the vital signs of a brain-dead patient at a hospital in Hefei, Anhui province, Sept. 29, 2016. IC)