LCQ18: Handling of abortuses
****************************
Question:
Some women who miscarried before the 24th week of pregnancy have relayed that as the Hospital Authority (HA) will not issue certificates of still-birth for stillborn foetuses of less than 24 weeks’ gestation, it is difficult for them to find licensed organisations to provide burial or cremation services for the stillborn foetuses. These stillborn foetuses, if unclaimed by their parents, will be treated as clinical waste by HA and sent to the Chemical Waste Treatment Centre for disposal. In this connection, will the Government inform this Council:
(1) whether it knows the total number of abortuses in each of the past five years and, among them, the number of stillborn foetuses of less than 24 weeks’ gestation;
(2) notwithstanding the Government’s claim that pet cremation service organisations may cremate stillborn foetuses of less than 24 weeks’ gestation, but some members of the public have indicated that the vast majority of such organisations are unwilling to provide cremation services for stillborn foetuses, how the Government helps the parents of these stillborn foetuses obtain such services;
(3) whether any government department is currently responsible for monitoring the provision of cremation services for stillborn foetuses of less than 24 weeks’ gestation by private organisations; if so, of that department; if not, the reasons for that;
(4) as some officials of the Food and Health Bureau have told me that there will be new private cremation facilities providing cremation services for stillborn foetuses of less than 24 weeks’ gestation, whether such facilities are required to be issued with the relevant licences; if so, whether there is a licensing timetable; whether it knows if the facilities concerned are situated in temples or Taoist monasteries or are set up by organisations with religious background;
(5) given that the Catholic Diocese of Hong Kong set up last year a garden of remembrance called “Angel Garden” at the Holy Cross Catholic Cemetery at Cape Collinson for the burial of stillborn foetuses of less than 24 weeks’ gestation, whether the Government will draw reference from such practice and set up gardens of remembrance in public cemeteries for burying this type of stillborn foetuses; if so, of the details (including the names and charges of the selected cemeteries); if not, the reasons for that; and
(6) whether it knows if HA has expressly required its healthcare staff to proactively explain to women who have miscarried that stillborn foetuses not collected will be treated as clinical waste; whether HA will consider producing brochures or adopting other means to step up its publicity efforts on such arrangement among women who have miscarried; if so, of the details?
Reply:
President,
My reply to the Member’s question is as follows:
(1) Insofar public hospitals are concerned, doctors of the Hospital Authority (HA) will issue a Certificate of Still-birth under section 18 of the Births and Deaths Registration Ordinance (Cap. 174) in respect of a still-born child. The number of stillbirths in public hospitals in each of the past five years is tabulated below:
| Year | Number of stillbirths in public hospitals |
| 2013 | 112 |
| 2014 | 122 |
| 2015 | 125 |
| 2016 | 133 |
| 2017 | 128 |
The HA follows the guidelines issued by the Hong Kong College of Obstetricians and Gynaecologists in the definition of “stillbirth” as a baby born with no signs of life at or after 24 weeks of gestation, or with a birth weight of more than 500 grams when the gestation age is uncertain.
The Department of Health (DH) and the HA do not maintain statistical record on the number of cases of miscarriage before the 24th week of pregnancy.
(2) to (4) To ensure the proper operation of the establishments for cremating human remains, it is necessary for the Government to stipulate in legislation that crematoria can only provide cremation services for members of the public who have obtained a death certificate, medical certificate, cremation permit, cremation order or other related documents. According to Part 6 of Schedule 5 to the Public Health and Municipal Services Ordinance (Cap. 132), there are six private crematoria in Hong Kong, which are established at monasteries/temples. They provide cremation services for their members or residents. Abortuses of less than 24 weeks’ gestation do not meet the requirements for obtaining the death certificate, medical certificate, cremation permit or cremation order.
There are also private companies providing cremation services for the remains of living organisms in Hong Kong. Such services are regulated by the provisions of relevant legislation (including the Buildings Ordinance (Cap. 123), the Fire Services Ordinance (Cap. 95), the Dangerous Goods Ordinance (Cap. 295), the Air Pollution Control Ordinance (Cap. 311) and the Public Health and Municipal Services Ordinance (Cap. 132)), and land leases.
(5) As for the assistance given to parents in proper handling of their abortuses, the Food and Environmental Hygiene Department (FEHD) approved in mid-2017 the application from the Catholic Diocese of Hong Kong for amending rules for the management and control of its cemeteries, thereby allowing the Catholic Diocese to process applications from the parents concerned for keeping their abortuses in its designated cemeteries (delineated areas other than grave space). A similar application from a private cemetery has been submitted to the FEHD and is currently being processed. The Government has actively reached out to private cemeteries operated by religious bodies and encourage them to offer a resting place for abortuses so as to give the public more choices. At present, operators of three other private cemeteries have also indicated to the FEHD that they will explore the feasibility of providing the service in their cemeteries. If operators of other private cemeteries wish to make such applications, they may apply to the Director of Food and Environmental Hygiene in accordance with section 3 of the Private Cemeteries Regulation (Cap. 132BF), and submit with their applications newly formulated/revised rules for the management and control of cemeteries, setting out clearly their intentions and arrangements in this regard. Under the existing legal framework, the FEHD is unable to make similar arrangements in its public cemeteries.
(6) When performing treatment for termination of pregnancy for women whose abortuses are of less than 24 weeks’ gestation, the Department of Obstetrics and Gynaecology of the HA will give the patients concerned a written explanation via an operation consent form or a verbal explanation that the tissues removed will be sent to the hospital’s Pathology Department or treated in accordance with the normal procedures. Where feasible and provided that relevant legal requirements and such conditions as public health have been met, the HA will let the parents concerned claim the abortuses and will not treat them as clinical waste. Abortuses which have not been claimed will be handled by the HA in accordance with the relevant legislation. The HA will consider stepping up its publicity efforts by producing brochures or through other means when necessary.
Ends/Wednesday, April 11, 2018
Issued at HKT 14:54
Issued at HKT 14:54
NNNN