Statistics have revealed that in the last ten years over 6,000 people, including 270 children,
have died whilst waiting for an organ transplant that never came. Almost 7,000 patients are
currently on the UK’s transplant waiting list and 30% of them have been waiting for more
than two years. A further 500 of them have had to wait for over five years; that’s over 1,800
days of poor quality of life, pain and suffering each.
Despite an increase in new registrations this year to the NHS Organ Donor Register, the
demand for replacement organs is still far from being met. Currently in the UK, the only way
a person becomes an organ donor is by actively signing up to the register. So the idea of
introducing an “opting out” system in England could be the way to increase registrations.
Next week, from 1st December, the law in Wales will change to a soft “opt-out” system. This
means that if you want to be a donor you can register – this is “opting in” – or simply do
nothing. If you do not want to be a donor you can register this choice - “opting out”. Should
no action be taken it is assumed that there is no objection to donating your organs – this is
called “deemed consent”. You can also appoint a representative to make the decision for
you after your death. Such a scheme bases its success in the idea that only those with strong
opposing views will not eventually donate their organs.
Recently the Nuffield Trust has been looking at how to increase the participation in organ
donation in an ethically sound way. Their report considers how far it is reasonable to go to
encourage people to donate their body tissues and organs. Financial compensation is a
contentious issue as voluntary organ donation is often safer and does not target the poor
and vulnerable. Paying for or making a contribution towards the funeral costs of organ
donors would, I feel, be ethically justified, as this poses no harm to the donor and would be
an acknowledgement of the donor’s selfless act. The success of a scheme such as this needs
public support, something which can be hard to come by if people feel that the vulnerable
are being extorted in any way. Hopefully a pilot scheme of this nature will be carried out in
the near future so that public acceptance can be built up slowly over time. Healthy people
are already paid to participate in scientific research and in drug trials, and here the risk of
harm to the volunteer is greater.
The ever-present lack of suitable donors throws up the question of whether a patient who
themselves refuses to join the donor register should be eligible to receive a new organ. In
regards to blood donation, a person has never been denied a blood transfusion on account
of never having given blood themselves. However it seems very unfair that a family who are
all themselves donors may, for example, lose a child due to the inability to find a donor
match. Despite this, it is obvious that a person’s wishes must be respected and that their
previous actions should not harm their survival. It has been suggested that donors should be
given higher priority for transplant organs, but this is not ethically sound is if this were
implemented it would be using the threat of suffering and death as an incentive to register.
Hopefully a better understanding of the benefits of organ donation will encourage organ
donation for more altruistic reasons than this.
A large part of boosting the numbers on the donor register may be about reducing the
confusion or fear felt by people about what donation involves. The NHS and other health
care organisations could focus more on dispelling dangerous rumours surrounding organ
donation. Yes, the doctors will focus on saving your life as a priority and not somebody
else’s. No, people cannot buy and sell organs; the transplant laws in the UK forbid selling
human organs or tissue. There needs to be public reassurance that all organs and tissues are
removed from a deceased donor with great care and respect, and the dignity of the body is
made paramount in the operating room.
Offering to donate your body parts after your death is a huge act of selfishness, and should
be celebrated in the community. As such it should be altruism which is central to our
approach to all types of donation. However, this is not to say that the possibility of allowing
some form of payment in special circumstances should be dismissed.
An organ transplant can save or massively improve a person's health and quality of life. You
can choose to donate online or by speaking to your doctor. It can be important for your
friends and family to know that you have made this decision.