Families Refuse to Honor Organ Donors’ Wishes

Families Refuse to Honor Organ Donors’ Wishes

Walaa Hawari, Arab News
Sunday 17 February 2008

Saudi Arabia, like the rest of the world, suffers from an organ-donation deficit. With a waiting list of over 10,000 people, according to the Saudi Center for Organ Transplantation (SCOT), many patients will face death before getting the needed organs.

Rana Al-Sabbag, a SCOT coordinator, says that while the number of Saudi patients needing organs continues to grow, the number of people willing to donate their organs has remained steady. And the wishes of people who are willing to donate life-saving organs when they die aren’t always fulfilled due to family intransigence. Many families are reluctant to have organs harvested from relatives; especially those deemed brain dead (people whose bodies can be kept alive but are considered clinically dead).

This issue is hardly isolated to Saudi Arabia.

A study in the British Medical Journal in 2006 showed that 41 percent of families blocked the harvesting organs from patients that had given permission to do so when they were alive. The study showed Britain has the lowest number of donated organs per capita of any western European country; Spain has the highest.

The study pointed out that 91 percent of the time, UK families of the deceased were asked to sign waivers for harvesting organs of people that had wanted their organs harvested. As a result of these waivers, only 59 percent of people who wanted to give up their organs after they died were able to do so.

The United States has a similar system and similar problems; families there are often required to provide consent for organ harvesting even when the person had authorized organ donation before death.

In Saudi Arabia, 526 brain-dead cases were reported in 2006, a 28.3 percent increase from the previous year. Out of these cases, 111 families were approached about organ harvesting; 60.6 percent of them declined permission to acquire organs, according to SCOT. Nevertheless, there was a record at King Faisal Specialist Hospital & Research Center showing 17 cases of organ donations in the month of January. These included a young man suffering from brain cancer who expressed his wish to donate his organs after he dies.

Al-Sabbag points out that Saudi Arabia applies the latest standards for determining if a patient is clinically dead, even if the vital organs can be kept alive through mechanical respiration.

Patients that are suspected of being clinically dead undergo myriad tests to determine that no blood vessel activity is occurring in the brain and that the body would expire if the respirator were turned off.

From an Islamic perspective, a fatwa by the Amman-based Islamic Fiqh Council from the mid 1980s ruled that brain death is equivalent to legal death. And a decision by the Council of Senior Ulema ruled that it is permitted in Islam to remove organs from dead people to save the lives of others.

Scholars consider it as a form of charity. Yet, there are families who still seek advice from people who are often not qualified to rule on such issues.

Al-Sabbag recounted the story of a 26-year-old woman awaiting kidney transplant who died after failing to find a donor. When a brain-dead donor was available, the man’s father intervened.

“The father hesitated after consulting with the imam of his mosque,” she said. “We urge organ donors to inform their families of their wishes — a donor card or signing a consent form is not enough.”

In SCOT, the brain-death case coordinator is trained by psychologists and sociologists in the best way and time to approach the potential donor’s family and convince them. “But should the family refuse, there is no harvesting of organs,” Al-Sabbag said.

Of course, not all organ donations need a corpse. Living persons can give kidneys, which is the most commonly transplanted organ. In 2006, 220 Saudis donated kidneys while 151 kidneys were harvested. Eight children received kidneys in 2006 in the Kingdom.

Al-Sabbag is calling on Saudis to be more aware of the importance of organ donation. “We need to ask ourselves: ‘What if it was me, or a dear member of my family (that needed an organ)?” she said.

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