Controversy mounting over 'opt-in' organ donation move

[okarol]

Controversy mounting over 'opt-in' organ donation move

By Tom Prendeville
Sunday October 05 2008

The Government is moving to make organ donation compulsory, unless the donor or their family clearly specifies otherwise.

The move, which some believe amounts to the 'nationalisation' of a citizen's body by the State, is set to provoke fierce controversy if Health Minister Mary Harney tries to enact the so-called 'opt-in' organ donation legislation into law.

At present 600 people in Ireland are on a waiting list for organs. Organs are donated voluntarily by the next of kin, or if the deceased person expressed such a wish by means of an organ donation card.

The Human Body Organs & Human Tissue Bill 2008 is a private members bill, and was proposed by Senator Feargal Quinn.

During a debate on the bill last week he said: "It is intended to provide in general for a presumption in favour of consent having been given, unless it is expressly withheld. The objective of the bill is to save lives.

"Ireland has a rate of organ donation approximately half that of Spain ... In effect the bill would reverse the current position whereby we must opt-in to consent to organ donation and, under its provisions, if someone does not withhold consent, it would be presumed that person has consented," said Mr Quinn.

Mr Quinn said he has personally known friends and colleagues who were on waiting lists for organs.

"There is a personal background to it. The son of a person who worked with me in Superquinn a few years ago, he was 19 when he learned that the problem in his heart could only be solved by way of a heart transplant.

"His mother contacted newspapers to highlight the need for organ donation. She ran a campaign with her colleagues and customers to promote the donor card scheme.

"On Good Friday 2000 after an 18-month wait a donor was found. Unfortunately two days later the transplanted heart was rejected. The medical advice was that the 18-month delay in waiting for the transplant probably contributed to his death,'' said Mr Quinn.

In order to harvest the organs of a person who has been declared 'brain dead', the individual must be alive whilst their organs are being removed. Otherwise, the transplant team would be removing dead organs from a corpse, which are of no use.

After the world's first heart transplant in 1967 the concept of 'brain death' came into being.

The new medical definition of death was meant to remove the moral and ethical ambiguities surrounding the practice of removing organs from a critically injured person.

Up until now, no one has questioned the medical definition of death. However, a major debate on what actually medically constitutes death has begun in the US after the New England Journal of Medicine questioned whether 'brain death' or 'cardiac death' were valid signs of true death.

Dr Robert Truog, Professor of Medical Ethics at Harvard University, and Dr Franklin Miller, a specialist in Bio Ethics, wrote a joint paper arguing that our medical definition of death might not be valid at all.

Sentiments shared by Senator Ronan Mullen, who, although a lone Senate voice, questioned the wisdom of the proposed organ donation bill.

"People are beginning to question whether what has been called brain death, is, or can, constitute death. I suggest that were there a possibility of recovery, it might have implications for the concept of presumed consent."

The Minister for State at the Department of Health and Children, John Moloney, signalled that the Government is in favour of presumed consent.

"I hope that through this debate, Deputy Harney can work at the finer details and produce a bill that meets everyone's expectations."

However, Mark Murphy, CEO of the Irish Kidney Association, is concerned that the proposed new law -- however well intentioned -- will ride roughshod over the wishes of the next of kin, and would ultimately prove unworkable.

"You can't go against the wishes of the next of kin," Mr Murphy said. "Our position is that we are against presumed consent. They have tried it in other countries across Europe and it does not work. A lot of countries have given up on it.

"What is needed are transplant co-ordinators who are trained to ask bereaved families for an organ donation, not an intensive care nurse, who only minutes earlier was treating the same person."

- Tom Prendeville

http://www.independent.ie/national-news/controversy-mounting-over-optin-organ-donation-move-1490348.html