The doctor's view
Consenting to organ donation is the hallmark of a caring society * Nigel Heaton
* The Observer,
* Sunday September 28 2008
To me, if a young person dies in an intensive care unit and their organs are not donated, that's a waste.
I remember the tragic case of a young man, aged about 20, who was in a road traffic accident. Not one good thing came of it. He was dead. The family were devastated and, in their grief, didn't want to entertain the prospect of organ donation. Yet when relatives do say yes, they can gain solace because there's something tangible left behind that's a marker for someone's life. A liver or kidney transplant patient will always think about their donor.
Organ donation is incredibly important. But the basic problem is that we don't have enough organs. And we have ever-increasing waiting lists of people needing a transplant. It's 7,900 at the moment, but in 2003-04 it was 6,061.
We should move to the same system of 'soft' presumed consent as Spain. There, people are assumed to have agreed to their organs being removed unless they have refused permission or their family objects at the end of their life. Donation rates there are three times ours, which are among the lowest in Europe. A recent ICM poll for the BBC found that 66 per cent of people said they supported presumed consent.
The NHS needs to give organ donation much greater priority because there are potential donors out there whose families aren't being approached. When it looks like a patient is brain dead, the family should automatically be approached by a professional, compassionate, knowledgeable person to talk about organ donation. That is done in some places, but staff aren't consistently good at it. Some doctors in hospitals are not approaching families. Some doctors simply don't raise the subject. Consistency on this would reduce the refusal rates, which are 25 per cent across the country and 49 per cent in London, and could double the number of people whose organs are donated.
The Organ Donation Taskforce has proposed making payments to hospitals to cover the extra costs to intensive care units of looking after patients until their organs can be transplanted. Personally, and I accept that this is a controversial point of view, I also favour the state paying some or all of an organ donor's funeral expenses. Some people might feel that constitutes bribery, but from a compassionate point of view, helping them have a decent burial would be a sign from society that we are grateful.
To me, the thought that I'm going to be changing other people's lives by agreeing to donate my organs is very powerful. I regret that the debate over whether people should opt in or opt out has become a political football. Presumed consent is not about 'control' or families 'having' to consent, as some people have said. It's about ensuring that people are always offered the opportunity of organ donation, and the opportunity to transform someone else's life. It would be the hallmark of a caring society that instinctively wants to help others.
• Professor Nigel Heaton is head of the liver transplant unit at King's College Hospital, London, which carries out 200 such procedures every year
http://www.guardian.co.uk/theobserver/2008/sep/28/nhs.organ.donation
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