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Organ donor campaigns do little to help the immediate problem…

Posted Aug 01 2011 8:45am

The Indy suggests that nudging people towards becoming organ donors when they apply for a driving licence will improve the availability of organs. An old, and fallacious, argument.

The organ crisis is here, now. Just as it always has been. Most new licence holders, even if they sign up, all things being equal will never become organ donors – only those who die, or are killed in suitably non-mangling circumstances will actually become donors, and then the majority not for many years.

Really, then, in the near future precious few viable organs are likely to result from hassling people to become donors.

And before anyone asks, although I’ve surrendered my licence because I’m now too ill to drive, I was a registered donor for many years (still am, presumably), and though my heart and lungs are shot, most of my bits are in pretty good nick, but I’m now at an age, and overall state of health, at which I wouldn’t be considered suitable donor material for some of my organs, though overall there is no age limit.

There is an organ shortage not simply because there is a donor shortage, but because people just aren’t dying sufficiently conveniently to supply the demand, which is pretty damned inconsiderate of them. More donors won’t increase the death rate, and that’s what matters (well, actually it will, a little – the same proportion, on average, will die, but with more donors registered, that proportion will contain more donors – no guarantee it will yield more viable organs though).

The bottom line, though, is that no donor campaign is going to solve the immediate problem – never has, never will. Tragic for those in need, no doubt, but much less tragic for the families of those who don’t die to yield up their organs.

The current opt-in system has never worked that well – witness the more or less perpetual donor appeals – either through inertia or revulsion; a surprising number of people balk at the thought of organ-harvesting, while the idea of an autopsy doesn’t worry them overmuch, but logic often plays little part in worries about what happens to one’s body after death.

What we need is an opt-out system, If, for whatever reason, becoming a donor is not what you want to happen, either for religious reasons or just plain Yuck! reasons, you can opt out of the scheme.

Everyone else is fair game. It would solve an awful lot of problems.

Yes, there are those who claim that unscrupulous doctors might tip borderline patients over the edge – one death, which would probably have happened anyway, versus several lives saved or enhanced. And, indeed, a notorious Panorama programme did blow the lid off this sort of thing about 30 years ago, when patients not actually, well, dead, by current standards,** had their organs harvested, as a result of which far more stringent checks and balances were put in place. These days a team of people is involved, not just one dodgy or overworked, doc saying, yeah, he’s gone.

**Nor were they, strictly speaking alive, but there was some residual brain activity which caused a great deal of consternation, and rightly so. There must never be any doubt that a donor is dead beyond any hope of recovery.

I did wonder, though, on what religious grounds some people do opt out of donation, as I don’t know of a single religion whose founders foresaw organ donation and proscribed it. In fact, on investigation, it turned out that none of the major religions forbid organ donation . And some – Shariah Islam, for example, to my surprise – actively approve of it, waiving restrictions.

I tend to favour, too, withholding donated organs from those people who opt out. After all, if they believe – or just say they believe – that organ donation is simply wrong, then being a recipient must be equally wrong, surely? Can’t have it both ways, kiddies.

So come on folks, if you’re not an organ donor already, register now. As I said, it won’t solve the immediate problem, but it might solve someone’s years in the future. The process starts here .

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