The law on organ donation will change this spring. Rather than signing up for organ donation by signing the national register, adults are supposed to be organ donors unless they have indicated otherwise. The government says that an opt-out system will save an additional 700 lives per year, but critics claim that organ donation should be a gift, not a given. Here the experts from the Mail give their opinion.
Dr. Martin Scurr: Three people die every day due to lack of an organ transplant. And although 90 percent of people say they would like to be a donor, many cannot sign the register or inform their family members about their wishes
I have donated one of my kidneys
Dr. Martin Scurr: Three people die every day due to lack of an organ transplant. And although 90 percent of people say they would like to be a donor, many cannot sign the register or inform their family members about their wishes.
As a result, 40 percent of the possibly used organs are lost.
Changing the organ donation register from an opt-in to an opt-out system means many more children and adults who, without a transplant, can get days, months or even years of anxiety and ill health followed by an early death saved.
My vision is not only supported by medical knowledge, but also by my personal experience. I have seen not only one but two loved ones transplants – and I have been a donor myself.
A healthy person can lead a normal life with only one kidney, and in 1992 I gave a kidney to my then wife Glynis.
A rare genetic disorder meant that she had suffered from declining kidney function since childhood and had reached a point of crisis – a transplant was her only option.
Tragically, her new kidney failed on the fifth day after the operation. Six weeks later I was back at work, but Glynis spent two months in the hospital recovering and started dialysis. This saw her connected to a machine that fulfilled the function that her kidneys should have. She had to do this two or three times a day, every day.
Our whole life has been dominated by dialysis, the recurring complications, a succession of successive surgeries and constant medical care needed to help her cope.
This stress was almost unbearable, until finally, 12 years later, another kidney was found. She survives and is still healthy today.
Our eldest son, Ben, had the same hereditary kidney disease, as well as diabetes, and in the late 1930s he also underwent transplantation.
Miraculously he received a new pancreas and a kidney.
After years of dialysis and insulin injections four times a day, he now healed.
With a series of life experiences like this, that would not support any movement that would help all those who wake up every day hoping for a phone call informing them that a kidney, or a liver, or a heart, or lungs, was last found ?
As a medical student at University College London, I passed every day the preserved body of philosopher and social reformer Jeremy Bentham, who was sitting in a hallway in a case.
Bentham, who died in 1832, called for individual and economic freedom. He argued for the abolition of slavery, the death penalty and corporal punishment, and he was an advocate of animal rights.
He was also the founder of the utility philosophy that I take as my guide. It says: “Actions are good if they are in the interest of a majority.”
Like him, I am convinced that the best action is the one that delivers the greatest well-being for the largest number of people.
Instead of allowing the government to claim possession of our bodies and organs, an opt-out system would enable many more people, such as Glynis and Ben, to enjoy a second chance at life.
We have a duty to each other, and a society that is supposed to donate has made a big step forward.
Dr. Max Pemberton: do I support organ donation? Sure I will. It transforms lives and is an extraordinary gift
State interference is NOT the answer
Dr. Max Pemberton: Do I support organ donation? Sure I will. It transforms lives and is an extraordinary gift that gives someone a second chance at life. But that’s it, a gift – and it has to stay that way.
If someone who has seen patients die while waiting for an organ donation, I know that the deficiency needs to be addressed. In fact, a family member of mine died a few years ago while waiting for a new kidney.
It seems a terrible waste that organs are buried or cremated when they can be used to radically change or even save someone else’s life. But the new legislation – introducing presumed consent, which requires people to “opt-out” for organ donation rather than “opt-in,” as they do now, raises important ethical issues. I feel uncomfortable with it.
Donation works at the level of the individual; it is an altruistic act. How can a government make assumptions about the wishes of an individual? About their generosity?
This seems overwhelmingly arrogant and, well, overbearing. Currently only about a third of the population is in the organ donor register, while polls indicate that as many as 90 percent want to donate their organs after their death.
The discrepancy is due to slowness, because most people just never come close to registering.
However, the way to tackle this is not through more government intervention.
Absolutely encourage people to register and address public apathy. But the government does not have a mandate to specify what I want to do with my mortal remains, or to guess that, because I have not checked a box somewhere, I would like to donate my organs when I die.
Such a scheme runs the risk of removing organs from those who did not want this to happen but had not registered their objection. This would seriously undermine public confidence and also mean a further state break in our lives.
I am not saying that people should not donate their organs, just that it cannot be assumed that we will.
I am in the organ donor register and my family knows that when I die, I am more than happy that every part of my body is used to help someone else.
It was a choice I made because my body is mine, not the state – something that the government must remember.
As someone who has talked about organ donation with families who have just been robbed, I have seen what a transformative discussion this can be, and I think that presumed consent completely removes it.
The fact that donation is a gift and a gift that involves loved ones has real psychological benefits for the grieving friends and family.
The idea that their loved one has succeeded in helping someone, even in their death, offers enormous comfort to many.
Although nothing will bring the person back, many have told me they think it is what the person would have wanted, and there is a sense that the family is part of keeping the memory of their loved one alive.
The idea of supposed permission deprives all of this. You don’t really give your body, you just don’t object to having it taken. That is not a gift in the real sense of the word.
But apart from the ethics of supposed consent, there is an even greater reason for not following this path. The reality is that all evidence shows that it just doesn’t work.
In countries that have already applied this approach, such as Wales, donation has not increased significantly at all.
I think the reason for this is the real problem. That is what we must keep in mind and do everything we can to address that.
The biggest barrier to donation is not that the individual has not signed the organ donor register, but that the family is blocking the donation. This is what happens under the current system, where you must log in to the registry.
The new system of supposed permission does nothing about this. Families will still be able to veto, and it seems that they do so often.
The presumed consent therefore distracts us from the real work that needs to be done: informing the public about what a wonderful offering is and encouraging people to have clear conversations with family members about the fact that they want to donate.
When the time comes, families will be better informed about what the person really wanted to happen.
The country we need to learn from is Spain.
There was no increase in the number of organ donations there during the first ten years after an opt-out policy was introduced.
What improved the number was not the assumption of consent, but the development of dedicated and highly trained transplant teams, who would meet families to discuss donations and answer all their questions. This is the way to do it.