2007-02-13

To Donate Or Not Donate; There Should Be No Question.

Having a donor card is pointless. Time after time distraught families veto any altruistic last wishes of a donor. I don't know how it came to pass, but somehow the rights of the person over their body end with death despite the fact that their rights of control of their money continue through a will. Would anyone allow their next of kin control of their money and possessions after death, most likely not, but somehow the law allows just that control despite a persons wishes over their physical body.

There are two solutions to this problem, one moderate, one comprehensive. I'm going to put forward first why any solution is better than the current situation and second why the comprehensive solution should be considered above the moderate one.

The donor card scheme seems a sensible scheme until you realise that it has no legal basis for success. You can register as a donor, but this registration may not be found at the right moment through a donor search unless you are carrying a card, so the legal option is to assume donation was not permitted. If you are carrying the card, your right to organ donation may be usurped by the rights of your next of kin to whom the absolute right over your body is granted upon death. The moderate solution is to decide that if a person wishes to donate their body to help others upon death then the right to do so is entirely the persons and no one elses. The moderate solution is to make carrying a donor card or registration on a donor database legally binding. If the deceased wishes to donate then the decision to use the body for organs is then given to the doctors at the time. This moderate solution at least stops the donor system from being a damp squib of a system (pardon the euphemism). If I want to donate my organs I should be able to and the decision to do so should be entirely mine to make.

A BBC survey ( http://news.bbc.co.uk/1/hi/health/4165656.stm [BBC News] ) suggests that the majority of people are in favour of organ donation. The survey data is not something I have access to and the BBC journalism in the news article is suspect in terms of statistics and what it is really trying to say, but the points it raises are important to my argument for an opt-out system rather than an opt-in system, which is my comprehensive solution.

One key statistic though is that 2.724 organ transplants took place last year, but 7,708 people are awaiting transplants. This either means that all people waiting will get one in approximately three years time if the figures are steady or that a lot of the 7,708 people will die or have an extended period of serious ill-health and discomfort because they don't get an organ time. However, as people get ill all the time the number of people requiring organ donation will be added to. In short there are not enough donor organs for those requiring a transplant.

We need in increase the number of people donating organs. One way is my moderate approach above, it will increase the number of donated organs, but will that be enough. Firstly there still may not be enough organs available and secondly not all organs donated are of a suitable match to the transplant patient or in a suitable condition to be donated. Really we need to increase the number donors in total. A fact is that a lot of people would donate, but "haven't got around to it"; that old chestnut. Our inherent laziness or pragmatism that says we either can't be bother to do something or that the something has not become sufficiently important in our hierarchy of needs that we'll actually do it. Sure we'll feel guilty about it or concerned that we "should do something", but that won't happen. We should change this.

People also have misconceptions about donation, thinking that their bodies will be experimented on or that because they drink heavily or are overweight their organs are not useful. Sure you may damage your liver drinking, but that shouldn't affect donation of your cornea to a blind person. And, of course, you certainly will not be experimented on, many people confuse organ donation to donating their bodies to medical science. They are very different things. So we have laziness and misunderstanding to blame for a lack of donors, surely we can overcome this.

One way to overcome it is to spend money on education and on campaigns to recruit donors, but recruiting a donor is costly and must be done time and again. Each new generation of adults needs education and recruiting, which means that this is a continual cost to government. An efficient mechanism is surely to legislate an opt-out scheme. For a one-off cost of parliament you get an increase in donors immediately. An increase that continues as a steady level of donors for good.

Many people object to organ donation and they have a right to do so, they also have a right to preserve their bodies thus the opt-out scheme would allow these people to object and opt-out of donation. I believe this is the right way to go, it allows an increase in donors and respects the rights of those that want to preserve their bodies upon death. Many people feel this way, but their inherent laziness or pragmatism means they won't get around to opting out, and this way we also overcome ignorance or misconception of donation.

There's been a lot of talk about how we should move the right of the dead, or rather the right of the next of kin from opt-in to opt-out making it a right of the living to continue to live through donors. Many European countries do this and I've signed the petition at the government website (http://petitions.pm.gov.uk/Organ-Donation/ [UK government Website] ) in favour of this. It's a shame that more people are interesting in road charging ( http://news.bbc.co.uk/1/hi/uk/6349027.stm [BBC News] ) than preserving life. I'm not saying 1 million people shouldn't petition against the road charging proposals as there are fundamental human rights at stake there too, but I think 1 million people should equally petition for life through donation of organs, which is a more significant and fundamental human right.

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