In the news today: Organ Donation - the debate...

On the news today, new discussions have been surfacing on organ donation and how to bridge the large void in lack of organ donors to meet demand. There is the withstanding debate as to whether organ donation should become opt-out or remain opt-in – becoming opt out would mean that more people would become organ donors if they had no particular desire for their cadaver to remain intact, instead of the current system, which requires donors to have a particular desire for their organs to be used. According to the BBC with welsh government are planning to introduce an opt out scheme commencing by the summer of 2012 [http://www.bbc.co.uk/news/health-16988213]

Awareness is increasing however; the previous three years have seen an increase of 25% in organ donors. The figures still full short of the 50% target set by the BMA for 2013. Suggested ideas to increase donation include allowing higher risk donors to donate, reducing the refusal rate with encouragement and to ventilate patients to no advantage to their health, but to increase their chances of successful donation. Obviously a system such as the latter would be seriously controversial and if there were complications in the process causing the patients health to be, it could give rise to mass rejection of organ donation by other patients too. Another option to be considered is of a ‘softer’ opt out, which allows families to say no to donation on behalf of their deceased relative. Another possible approach is reciprocity – those who are donors will have a higher priority for organ donation over those who do not. To begin to prioritise health care like this would, too, be controversial – instead of judging a patient on their state of health and fitness, patients could be judged on their social decisions, and although arguably fair, would no doubt give rise to further controversy.

When compared to Spain, the UK has a much lower donation rate – they operate on an opt out system, although they do ask the permission of the relative before any action is undertaken. They also incorporate the use of higher risk patients and have more intensive care beds, which means that more organs are readily available for donation.

Overall, I believe the best practice to be awareness. The population should adopt a psyche where one is clear that they are for or against donation of their organs to avoid discrepancy; currently 43% of families reject donation of their relative’s organs, purely because they did not know their wishes. Awareness would decrease the requirement of an opt out system, because people will become increasingly more conscious of the problem and take steps to sign up for the service to help.