Organ donation rates

The Herald reports:

Mr Tookey, whose teenage daughter Katie will need a liver transplant eventually, faults the licence database, but also, tongue in cheek, suggests an improvement.

“They ask, donor, yes or no. If they put a question before that, ‘If you need an organ to live, would you accept one’, if they tick yes to that, they are hardly likely to say no to the next question.”

That’s not an entirely bad idea. Ask about being a recipient before you ask about being a donor.

Our donor rate per million population, at less than nine, is around half of Australia’s, and far below the world leader Spain on about 35.

One change we should make is for a donor’s wishes to be paramount, and their family unable to over-ride them.

When an ICU patient’s brain dies, perhaps from a road crash, a breathing ventilator can keep their other organs alive while their family is asked about donation. Grief may make it hard for a family to hear their loved one’s death could save others. Fifty-three per cent of licence holders have indicated “yes” to being a donor, but ICU and donor staff don’t routinely check the database.

Janice Langlands, of Organ Donation NZ , said they looked only if the family asked, as many already knew their loved one’s wishes.

This is all wrong. The database should have legal force,and the first thing that should be done is to check the database, and then simply inform the family of their wishes.

The Health Ministry says if family members report the person had stated their wish regarding donation, doctors are legally permitted to act on this, but can choose to follow the family’s position, even if it contradicts the patient’s.

I think we need a law which gives legal force to the wishes of someone deceased or about to die – both for details of burial (to stop body snatching) and for organ donation.

Ms Langlands said ICU staff followed families’ wishes out of concern for their wellbeing.

“I personally don’t believe that we should ever be more interested in the potential recipients and the wellbeing of an unknown recipient than we are about the wellbeing and health of that family at the time

When do the wishes of the person who agreed to donate get taken into account?

Families did not always oppose donation. Some permitted donation even when the licence said no, as the person had falsely believed he or she was too old.

Also wrong to have the family say yes if the person has said no.