CONTROVERSY has arisen as Wales is set to become the first country in the United Kingdom to introduce an “opt-out” system for organ donation.

As of December 1, Welsh residents will automatically be registered as organ donors, with the responsibility being given to the individual to opt-out if they do not wish to donate.

According to Organ Donation Wales, in 2011 around 250 people died in a way that would have allowed them to become a potential donor but only 67 became organ donors.

With 36 patients dying the following year due to a lack of donors on the register, it’s no wonder that members of the medical community are applauding the reform.

However, not everyone is so certain that this is the solution to the UK’s organ donation crisis. Adnan Sharif, writing for The British Medical Journal, argues that the system is “well intended, but misguided”.

Dr Sharif, a consultant at Queen Elizabeth Hospital in Birmingham, maintains that the current organ donation system is flawed, as it only acts as a register of interest and does not reflect the consent of the deceased.

“We still allow families to over-rule the wishes of their deceased loved ones despite them giving explicit consent in life.”

In order to achieve a real change to the public’s stance on organ donation, Dr. Sharif proposes a radical change to the current, two-forked, opt-in/out system; suggesting that we need to focus on changing public views on organ donation as a whole.

“Our message to unwilling donors must be clear: if you are happy to receive organs you must be willing to give. There are no legitimate excuses for hypocrisy… We should instead prioritise registered donors to receive donated organs. ”

Anthony Staines, cancer epidemiologist and chair of the Irish Blood Transfusion Service (IBTS), believes that whilst a change from opt-in to opt-out could save lives, a larger restructure to the donation system needs to take place.

“The reality is you can have an opt-out system, but if you don’t have enough staff dealing with the donor’s families, essentially it makes no difference. You need to have the systems in place to manage the staff, systems in place that manage public conversation about donation.

“By itself an opt-out system doesn’t do enough, but as part of an overall package it can be very effective.”

The academic knows first-hand the importance of the UK’s donor system; he had his first liver transplant in early March 2000, and has had a further four liver transplants since.

“I’ve had three transplants in a week – which was a bit of a disaster. But it makes me appreciate the fact that I owe the donation system and the donor’s families a great deal, because otherwise I’d unquestionably be dead.”

When asked what he would say to a member of the public in Wales contemplating opting out of the donor system, it was clear to see that for Anthony, organ donation is a gift.

“I would say to people when you’re making this decision you need to think about the consequences.

“Most people never even become organ donors… I think we always have to be in mind that [organ donation] is a gift, there’s no entitlement to demand someone be your donor, there’s no entitlement for someone waiting for transplant to demand a transplanted organ. It is a gift, a very generous, altruistic gift.”

By Jamie Mountain
@JamieBlueM

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