Thursday, March 24, 2011

Organ donation

A letter in the Irish Times (8 March 2011) refers to the proposal in the recently published Programme for Government 2011-2016 of the newly-elected Irish Government that the existing ‘opt-in’ system of organ donation should be changed to an ‘opt-out’ system instead.   The letter-writer says:

‘…As has been well flagged by the Irish Kidney Association and other bodies, there are flaws with an opt-out system.  Statistics show that in countries where the system has been tried, no discernible difference was made to the rate of transplants.  An opt-out scheme would obviously increase the number of potential donors – but it is pointless having potential donors when the environment in which our health service operates is still hopelessly ill-equipped for the donating and harvesting of organs. …’

This is what the new Programme for Government says:

‘We [Fine Gael and the Labour Party] will legislate to change the organ donation [system] to an opt-out system for organ transplantation, rather than an opt in system so as to improve the availability of organs for patients in desperate need.’

That doesn’t sound very reassuring, now, does it?  

Using the opt out system a person is presumed to have consented to donate his or her organs after death unless he or she has specified otherwise.
This is an area of deep concern as it also involves the issue of the definition of death

An article published in the New England Journal of Medicine has re-opened the debate about the ethics of organ donation. The article warns that organs can be - and are being - harvested from the bodies of patients who cannot be convincingly termed 'dead'. The authors do not oppose organ harvesting on these grounds, stating:

The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead.
very worrying