“These successes depend on acts of altruism.”

In the Sunday Times, Liam Clarke has a considered article on the recent [ongoing?] campaign by BBC NI’s Stephen Nolan to affect a clinical decision in the case of a 19 year old with alcohol related liver failure. From the Sunday Times article

One of the most compelling moments on the Nolan show came when a caller asked Stephen Nolan if he carried a donor card himself. “No, I don’t,” the presenter replied. Asked if that made him a hypocrite, Nolan argued: “I have never said someone should become an organ donor. I have never said that, nor am I saying that Gareth should get an organ.”

Yet over three hours of broadcasting Nolan had lambasted politicians for failing to intervene and grilled medical teams. They were unable to disclose the full background to the Anderson case due to considerations of confidentiality, but it is considerably more complex than the inflexible application of a six-month rule.

Liam mentions the solution favoured by some – automatic donation of organs unless an opt-out is specified.

All the world’s main religions support organ donation, but people tend to be squeamish. Although doctors often recommend making organ donation automatic unless an individual opts out, there has never been the political consensus necessary to legislate for this. Assuming consent unless the person carries a card stating the contrary would make life-and-death decisions such as the one hovering over the Anderson family largely irrelevant. There would be enough organs to go around.

Instead, we have collectively opted for a voluntary system, and that alone gives the howls of outrage surrounding cases such as Gary Anderson’s a hollow ring. Most people don’t volunteer. Following Best’s death, the number of donors in Northern Ireland fell, probably because, despite the public outpouring of grief at his funeral, he was seen as an “unworthy” recipient. People weren’t willing to give the gift of life to someone who might die in a few years through alcohol abuse.

I say some favour the automatic donation route because although superficially attractive as a solution to the problem, which it probably would be, my view is that implementing such a scheme, even with an available opt-out, would, at the very least, call into question who owns your body – you or the state. Currently you have the choice of what you want to do with your organs, or your next of kin can decide on your behalf, while you are still alive. An automatic donation scheme gives that right directly to the state. In this example, that might seem to be for the greater good, but it risks altering the relationship between citizen and state in a fundamental way.

But, as Liam says at the end, there is an alternative

I hope Gareth pulls through and that his case serves to bring about a change of attitudes. We must, as a society, take our heavy alcohol consumption, particularly by the young, more seriously. Drink kills 30 times more people than drug abuse, but this is not reflected in the efforts to enforce licensing regulations or the sale of drink to the young.

There is also a challenge to every citizen to show practical concern for cases such as Gareth Anderson’s by carrying an organ-donor card. My new one is in the post. I hope to hear Nolan, arguably Northern Ireland’s most influential broadcaster, giving an example to his listeners by saying the same when I tune into his show tomorrow morning. There is a link on his own website where he can register online.