Assembly calls for debate on consent for Organ Donation

A couple of weeks ago the assembly had a debate on organ donation in Northern Ireland and discussed the option of presumed consent as a mechanism to increase organ donation rates. Edwin Poots called for a public debate on the issue. The issues in this are complex. Presumed consent may substantially increase the number of organs available for transplantation since although a majority of people state a willingness to donate their organs following death only a minority are registered donors. The statistics are not entirely clear, however, and countries with presumed consent do not necessarily have significantly higher donation rates (see “Can parallels be drawn from the EU?” from this article). The high rate of organ donation in Spain is not merely related to their position on consent. Furthermore there are concerns that presumed consent may effectively equal no consent.

In recent years there has been an acceptance of organ donation from non beating heart organ donors. There is a simplified wikipedia explanation of this here and it is not a practice without ethical problems though examples of the practice may allay many of the ethical concerns.

The fundamental issue remains that we have an increasing number of people who would benefit from organ transplantation yet the number of transplants has remained relatively static over the last two decades. Much of the lack of rise is from entirely good reasons: traditionally road traffic accident victims provided many of the transplanted organs yet the improvements in vehicle safety and medical care have improved survival from such accidents. This is of course to be welcomed but it does mean that there will be fewer organs available for transplant. Other advances in medical care have reduced potential donor rates and although obvious it must be remembered that for most organ donations someone else has had to die.

It is also the case that a change in the law regarding consent here in Northern Ireland will not have an enormous effect on transplantation rates as the transplant network is all British Isles and indeed pan European. It is, however, a reasonable debate to have. The information on how to register to become a donor is here and the transplant rates for the last year are here.

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  • I admit to a certain discomfort with it. And its possibly generational.
    My default position is that I would not give consent for a relative but would hypocritically want a child or grandchild to benefit if needed.
    For the most part my distaste is for the medical people…….and while we all have had occasion to be grateful for medical care, standards of care and ethics are falling and I suspect before long it will be the case where there will be financial incentives for organ donation…..just as in the Third World where doctors will willingly transplant an organ from a poor person to a rich person. Indeed Id be interested to know if there is a black market in this area.

    My default position is to be extremely wary of professions who are understood to have “ethics”. In my humble view, people from all walks of life have ethics….professions dont.

    I am always wary of medical advocates who talk about such things. Although my default position is that I would withold consent in respect of a relative (and as my children are married, this effectively means my wife), I do in fact carry a donor card. Obviously the decision falls to my widow or sons. I will be past caring…..and as I am getting cremated, it hardly seems important where my kidneys and/or liver is.
    But I think this is primarily an issue where the medical jobsters could do themselves some favours and engage in a real debate that didnt place themselves on a pedestal.

  • cynic2

    Just imagine this applied to the population of our own dear politicians

    You wake up in hospital to find that your transplant has been a great success and you now have been donated:

    * Gerry’s Heart – he really cares you know or

    * Sammy Wilson’s spleen or

    * Marty’s Brain – all those memory lapses cant be a good omen or

    * Anything at all from Tom Whats’isname (unless you live in Fermanagh)

    Scary isnt it

  • Not scary at all.
    Thats probably the best thing about transplants.
    Memorably there was the case in England a few years back where a person wanted to donate organs……but only to a person of the same colour.
    Controversially but I think rightly the offer was politely declined on the grounds that the donation cannot be qualified.
    There are people in Norn Iron who have had to reflect that they do indeed have organs donated by one of themmuns.
    Hopefully it makes them think twice.

    The degree to which we can trust “doctors” and I am loathe to lump them altogether is a factor. Surely over 30 years we have heard doctors whether locally or abroad say things that seem to agree with their political masters. For example “the closure of this ward/hospital/ambulance depot will not have a negative impact on the local community and result in deaths”.
    Surely the majority of us wonder just how true that is.

    While medicine has made great strides, it has produced for some moral dilemnas and we are entitled to as questions.
    And one has to wonder if Minister Poots is perhaps the right man to encourage organ transplant………when he seems to have an issue with blood donation from people who are gay.
    Personally I have no issue with that at all and Id be surprised if anyone really had.
    Would anyone seriously prefer a blood donation from a person who was straight rather than gay.
    Can we make that kind of demand.
    Would Poots prefer gay people do not donate organs……..would he thank them for their public spirited stance but respectfully suggest that they should not do so?

    All of us have an issue with at least one part of medical advance……..each according to our own.
    In extreme circumstances Society over-rides the issue of conscience……for example the State might well intervene in the case of parents refusing a blood transfusion for a child…..I think we would say that Society would be right to so do.
    But that does not mean that we would not have a conscientous objection in other areas…….and Id suggest that for most of us….”implied consent” would be just a step to far.

  • cynic2

    Would Poots prefer gay people do not donate organs…

    He might even prefer they didn’t exist … especially in the DUP. Still in good time his invisible friend twill caringly cast them into the fiery lake for their sins

  • carl marks

    “Would Poots prefer gay people do not donate organs…

    He might even prefer they didn’t exist … especially in the DUP. Still in good time his invisible friend twill caringly cast them into the fiery lake for their sins”

    I’m willing to bet if he needed a new heart (assuming he has one at the moment) he won’t give a dam if the donor is a gay black catholic, or a free p, like the rest of us he will take it and the chance to live a bit longer.
    On organ donation I believe that a system that makes everyone a potential donor unless you actively opt out.