(British Medical Association campaigns for changes in UK Organ Donation)
By Leon Horton
Illustration Mark Fisher
It’s one of the many high-minded, altruistic gestures I keep meaning to do, but never get round to: become an organ donor, carry the card. For years I’ve had a recurring dream where a loved one needs a new kidney, and of course, being the hero of my own dream, I volunteer. Any amount of pain can be endured for a loved one. No sacrifice too great. As I count down from ten on the operating table, I usually come round in the real world with one thing on my mind: become an organ donor, carry the card.
If only dreams were promises.
According to the British Medical Association “statistics show that 82 percent of the population definitely wants to donate or would considering donating their organs” and “right now more than 10,000 people in the UK need an organ transplant that could save or dramatically improve their lives, but each year around 1,000 people die while waiting for a transplant.” This discrepancy, say the BMA, is due in part to the fact that “only 50 percent have talked about it with their family, and it is family members who will ultimately need to agree to organ donation going ahead.” (1) The BMA wants to change this.
Become a donor, carry the card.
I have never discussed becoming an organ donor with my family, nor have they with me. I have no idea if my sister carries the card, or what – if any – arrangements my parents have made. Once or twice, my parents have attempted to broach the subject of their respective wills – pragmatically, I suppose – but I find the subject morbid and change the subject.
Perhaps my desire to turn away from death’s details is human instinct, innate in us all; perhaps it’s a cultural influence – I live in a milieu where death is hidden away in coffins and hearses, behind curtained crematoriums and chapels of rest; perhaps I just don’t want to think about it. In a briefcase in a cupboard in my hallway there is a last will and testament document. It’s been there for ten years. It’s blank. I don’t want to think about it.
The problem, then, is me – and people like me. The problem is negligence, apathy or denial. I suspect most people, like me, have considered becoming organ donors; are for the most part willing, but never get round to it – like my friend who professes his political leanings but can’t find the time to vote. I suspect most people, like me, would sign-up on the spot if they were approached in the street by the NHS Organ Donor Register.
Currently, there is an estimated twenty million people registered on the NHS Organ Donor Register, which sounds misleadingly healthy. NHS Choices say: “Even though about a third of the population have joined the register, less than 5,000 people a year die in circumstances that allow them to donate their organs.” (2) We have a shortfall of suitable organs, then, that results in approximately 1,000 deaths per year. So what can be we do about it?
Become a donor, carry the card.
The UK (with the exception of Wales) currently uses an opt-in system for organ donation, whereby a potential donor must have registered their wishes – either by carrying the card, making provision in their will or telling their family and/or GP. If no such provision has been made at the time of death, a doctor can, by law, approach the next of kin and consult them on the subject, but cannot proceed further without their consent. This system is similar to that practised in the US, Australia, Canada and Germany.
In 2013, the National Assembly of Wales voted to go ahead with an opt-out system, whereby your consent is presumed if you have not registered, but your relatives still have final consent. This is known as a ‘soft’ opt-out system. Many countries where an opt-out system has been implemented (such as France, Spain and Italy) have reported a marked increase in organ donation, and it is for this reason that the BMA, along with the British Heart Foundation and Kidney Research UK, are campaigning for the rest of the UK to follow the Welsh example.
There are, of course, religious, cultural and philosophical reasons why we might not want to become donors, and why we might, quite rightly, raise concerns about the possible risks involved in an opt-out system. I must admit, the proposed system of presumed consent worries me somewhat. What if I die without having registered my wishes – do I then belong to the state? What if there is a bureaucratic error? What if malicious hackers compromise the register? What safeguards would be put in place to protect my personal data?
The BMA says they want an “extensive, high profile awareness campaign to inform the public about the proposed new system and to encourage them to consider their own wishes about donation after their death”. To allay any fear of bureaucratic error, the new opt-out system would establish a database with “a mechanism for people to easily and quickly opt-out if that is their wish. Once implemented, when someone over the age of 16 dies and donation is a possibility, the opt-out register must, by law, be checked and if the individual has opted out donation could not proceed. As an extra safeguard, if the individual had not opted out, family members would be asked if they were aware of any unregistered objection. If the relatives were not aware of any objection, they would be informed that donation would proceed.” (1)
For any change in UK organ donation law, there needs to be a change in public opinion regarding the means by which we make our personal choices. Many of us are happy to opt out of tax, household insurance or the TV licence, but the human rights issues concerning organ donation need to continue to be debated. Until then, should we wish to help save someone else’s life in the event of our death, we only have one choice:
Become a donor, carry the card.
To find more information on the BMA opt-out campaign visit: www.bma.org.uk/organ donation
To register as an organ donor call the free NHS Donor Line on 0300 123 23 23
(1) “Become an organ donor”, British Medical Association
(2) “Organ Donation”, NHS Choices
About the Author
Leon Horton is a journalist and scriptwriter. After gaining his masters degree from the University of Salford, he cut his teeth on local magazines, enjoyed a caretaker stint as the editor of Old Trafford News then returned to freelance writing. His work has been published in Nexus New Times, the Animals’ Voice, Empty Mirror and Erotic Review.
Leon lives in Manchester, England, and can be contacted at firstname.lastname@example.org
Art by Mark Fisher