Earlier this year, France changed its organ donation system from an opt-in system, (like Australia’s) to an opt-out system. The aim of this is to increase the proportion of the population who are organ donors. The new law presumes that consent has been given, even if it goes against the wishes of the family. Prior to this, if the prospective donor had expressed no wish one way or the other, the doctors would be bound to consult the family, who in about 30% of cases, refused to allow the removal of organs1.
Globally, organ donation rates are measured in donors per million of population (dpmp)2. Spain and Croatia are considered the world leaders in organ donation and both have an opt-out system like that beginning in France. Spain and Croatia both have a rate of organ donation of 40.2 dpmp. In Australia, the rate is less than half this, at 18.1 dpmp2. This means that in 2014, there were 378 deceased organ donors in Australia. If we had a donation rate up there with Spain and Croatia, there would have been about 830 donors. That difference means a higher proportion of the 1400 Australians on organ transplant lists died in the queue. This may be as many as 30 per annum, dying while waiting. That is someone’s mother, father, daughter, son, brother, sister, wife or husband dying simply because your haven’t bothered to register as an organ donor.
According to the Organ and Tissue Authority (OTA), Australia is unlikely to go for an opt-out system. This is because more than half of Australian states had already considered such an approach and decided not to proceed. The spokeswoman for OTA said, bizarrely “In Australia organ and tissue donation is recognised as an altruistic decision; it is not forced on the community”3. How this could be construed as a sensible thing to say is beyond me. The opt-out system does not force donations. The clue is in the name.
Transplant Australia CEO also stated something equally ridiculous. He said the “compulsorily acquiring” organs ran the risk of “turning what is one of the most altruistic acts into a system of mistrust and misunderstanding”. If this is the case then how do Spain, Croatia and all the other nations cope with opt-out systems, yet we cannot. Are we too stupid? The Federal Government is not convinced that scrapping to opt-in system would boost organ donation rates, and there is little evidence to suggest it does. However, the 5 countries with the top organ donation rates all have opt-out systems. One thing is for certain, the $240 million spent since 2008 on the National Reform Package to try to increase organ donation rates has had very little effect2.
Perhaps one of the most perceptive comments came from the surgeon who gave Derryn Hinch his new liver. He said he wouldn’t ask people to tick a box asking if they wish to be an organ donor; he would ask them if they would accept an organ transplant if one was needed4.
With a bit of luck, I’ll be old enough such that my organs will be knackered by the time I kick the bucket, but if they are of any use to anyone, they can have them. I definitely won’t need them. Sign up to be a donor.
An interesting opinion piece. What I find difficult is that no matter how many official forms you state that you are an organ donor on – family members can still over rule. I was also bemused when they stopped putting organ donor information on driver’s licences. I have made sure that all my family members know that I want as much donated as possible.
I also think if you are an organ donor this should be mentioned in passports. Since I am passionate about organ donation I tried to find out what happens if you die while overseas. Do your family get asked if you want your organs to be donated in the country that you die in. I don’t have the answer.
I was considering donating a kidney to a cousin a few years ago and was travelling to Germany. My employer at the time while a bit uncomfortable having the discussion with me did make note that if something happened to me and I was being kept alive through artificial means they would fly my body plus medical staff back to Australia. I also found out that a kidney would not remain ‘alive’ during the flight back to Australia.
What I find hard to understand is that in France, some 150,000 have opted out. I’d like to see their reasoning, if that is what it could be called.