Thursday, September 4, 2008

OptingInToOptingOut

In the UK there are over 7,000 people currently on the active waiting list for donor organ transplants, and that number grows about 8% each year.

It is proposed that, in future, instead of the current system whereby people must opt into donating their organs, they will have to opt out. In other words they will have to carry a card stating that they don’t want their organs donated when they die and not the other way around.

Every year almost 1,000 people die either while on the list, or having become so ill they are no longer able to withstand transplant surgery.

Nevertheless, some intensive care doctors state that they are deeply concerned about this radical change to the law on organ donation.

It was Prime Minister Gordon Brown who politically led this call to change to the opt out system called presumed consent. A UK-wide government taskforce is due to report in the next few months.

A BBC poll of adults across the UK showed support for this idea running at two thirds - but intensive care doctors are more divided.

The Intensive Care Society says it has research suggesting that many specialists are worried such a move might damage the trust between patients, their families and doctors.

Kevin Gunning, a consultant at Addenbrooke's hospital in Cambridge carried out a survey of specialists for the society. The 125 responses from doctors around the UK shows that their opinion is evenly divided.

Some of the doctors polled express the concern that presumed consent might instill doubts in patients and relatives about a potential conflict of interest. I believe this is a genuine concern that has not been thought through.

Mr. Gunning said: "In intensive care patients are often admitted suddenly and the families have to comes to terms very quickly with the fact that someone may not survive. It is very important in this situation that we have their trust, that we are doing is going to be in the best interests of that patient."

Whilst Gunning strongly supports the principle of organ donation, he believes the consideration of presumed consent is premature.

"The trouble is we live in a society where people are very much worried about the interference of the state. I think you would find that families would view this as taking the organs - and that would create a tension."

The statistics are that about one third of patients who enter intensive care don’t make it to the exit door, dying before they can leave. The generally accepted argument goes that their deaths have the potential to benefit patients on the transplant waiting list.

Personally, however hard I try to reconcile my instincts to do good with my reluctance to donate my organs I can’t get over my reticence. I shall be one of those people, if this new law is successfully launched, to carry a card saying leave my body alone.

My reasons are primal; I want to go out of the world just as I came into it, with nothing, not less than nothing. In light of this decision I have been trying my best to wear everything out in my body so no one would possibly want anything I’ve got and that way we’ll all be fine with my decision.

However, I’m already worried that one day, as I’m lying there dying, some medic will look at my anti donor card and, out of spite, because we don’t agree politically; will let me die. I do empathize with the well-intentioned motives behind this proposal but not the coercion implicit in the way our nanny state seeks to impose their moral perception on us all. No one voted to give them that right.

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