English: Dr. Ehtuish Preforming An Organ Transplant. (Photo credit: Wikipedia)
The Organ Transplant Authority is consulting over proposals to give priority on transplant waiting lists to those who are already on the Organ Donor Register, in addition to removing the rights of grieving families to overrule the wishes of deceased relatives who were on the Register. This comes just days after the devolved Welsh Assembly legislated to introduce opt-out donation instead of the existing opt in system. Though I agree with an opt-out system in principle, I have said before in a letter published in The Independent that if introduced too soon, it may actually reduce organ donation rates. So, what should we make of the changes proposed in England?
Israel and Singapore both introduced a ‘donors first’ transplant policy and benefited from spectacular results. Not only did it dramatically increase donation rates and slash waiting times for donors, but it slightly reduced non-donor waiting times as well. The scandal of people dying whilst waiting for a kidney could become virtually a thing of the past. However, this undoubtedly poses an ethical dilemma. Surely transplantation should be on the basis of need and the basis of need alone. Any outside factor, such as ability to pay, contributions made by the patient to society and their age, for example, it is argued, should not be relevant. On the face of it, this is a powerful argument.
Nevertheless, I find it difficult to justify a claim that somebody who isn’t willing do donate their organs should they die should not only expect others to make that ‘sacrifice’, but also be treated with complete equality compared to others who are willing to donate too. A crude metaphor would be that the person who refuses to pay the fees of a lottery syndicate insists on an equal slice of the winnings. I simply don’t understand the standpoint of those who cite religious or moral objections to organ donation but don’t seem to mind receiving organs when their life is at risk. That may be a tenable position, but to date nobody has explained to me how it is.
The only argument against a donors first policy that carries any weight in my eyes is that is effectively blackmails people into becoming organ donors. I agree that pressurising people into making decisions that they are uncomfortable with in relation to their body is unacceptable. We should work towards a time in which everybody feels comfortable in taking a logical and scientific approach towards organ donation. In my opinion, it would be a terrible thing if I were to deny lifesaving treatment to someone because I am emotionally attached to the idea of burying some cells that I once used rather than giving them to people who needs them. But that is my personal opinion: it would be dreadful to impose that view on somebody else.
If we intend to proceed with donors first, we must be certain that we are not threatening people’s free choice.
