UK moves closer to presumed consent for organ transplantation purposes

Every day people die unnecessary, preventable deaths because most of us are essentially lazy. Across the world we are suffering a serious shortage of organs available for transplantation purposes. This is not because there is a shortage of people dying premature deaths in car accidents and the like, but because these people have forgotten to sign the necessary forms permitting doctors to take their organs after they have died, in order to transplant them into people who are unable to survive without suitable transplant organs. Any survey that has ever been published on this issue shows time and again that many more people are prepared to donate their organs after their death in order to preserve a fellow human beings life. However, many of these very same people forget, don't know where or how to sign the necessary papers permitting them to become organ donors. The result is that their organs are inaccessible in case of their death, and the result is avoidable deaths of people in need of transplant organs.

Anglosaxon countries, traditionally preoccupied with individual rights and individual liberties have dragged their feet longest when it came to considering changes to this lamentable status quo. More community oriented societies such as France, Spain and Iran, have long implemented an op-out system whereby people who do not wish to see their organs removed for transplantation purposes after their death have to state explicitly that they do not want to see their organs utilized after their death to save others. The results have been astonishing, to say the least. Waiting lists are substantially shorter, and fewer lives are lost due to lack of transplant organs. For once, people's laziness to deal with this matter is deployed in favor of preserving lives instead of letting go of them.

The English Chief Medical Officer has started a campaign to change regulations in England toward such an opt-out system. Sir Liam Donaldson argues that some 1000 or more lives are lost each year in England alone, because people need to opt-in to be considered as organ donors after their deaths. Surely agreeing to an opt-out system is the least we can do to change the odds of survival for our fellow citizens in need of a transplant organ. Hundreds of lives could be saved by means of this change of policy. The health care system in the UK is a devolved one, so it is worth noting that the train has departed in a similar direction to the English in Scotland. In fact, the Scots have very much taken on the role of change agent in the UK in this context.

There can be no doubt that there is something distinctly uncomfortable about the idea that unless I object to someone taking something off (not to say, out of) me after my death, I am presumed to have consented. However, equally, one wonders what good reason anyone could have to deny in death someone else the gift of life? Surely it is only a small minority of people insisting to be buried with their whole set of organs included. Why should we as society not ask them to let us know that they wish to utilize their organs to feed worms in the cemetery instead of permitting another human being to continue to live? That the majority of people disagrees with the friends of cemetery worms, when asked, in survey after survey, gives us arguably some reason to presume consent.

Pro-life activists have already responded to this new 'threat' in their traditional disingenious ways. Here's a quote from lifenews.com: 'In what pro-life advocates see as a further scaling back of the respect government should have for patients and their right to life, British Prime Minister Gordon Brown has endorsed allowing hospitals to take organs from dead patients without their consent.' Patients' right to life is subverted by taking organs from DEAD people. Yeah, sure, the dead can't get up walking again after their liver is taken out to save someone else's life. Normally the dead would go straight from their hospital bed to soccer matches, or church or whatever else they fancy. But now that those nasty politicians propose to extract organs from dead people in order to save someone who is still alive, the dead people's participation in public life is seriously under threat. Thank goodness prolifers managed to alert us to this danger to the lives of dead people.

Canada would do well to follow the French, Spanish, and hopefully soon Scottish and English examples suit. That much is surely owed by society to those of its members dying preventable deaths due to a lack of transplant organs.

- post scriptum: a shortened version of this opinion appeared on Jan 17, 2008 in the OTTAWA CITIZEN, and the Windsor Star.

Kidney Transplant TV Show Is a Hoax

Nice story came via Associated Press last night. It's to do with a Dutch TV show (designed by the infamous Endemol production company (creator of Big Brother among other programmes). The idea was that several contestants in need of a donor organ would compete (on air) for the kidney of a dying woman. The winner would receive the kidney and thereby be spared infinite dialysis (and likely premature death). There has been a huge outcry over this internationally. - It turns out, the story (and show) was a hoax. Here's the AP item:

Saturday June 2, 2007 12:46 AM


By TOBY STERLING
Associated Press Writer

AMSTERDAM, Netherlands (AP) - A television show in which a woman would
donate a kidney to a contestants was revealed as a hoax Friday, with
presenters saying they were trying to pressure the government into reforming
organ donation laws.

Shortly before the controversial program was to air, Patrick Lodiers of the
``Big Donor Show'' said the woman was not actually dying of a brain tumor
and the entire exercise was intended to put pressure on the government and
raise awareness of the need for organs.

The three prospective recipients were real patients in need of transplants
and had been in on the hoax, the show said.

The program concept had received widespread criticism for being tasteless
and unethical.

But Lodiers said that it was ``reality that was shocking'' because around
200 people die annually in the Netherlands while waiting for a kidney, and
the average waiting time is more than four years. Under Dutch rules, donors
must be friends, or preferably, family of the recipient. Meeting on a TV
show wouldn't qualify.

``I thought it was brilliant, really,'' said Caroline Klingers, a kidney
patient who was watching the show at a kidney treatment center in Bussum,
Netherlands.

``I know these transplant doctors, and I thought they'll never go and
actually do it. But it's good for the publicity and there are no losers.''

During the show, 25 kidney patients were vetted by ``Lisa,'' and most were
quickly dismissed for being too old, too young, smokers, ex-smokers or
unemployed. Contestants gave moving pleas for why they should receive the
organ.

``It really hurt watching that,'' said Tim Duyst, whose wife is awaiting a
transplant and cannot work. ``You're dismissed in a wave of the hand.''

Viewers were called on to express an opinion or vote for their favorite
candidate by SMS text message for 47 cents.

The show was produced by Endemol, which created ``Big Brother'' in 1999.

The Royal Netherlands Medical Association, known by its Dutch acronym KNM,
had urged its members not to participate and questioned whether the program
might just be a publicity stunt.

``Given the large medical, psychological, and legal uncertainties around
this case, the KNMG considers the chance extremely small that it will ever
come to an organ transplant,'' it said.

All seven of the country's transplant centers had said they not cooperating
with the program, KNMG spokeswoman Saskia van der Ree.

Earlier in the week, the Cabinet declined suggestions from lawmakers to ban
the program, saying that would amount to censorship.

Why not sell your wife's kidney?

DIE WELT, a conservative German broadsheet, reports that a Pakistani national sold his wife's kidney so that he could pay for the purchase of a new tractor. His cunning plan (successfully executed, mind you) involved beating her to pulp in order to have a pretext for having her admitted into hospital. Once there she was quickly put to sleep by medical staff and the relevant organ extracted. Of course, she was the only one not knowing about this until a medical check-up some 18 months later revealed what had happened. Remarkably, relatives of the couple were in it as well as the medical staff.

So, while we go on about informed consent in biomedical research and health care practice... there's also the Pakistan version of the same.

Here's a pretty good documentary about organ sale in Pakistan.