New system needed for organ donations

April 7, 2006

URGENT action is needed to ensure that as many organs as possible are available for transplant so that life-saving operations can take place.

“It is not automatically assumed that everyone wants to be a donor after his or her death,” says Deputy Brian O’Shea.

“Irish residents have to make their wishes known by telling their family or carrying a donor card. We do not have a central register. Signing an organ donor card indicates your willingness to have your organs used for a transplant but it does not necessarily mean that they will be used.

“The law is not clear, but it seems that your next-of-kin are not bound to abide by your wishes. In some cases, the medical team may request the next-of-kin to donate the organs of a deceased person. There is no law dealing with the issue of consent and in practice, the consent of the next of kin is accepted as valid and a refusal is not contested,” says Deputy O’Shea.

The current procedure of donation in Ireland is perceived by some as failing the needs of transplantation, says Deputy O’Shea. It requires the direct, expressed consent of the donor, and almost always, the donor’s family. Dissatisfaction with the current system stems from a progressive deepening of the tragic imbalance between the need for and the supply of organs.

Deputy O’Shea recently asked the Minister for Health, An T·naiste Mary Harney TD, in the Dail what proposals she has to meet the concerns outlined to him by a young transplant patient.

An Tanaiste said the annual organ donor awareness campaign organised by the Irish Donor Network and administered by the Irish Kidney Association highlights the necessity for organ donation generally.

“There are two systems that can be used to ascertain an individual’s wishes on organ donation: the opt-in system and the opt-out system,” she said. “The opt-in system, which operates in this country requires that the specific consent to donation of each person or their relatives be obtained before organs or tissues are removed. The optout system presumes that all citizens consent to donation unless they have specifically expressed a wish to the contrary.

“The practice in this country is that even when a person has indicated his or her willingness to donate organs by way of carrying an organ donor card or a driving licence marked accordingly, the consent of the next of kin is always sought.

“Even where opt-out systems are in operation, the relatives of the deceased are approached as part of the donor screening process to seek a medical history of any high risk behaviour. Thus the relatives will always be aware that a donation is being considered and can register an objection to the donation.

“The European Commission is currently considering the question of a Directive in respect of organ transplantation, including the issue of consent, and proposes to conduct a thorough scientific evaluation of the situation. It will present a report on its analysis to the Council of the European Union and it is expected that this report will inform decisions regarding the development of a legislative framework in this area.

“In the context of increasing the number of donor organs available for transplant, the Health Services Executive has been asked by the Department to undertake a review and analysis of the factors that impact on organ procurement and retrieval rates in hospitals around the country,” said An T·naiste.

Copyright © 2006 Waterford News & Star.

This article posted May 6, 2006.