Only once have I had to do this, but it’s one of those things I hope I will never have to do again.
My mouth was dry, my palms sweaty and my voice was tremulous — the only thing that kept me focused was the thought that things were so much worse for the family I was talking to.
I was in my first year of work as a doctor towards the end of my surgical training. That time was filled with frightening, uncomfortable experiences, but the prospect of this one was, in many ways, the worst.
A woman in her early 20s had been in a road accident where she had suffered multiple injuries. She had been rushed to theatre and in between assisting there, I spent time talking to the family as they waited for news.
The surgeons were unable to save her life and she died on the operating table. Ashen-faced, the consultant broke the news to the family. I sat with them for some time as they sobbed quietly.
When I emerged from the room, the consultant was standing outside. ‘I think it would be nice if it came from you,’ he said. I stared at him blankly. ‘What?’ I asked. ‘About organ donation,’ he replied. I swallowed hard.
At medical school, I’d done a course on how to broach difficult subjects with patients, but this was altogether different.
‘I’ll be in there with you,’ he said, trying to calm my nerves. ‘You lead the discussion though.’
I began to feel sick. I opened the door and sat down, convinced I was going to make things worse. ‘It’s what she would have wanted,’ the mother said before I’d even finished. The father nodded.
While I had imagined they might be angry with me for bringing up such a subject in their moment of grief, in fact, they seemed pleased.
‘She was always so generous,’ her father said, and it was this sentiment that came back to me this week when I read about the Scottish government’s plans to tackle the organ donor shortage.
In England and Scotland, organ donation is a gift. It relies on the generosity of one individual to another and the onus is on people to sign up as donors, or on families to decide once a person has died.
But this week, Aileen Campbell, the Scottish Public Health Minister, announced proposals to place everyone in Scotland on the organ donor register unless they opt out. This follows the example of Wales, which adopted an opt-out policy in 2015.
It seems likely England will soon follow suit. But is this ethical?
As someone who has watched patients die in the wait for an organ, I know the need to address the shortage. A few years ago, one of my own relatives died while waiting for a new kidney.
It’s estimated that one person a day dies while waiting, so it seems a dreadful waste that organs are buried or cremated when they could be used to transform someone else’s life.
The problem is that only about a third of the population is on the donor register, though polls indicate that as many as 90 percents wish to donate their organs after their death. The discrepancy is down to inertia as most people never get round to registering.
But the way to go about addressing this is not with government meddling. Presumed consent throws up ethical issues, and it makes me feel deeply uneasy. A donation is an altruistic act by an individual — how can a government make assumptions about someone’s wishes and generosity?
By all means, encourage people to register and try to tackle public apathy, but the Government is not mandated to pontificate on what I want done with my remains, or to guess that because I didn’t tick some box, I’m happy to be cut apart and divvied up when I die.
Such a scheme runs the risk of removing organs from those who did not want this to happen but who had not registered their objection, which would seriously damage public confidence.
I’m not saying people shouldn’t donate their organs, just that it shouldn’t be presumed they will.
Since the opt-out system was introduced in Wales, there’s been no increase in donations. This shows doctors are quite good at identifying potential donors and asking families about it.
The real issue is that 40 percent of families say no. This is the number we should be tackling, and it won’t be altered by presumed consent because even then the family has the ultimate veto.
We should be encouraging everyone to make their wishes known to their loved ones and emphasising what a wonderful gift organ donation is. I’m on the organ donor register and my family know that when I die, I’m more than happy for any part of my body to be used to help someone else.
It was a choice I made because my body belongs to me, not the state. Something the Government should remember.
© Daily Mail