The gift of an organ to a patient who is in desperate need can be life-saving. A single individual can, after their death, donate their organs to save the lives and sight of up to 7 different people. Many people in the UK are waiting for organs to be donated and, every day, three people (1000 people per year) die waiting. Whilst the majority of people in the UK would accept an organ for themselves or their children to save their lives, only 29% are actually on the organ donor list.
As well as joining the donor list http://www.uktransplant.org.uk/ukt/Consent.do), it is also important to make sure that your immediate family know that you want to be a donor. This means that, if they are asked about your wishes, they can consent to the use of your organs for donation, quickly and without any guilt, confident that this is what you would have wanted.
Recently, I asked some of my non-medical friends if they were organ donors and was surprised that that very few of them are. These are some of the reasons that they gave for their decisions and my answers to them.
1. Haven’t people woken up from severe brain injury years afterwards? I am worried that if I am a donor I will be declared ‘dead’ even though I may still have a chance of recovery.
Organs are only taken from patients that are on life support machines in Intensive Care and are declared ‘brain dead” or from patients who have died but whose organs can be removed very quickly (within minutes) after their death (realistically this is only possible if patients die in hospital, usually on an intensive care unit). It is true that some patients with severe brain injury may recover up to years later, but these patients are not ‘brain dead’, they may have wide spread brain injury or be in a ‘persistent vegetative state’, but organs would not be taken from these patients as they are not dead. Brain death is a definite diagnosis that requires a complex series of tests 24 hours apart supervised by at least two experienced, senior and independent doctors registered with the UK General Medical Council. These tests show that there is no viable brain function, the brain will not recover and the lungs and heart can not function at all without life support machines in the Intensive Care Unit.
2. My sister had a terminal disease and was allowed to die at home, her body stayed with us for a couple of days. If she had been an organ donor, this would not have been possible.
In fact, the only people that can donate organs at the moment are those that are on life support machines on the Intensive care unit who are then shown to be ‘brain dead’ or those that die in hospital whose organs can be removed safely within minutes of their deaths. Patients with terminal disease are not suitable as organ donors for many other reasons so this would not have interfered with a conscious patient’s last days with her family.
3. I am worried that, if the doctors know that I am an organ donor, they will not try to keep me alive.
Every doctors’ primary responsibility is to their patients. No doctor would risk your life in the chance that you might save someone else by organ donation. The only way that you can become an organ donor is if you are declared ‘brain-dead’ by two independent doctors using specific tests, or in rare cases if you have already died and your own blood circulation has stopped, but your organs can be taken from your body very quickly, within minutes and kept cool on ice. The UK Donor Ethics Committee meets several times a year to consider ethical issues related to organ donation; they are very conscious that nothing should be done to a patient that is not in their best interests, particularly if they are on the organ donor register.
4. I am too old to be a donor, no-one would want my organs?
There is no upper or lower age limit for joining the register. Even if you are well into your 60s, some of your organs may be useful to someone. Some individuals may be chronologically old, but with hearts as good as a much younger person. It is best to be on the register and let the doctors decide if they want your organs or not than to use this as an excuse!!