The reluctant donors

08 May 2008

Helen Stewart is an exceptional woman. Literally. She's the exception to the rule that New Zealanders don't donate their loved one's organs.

New Zealand's organ donation rates are among the lowest in the western world. In the last international comparison, in 2006, Spain had 33.8 donors per million people. The United States had 26.9 donors. Britain had 10.5, Australia 9.8. And New Zealand had six donors per million people.

That was a particularly quiet year for Organ Donation New Zealand, with just 25 people donating their organs. Last year the number rose to 38 people, which still leaves New Zealand near the bottom of the international statistics and doesn't give a lot of hope to the 580-odd people languishing on transplant waiting lists. Most - about 530 - were waiting for a kidney, which can come from a live donor. It's sobering that last year just 68 single kidneys were donated.

Even those at the top of each list can't rely on getting the first organ that becomes available - organs have to be compatible with their blood and tissue types and, in some cases, their height and weight.

Little research has been done on the reasons for our low rates and ODNZ doesn't have data on how many potential donors we have in New Zealand each year, though it has just started a project - the first of its kind in the world - that will collect such information from intensive care units.

Some of those reasons are good things - ODNZ team leader Janice Langlands says we've become far less likely to die in road crashes, our treatment of brain injuries has improved and our hospitals take a gentle approach with grieving families.

Some other countries take a far more persistent approach, asking families several times even if they've alerady said no. "We wouldn't want that to happen in New Zealand," she says.

But it's probably fair to say that when it comes to the subject of sudden death and organ donation, we are a reticent and squeamish lot.

Just under half of New Zealanders with driver's licences have the word "donor" printed on them - but that's not an official consent, it's just an indication of their wishes. The decision still rests wholly with the next of kin.

Helen Stewart thinks everyone should discuss the possibility of organ donation with their families and says there's no ghoulishness about it.

"People close to me who were involved in the whole process with Rob, people who had been staunchly, 'Oooh, no, you're not cutting me up when I die,' have changed their minds.

"It's an awful time. You've just been told the person you love is going to die and there's nothing you can do about it. For some people I expect being asked for the organs at that time must feel intrusive. It must be something that people have a lot of trouble dealing with. In reality, the process is very, very dignified." Organ Donation New Zealand stresses that the organ donation process is anonymous and recipients are not put directly in touch with donor's families, though the families are kept informed about how the recipients are getting on and the recipients can then write letters of thanks.

Bronwyn Sell. Canvas Magazine, Weekend Herald. May 3 2008