Media Not Much Help on Organ Donation

The media are everywhere: infiltrating our minds, our views and our morals. Whenever we want to decide on something, we look to the media, and that's where we go wrong.

This was brought home to me lately when I attempted to find out where I stand on organ donation. I had to do some serious digging and brought to light a number of ideas that are popularly held in the media that are incorrect.

Many of us in Year 11 and up will be sitting our driver's licences. When we fill out our licence application form we will be asked if we are willing to become an organ donor in the event of our death.

The New Zealand Transport Agency can not actually issue our licence until we have ticked either "yes" or "no". However, if we tick "yes" and agree to become a donor, what we are not told is that our decision is not legally binding. In the event of your death, your family will be asked for their agreement to allow the organ donation to go ahead.

In New Zealand, of about 1.1 million licensed drivers, 42.3 per cent have agreed to become donors. Last year 21,190 New Zealanders died, but only 31 people donated their organs. Over the past decade in New Zealand our organ donation rate has ranged from six to 10 donors a million. While this is comparable to countries such as the UK and Australia, these rates are pitiful when compared with Spain, which has four times the organ donation rate.

So the question has to be asked, why is our donor rate so low?

The popular press suggests this is because relatives are overriding the deceased's wishes. In 2006 a National Party MP proposed the establishment of a legally binding donor register in response to the mistaken belief that New Zealand's deplorably low donor rate was due to families overriding the deceased's wishes.

In some cases - for cultural reasons, for instance - families do intervene, but only about 1 per cent of the time. So the media are partly right. About 30 per cent choose not to donate their organs after brain death, for many reasons other than cultural and religious beliefs.

However, the real issue is that as the road toll drops and medical procedures improve, fewer people are dying in circumstances where organ donation can take place. The implications of this are serious.

In Spain and America, where donation rates are higher than New Zealand, the ethics of organ donation are somewhat different from here. In Spain you can expect to be harangued until you say yes; in the US, moral blackmail - mothers of children who once donated might pay a visit to help you make a decision - isn't unheard of. The New Zealand approach is that people have a right to make an informed decision that is then respected.

As for donor registers, they are considered to have the potential to lower the organ donation rate. That's because families often only gain access to truthful and relevant information about organ donation when a doctor informs them that their family member is brain-dead, and discusses organ donation with the family. Once families know the facts, organ donation often makes sense to them.

If we had a donor registry, however, the families would not be able to donate, as it would be "illegal" to over-ride the deceased's wishes. If we had a legally binding donor registry, the likelihood is we would have an even lower donor rate than we do now.

There is also the fact that overseas studies of organ donation show donor registers have failed to enlist more than 20 per cent of the population. So donor registers are an utter no-go.

Is New Zealand just too morally and ethically righteous? And if so, isn't that a good thing?

Well, it might be, but it means that "there never is, never has been...(and) never will be enough organ donors for transplantation needs", says Dr Stephen Streat, clinical director of Organ Donation New Zealand.

The worse news is that we can't even help. Often, after a relative's "brain death", families are asked to donate that person's organs.

Commonly it is the first time that the family has been exposed to real information about donation and, although the dead relative may have said no on their driver's licence, the family choose to donate their relative's organs anyhow, because they believe their relation would have chosen to donate if they'd known what the family now knows.

So what to do? Dr Streat says it's hard to pick what trends will develop in the future because there are "too many variables outside our control changing all the time...."

He is travelling to a conference in Australia later this year to discuss with colleagues the use of pigs' organs. Also up for discussion is progress with stem cell research, that may soon allow us to grow someone a new organ and give them a new life.

But for now the best that can be done is "to maintain that level of 40-plus donors for a few more years," he says.

For that reason, say yes on your driver licence. It may not help, but it shows your support for the cause and gives some hope for the future.

Clare Hood, Year 11 St Cuthbert's College New Zealand Herald - College Herald