OPINION

Will organ donation ever be the norm?

26 May, 2011 | By Nadine Woogara

What will help organ donation become a routine, accepted feature of palliative care?

Why isn’t organ donation more talked about? It’s huge. It saves lives. But it’s still awkward. Like the child at the school disco who’d rather sit on their hands than dance.

At the moment of someone’s death it seems like talk of organ donation can all too easily become the elephant in the room. Something invasive and painful that’s hard to bring up when relatives are in the shock that can follow a death.

But Fiona Murphy, clinical lead for bereavement and donation at the Royal Bolton Hospital NHS Foundation Trust, spoke at this month’s Patient Safety Congress and proved that donation doesn’t have to be a painful experience. She says she has normalised organ donation as a part of end-of-life care giving. And thinks it crazy that other hospitals haven’t done the same.

When Fiona was given the job of increasing solid organ donations at Bolton Hospital she decided to make it into something big. By linking together the bereavement and organ donation services she was determined to provide equal support for all relatives, regardless of whether or not they had decided to donate their loved one’s organs.

All families were to be offered support and everyone was to be involved in creating a uniform bereavement care bundle. Even the porters were involved in how to deliver dignified care, as they were the ones who transported the bodies, and had insight into grieving when they found family members crying in the corridors.

According to the NHSBT, more than 10,000 people in the UK currently need a transplant. And of these, 1000 will die each year as there are not enough organs available. So what needs to change? How can organ donation become the norm? What has to happen at your hospital to make it possible?

Readers' comments (10)

Anonymous | 27-May-2011 9:17 am
privitising organ donation might help
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mike | 30-May-2011 6:59 pm
"She says she has normalised organ donation as a part of end-of-life care giving. And thinks it crazy that other hospitals haven’t done the same"

I find this attitude quite scary. For those who agree with organ donation, then this may be an acceptable stance to take. But you have to remember that there are many, many people who will never agree with organ donation for whatever reason, religious, social, personal, whatever, it doesn't matter; it is wrong to assume that it is simply a matter of 'convincing' them in the right way.

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Anonymous | 31-May-2011 6:38 pm
I think thats the point !
Its not about convincing anyone or assuming its about giving everyone a choice and then giving them support even if they don't want or agree with donation.
At the moment its only families that say yes to donation that get any aftercare.

Its about normalising donation and allowing the bereaved make the choice on behalf of their relative.
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Anonymous | 31-May-2011 10:57 pm
There's a huge difference between talking about the possibility of donation of an organ and 'normalising organ donation'.
'organ donation doesn't have to be a painful experience', I find not just scary but shocking. Calling organ donation the elephant in the room is not what makes me uncomfortable.
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mike | 1-Jun-2011 2:06 am
Anonymous | 31-May-2011 6:38 pm no it isn't. The attitude displayed here is typical of the 'donation drive', trying to convince people it is 'normal', it is 'not painful'. It shouldn't be about that at all.

Don't get me wrong, the aftercare for bereaved is essential, wether their relatives donate or not. THAT I agree with. However, this article, and Fiona Murphy display attitudes that go far beyond that.

If people want to donate, then wonderful. If they do not - for whatever reason - then that should be absolutely respected.

Not donating is as valid a choice as donating. Yet there seems to be an attitude of 'donation is necessary and right, how should we pursuade people, how does it become normalised so everyone does it?' There should be no pursasion. There should be no attitude of 'So what needs to change? How can organ donation become the norm? What has to happen at your hospital to make it possible?'

Very very unsettling.

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nadine woogara | 1-Jun-2011 10:03 am
Hi there

Thanks for your comments. Thought I should post to say that I completely agree that not donating is as valid a choice as donating, as was very clear from Fiona Murphy's talk. She spoke about providing equal care to everyone.

I can see that my questions at the end of this piece could have been taken as contrary to this, however this wasn't my objective.

Thanks for the debate!
Nadine
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Anonymous | 1-Jun-2011 10:31 am
it is and should remain a free choice without coercion and without stigma.

a donation is a gift which individuals should be free to offer.

in some countries in Europe they are trying to make it an opt out policy rather than opt in. which means that all those who do not wish to donate their organs would have to carry a card to this effect.

we need some freedom and liberty in our lives with the right to personal choice according to our own beliefs and values.
it could be highly stressful to some to always carry such a card and then there is the risk that it might not be found.

if we chose to carry a card saying we wish to donate organs this is an entirely different matter.
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mike | 1-Jun-2011 5:28 pm
Thanks for clarifying Nadine and apologies if I misinterpreted your words.

Anonymous | 1-Jun-2011 10:31 am I absolutely agree. I remember the government tried to bring that in in this country not so long ago and were almost unanimously voted against. The whole idea of it was scary to its very core and typical of the attitudes of many people at the time and now that I was talking about in previous comments.

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Anonymous | 1-Jun-2011 6:09 pm
From Anonymous | 1-Jun-2011 10:31 am

Mike, I agree with all your comments here too. The country I was referring to is Switzerland but I do not think this will be acceptable to the Sovreign citizens who have the right to vote on such issues either.
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Anonymous | 4-Jun-2011 12:12 pm
This is the debate thats needed!
Mike you are so right choice is paramount to all, it must be free choice with the patient at the heart of all that we do and follow up for everyone thats wants it following the death of a relative or friend. No cohersion but we should ask every time esuring that our wishes are met, Tissue donation is just as valuble and rarely do we ask- we should in the same way that we should offer religious support its all part of bereavement care and our duty of care as professionals. We should never assume but give families the choices available and help facilitate the decisions that they make their grief journey more bearable. If we don't ask we are making these choices on their behalf and I believe that is wrong.
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