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Opinion: Brian Belle-Fortune

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‘It is time to change our organ donation system’

'PM to change organ donation rules,’ says the headline. You don’t read headlines like that every day.

It appears this change of heart, excuse the pun, stems from the findings of a government taskforce headed by chief medical officer Sir Liam Donaldson.

The UK has one of the lowest donation and transplantation rates in the world. Each year 9,000 people with life-limiting conditions wait for organs. Yet only just over a third are recipients of those life-enhancing operations. Some people are forced to fly abroad for surgery. And others don’t even make it on to the list.

At the root of the problem is our system, which requires the UK population to opt into donating their organs at the time of death, rather than taking steps to opt out. The result is a landfill of organs that are buried or burnt. Spain is ahead of us on the transplant league table. Although one reason Spain has a more advanced system may be down to the fact that it has a higher automobile accident rate than the UK.

One can understand and respect the fact that some may have religious objections or ‘yuck-factor’ reservations. But I also feel there isn’t sufficient public understanding around the physiological cul-de-sac that is brain-stem death. Others find difficulties with the whole notion of presumed consent, encapsulated by a system in which one must actively opt out.

It raises the question – who owns a body and its parts? There is the argument that assuming presumed consent as a default position doesn’t consider those who just didn’t get around to objecting. In spite of these doubts, polls indicate that 90% of people in the UK agree with Gordon Brown and his government taskforce. We cherish the ideal of a free NHS so, surely, there is a morality in accepting that if we’re not prepared to give, we don’t have the right to receive? An inclusive system would be a hugely positive step for the NHS.

Three people a day die while waiting for organs. There’s a temptation to see all these figures as meaningless statistics unless you’re at the frontline as a nurse. Or beyond the frontline as was my brother, who died waiting for a heart that never appeared.

I was a proud card-carrying organ donation candidate until I found out that having multiple sclerosis excluded me from that option. I’m gutted. My body’s for compost. But I still believe, after my younger brother died before me, that it’s time for a change. And the time starts now.

Brian Belle-Fortune is a student practice facilitator at Great Ormond Street Hospital

NEXT WEEK: Linda Nazarko on nurses’ ignorance of how illness affects older people

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