By Alex Hale

“Every right implies a responsibility; Every opportunity, an obligation, Every possession, a duty”   John D. Rockefeller

Not everyone wants to donate their organs. Sadly, in our aging, obese, drug addicted nation, the demand for organs is on the rise. The keep our nation healthy. People seem happy enough with the default position: a full two thirds of people have decided not to opt-in to the register. What is less clear is whether this is laziness or an ethical position.

The organ donor register is a beautifully simple system. All you need to do is sign-up, select which organs you’re happy to donate when you die and then forget about it. But the signing up step seems to be a barrier as only a third of people in the UK have joined the list. Thousands of sick people are currently waiting desperately for the right organ which is so frustratingly hard to find. As I type, over 7,000 patients around the country are waiting for a donor organ and this number just isn’t going down.

20 million sounds like an ample amount of people to help save the lives of 7,000. That 20 million are the third of the UK that are on the organ donor register but it still isn’t enough, there are so many factors that get in the way of someone getting that life saving organ. The donor has to have healthy organs at the time of death, so this excludes the many that die from illness and whose organs aren’t healthy enough for transplant. There is also a chance that the recipient’s immune system could reject the new organ because it would recognize it as foreign, making them even sicker and ruining the new organ. The donor needs to have the same blood type as the recipient as well as similar cellular markers called major histocompatibility complexes, the more markers that are similar, the less likely rejection is. Sadly, finding an exact match is almost impossible so recipients usually need powerful drugs to suppress their immune systems after the operation.

Could fear, ignorance or misunderstanding be the reason that the medical community is in such dire need of new donors? One answer is the infamous opt-out system that’s been making the rounds in political, social and ethical discussion circles for years. Opt-out would mean you join the register automatically once you reach a certain age and then would have the option to unregister if you wanted to whenever you like. Wales has recently chosen the opt-out system and Austria has had the system for years. The result? Austria has eight times as many donors as neighboring Germany.

In general, one of the main contributors to organ donations comes from the unexpected death of healthy people, like in a car accident or extreme sports. Sadly, these sorts of deaths are associated with younger people but they often don’t end up being donors. They haven’t had thoughts of signing up yet and of course no one expects to die young. Under the opt-out system, the tragic death of one could help save the life of another.

What else could be done if the opt-out method is opposed? Economists have suggested that maybe a monetary incentive could be offered and the cost of this would be recovered by allowing so many more people to not depend on expense medical treatments. This however, could be seen as venturing into the unsavory world of organ sales and trafficking, a black market trade that has cost many people their lives around the world. A monetary incentive would also the raise the question of whether the kind people who have already joined the register would receive the compensation as well.

LifeSharers uses social incentives to encourage people to sign up to their private donor list; in return, donors are assured priority if they ever need an organ. This privatization is probably something the government would back as it would save them money but it suffers from several major drawbacks. If everyone signs up then they obviously can’t guarantee them first choice of organ when they need one, essentially invalidating the entire process. The small pool of donors that LifeSharers has also means that it would be much harder to find an organ that matches your immune system; if it’s hard to find a match with 20 million, imagine how hard it would be with much fewer.

Our aging, smoke and alcohol addicted, obese nation needs to make a decision soon on these issues. The health statistics that point to half the UK being obese by 2050 means a much higher number of people potentially needing heart and pancreas transplants. The ‘binge drinking society’ will be in need of liver transplants in a few years’ time and all those smokers are going to need new lungs. The list of people that need new organs will be never ending and ways to fix that are a different topic all together. The main concern is time, something everyone seems to be short of. How long can we let people wait for the organ that could change their life? Signing up today could mean the difference to someone’s life tomorrow.

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