THE ROW:

Bill uses ‘opt-out’ principle

Organs should automatically be donated for transplant when people die unless they have specifically requested otherwise, said the independent senator Feargal Quinn.

Quinn introduced a bill to this effect in the Seanad last week. Under his proposed opt-out system Irish people would have to state that they do not want their organs used for transplants. Under the prevailing opt-in principle, people give their consent for organ donation by carrying a donor card. Quinn argues that the move would overcome the reluctance of many hospitals to ask for donations after bereavement. The bill was not voted on last week because the Seanad ran out of time. The government is drafting its own proposals for publication next year.

THE ISSUE:

Hundreds are on waiting lists

New legislation over organ removal and retention was recommended after an inquiry by Dr Deirdre Madden two years ago. The inquiry was ordered after the pituitary glands of 14,000 dead children were removed in Irish hospitals between 1976 and 1998 without the consent of their parents.

There is a clear need to improve donation rates because 600 patients, many with life-shortening conditions, are currently waiting for new kidneys, hearts or other organs. The waiting list is currently 18 months, and about one in three cystic fibrosis sufferers awaiting a lung transplant will die before a donor becomes available. But there is disagreement over how organ donation should be regulated.

THE REAL ISSUE:

We don’t talk about our wishes enough

While Irish rates of organ donation are relatively high compared with some European countries, they need to double if hospitals are to meet demand. One in four Irish people carries an organ donor card, although 67% say they are willing to donate their organs, a recent EU survey found. Most Irish households do not know what family members would like to happen to their organs when they die, because just 40% discuss it.

These figures suggest that the current “opt-in” system is not working.

An international study in 2006 found that presumed consent can lead to an increase in organ supply of between 25% and 30%. This system operates in Austria, France and Spain.

THE BIGGER PICTURE:

Donor co-ordinators do the trick

Proponents of the opt-out system emphasise that families of potential donors can still veto donations even when their relative has opted to donate organs.

But presumed consent is still viewed as a radical measure in Ireland, perhaps for religious reasons.

In the end, changing the law may not matter that much. Mark Murphy, chief executive of the Irish Kidney Association (IKA), says high rates of organ donation in Spain and other countries that operate the opt-out system are more attributable to recruitment of donor co-ordinators who seek out potential donors in hospitals and are trained to discuss the possibly of organ donation with grieving families.

Times Recommends

• Congo's rangers risk their lives to guard gorillas
• Pearl farming in China losing its lustre
• Axl Rose mystery as album arrives at last