New Zealand has one of the lowest rates of organ donation in the developed world. Photo / Thinkstock
New Zealand has one of the lowest rates of organ donation in the developed world. Photo / Thinkstock

About half of us are carrying a driver's licence that says we are a "donor". It means that if we die we have given permission for our organs to be taken for a transplant to someone needing a healthy replacement. It was a big decision, even if the licence was issued long ago and we have not given it much thought since.

It is a brave person who does not pause before ticking the box to be a donor. It takes a moment to remind yourself that if ever the situation arose, you would be past caring. And another moment to imagine your heart perhaps giving somebody a new lease on life. Somebody such as David Rasmussen, who is featured in theHerald on Sunday today. Over the next few weeks we will be looking at donors' decisions, what happens thereafter and the waiting lists for more donors.

Although as many as half the drivers in New Zealand have stated their willingness to donate organs, we have one of the lowest rates of actual organ donation in the developed world.

The obvious reason that so few willing donors become actual donors is that the decision cannot be made until the donor has been declared brain dead in a hospital intensive care unit. At that point the donor's family are given the right to decide. They need to decide quickly while the organs are still useful and in their grief and stress the idea of allowing tissue to be taken from their loved one's body must be often too hard.Our rate is half that of Australia's. Something in our system is not working.

A government review into our low donation rate is under way. Its terms of reference have yet to be finalised but it seems unlikely to question our physicians' wish to let families have the final decision. Those running the system, Organ Donation NZ, do not question this policy. In fact they suggest we rank low on donation rates because some countries have ethically questionable methods.

Their solution, and it seems the right one, is to ensure that every family that has to make the decision does so after a discussion with a health professional who is skilled in explaining the possibilities with compassion and respect for their ordeal.

But there is possibly more that we could do, as donors and families of donors, long before the possibility arises. If we mean what we have said on the driving licence we should let our nearest and dearest know we mean it. We can leave them in no doubt that we would like our organs to provide or improve life for another person.

We hope our stories today and in the coming weeks can prompt that discussion. If your decision is more than a word on the driving licence, tell those close to you. Tell them you mean it. You could save a life.

Herald on Sunday