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Editorial: The long road to persuade more people to donate organs

Stuff - 25 January 2017


Wellingtonian Michael Boyes died suddenly at 25 and gave organs to seven people.

Wellingtonian Michael Boyes died suddenly at 25 and gave organs to seven people.

The rise in organ donations is good news. There were 61 deceased organ donors last year, a big leap from 36 three years earlier. This means saved lives and a reprieve for desperately sick people who live on a medical version of death row.

And yet the good news also shows how much further we have to go. New Zealand's organ donation rates have traditionally been middling-to-poor. For most of the last 20 years or so our deceased organ donation rate has averaged about 10 per million population. In Britain it is now about double that.

Australia used to have a similar rate to New Zealand's, but in the mid-2000s Australia began a major series of reforms. By 2015 its donation rate had climbed to over 18 per million. And across the wealthy developed nations New Zealand and Australia are nowhere near the world leaders Spain, with about 36 donors per million.

New Zealand has begun the process of change, and this has helped lift the donation rate in the last three years. Still we are well behind, and much more needs to be done.

A major review of the system last year suggested a much more systematic approach, with one body responsible for increasing organ donations and with more training of doctors and nursing staff in intensive care and emergency departments.

This would clearly be a crucial part of any improvement in donor rates. Decisions about donations are often made in highly stressed family situations, and it is obvious that any approach to the families must be skilfully and tactfully done. Spain seems to have developed great expertise in this area, and Australia has increasingly done so.

The system is clearly inadequate in other ways as well. About half the country's drivers are by their own choice listed as "donor" on their driving licence, but medical staff often don't know the individual's status and, surprisingly, often don't inquire.

This has led some to suggest a much more rigorous and formal national donors' list, which may well have some merit. Some countries such as Wales have switched to an "opt-out" system which assumes that everyone is a donor unless they have specifically indicated that they are not.

This might seem a useful approach, but in practice all countries allow families to override the wishes of the dead person, even when the person has clearly signalled their wish to donate. This has led to the now widespread publicity campaign, in New Zealand and elsewhere, to persuade families to discuss the issue before they are faced with hard decisions in hospital rooms.

When families know that their relatives want to donate, they are much more likely to agree to it when doctors ask. The inspiring story of Wellingtonian Michael Boyes last year showed how powerful such an example could be. Boyes died suddenly at 25; as his sister Amy said, Michael believed that "if you weren't an organ donor, you were a terrible human being." His organs went to seven different people.

Boyes' message of altruism should inspire more to donate. A better trained, focussed and responsive medical system would help it to happen. Many more lives could be saved.

 - Stuff

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