Otago Daily Times - 7 May 04

JONAH LOMU's renal failure, a cruel blow to an extraordinary sportsman in his prime, might yet prove a blessing to hundreds of other stricken New Zea1anders. His high-profile wait for a kidney should show just how abysmal donation rates are in New Zealand, in fact one of the lowest in the developed world. Lomu's illness will help prompt awareness and action to improve this appalling record, especially among Pacific Islanders and those of Maori descent.

The Government is at present consulting over planned changes to the law relating to the storage and use of body parts and human tissue, including organ donation for which five options are being considered. One of the review meetings was held in Dunedin at the end of last month and the Government aims to have a Bill introduced to Parliament by December. One option - as distinct from the current driver's licence system where ticking the donation box makes little actual difference because family consent is still needed - is that of "presumed consent." Organs would automatically be available unless a person had officially registered an objection. While there are important details to be worked through, and family veto might still be possible, such an approach is long overdue.

The best those who have died and their family can do, even amidst devastating grief, is to give to the living, to help others even outside the family circle. As a society, we have become so sensitive to individual hurt feelings and delicate personal issues that we are willing to let such responses override the broader good of saving lives and the prevention of misery in the community. It is time for a change in attitudes, or put another way, a Change in culture. Family and parental consent is overrated in such cases. As individuals and as a society, our duty to each other means the practical gift of body organs should be avai1able, whenever possible. The dead person is not complaining and there are plenty of potential recipients - about 350 at last count-  dying for help.

Donor rates since 1993 have fluctuated between a minuscule 34 and 46 a year, and those among "Maori" and Pacific Islanders are worse. Of 389 dead donors in the past decade, only four were Pacific Islanders and 13 Maori. Ethnicity can be important because of differing tissue types but making matters more acute is the fact Maori and Pacific Islanders are more likely to need organ transplants, for a disproportionate number suffer renal disease and need dialysis. Yet Maori at a hui in Rotorua last week were reportedly unimpressed with the presumed consent option because they felt it would not be right to make a universal presumption on such a sensitive subject. And a Tainui tribe expert has said many Maori are strictly opposed to organ donation, although he acknowledged opinions can alter, as they had over Maori blood donation.

So they should - and quickly. Cultural attitudes and protocols develop to meet particular needs in particular places and times. They can and do change and should do so right across New Zealand society. It needs urgently to become the accepted norm that the organs of the dead are presumed to be available to help the living. Lomu has put a face on the need for organ transplants. Everyone else should now recognise that a substantial increase in organ donations is necessary, and the government should lead opinion with strong legislation that will robustly lead to a much needed boost in donation rates.