For most Australians, it’s hard to imagine being in an intensive care unit waiting room confronted with the prospect of losing a loved one. For those who do find themselves in this situation, it’s a devastating, harrowing time.

SA nurse Lovely Victor, an intensive care nurse at Flinders Medical Centre, respected her parents' wishes and donated their organs after they died in a car crash. Photo: James Elsby

Imagine then, what you would say at this terrible juncture in your life if your loved one died and you were asked: “do you know if they wanted to be an organ and tissue donor?”  Do you know what your family and friends’ organ and tissue donation wishes are?

During this time of personal tragedy many say they simply don’t know. That’s not unique to the intensive care unit either, it’s reflected across our community. Forty per cent of Australians do not know their family’s donation wishes.

I’ve had these conversations with patients, and it can be really tough for those families that had not discussed with or known the donation wishes of the deceased. Many, in shock and grief, understandably can’t reach a decision. It can be too hard to comprehend or cope with at that time.

Not many people know that only 1-2% of people who die in hospital can ever become potential organ donors - you have to die in a very particular set of circumstances.  This means that it’s a precious few families who will ever be asked this question. Right now, of that small percentage, less than 60% of families will give permission for organ and tissue donation to proceed.

It’s no secret that in Australia we have had low rates of organ donation when compared with the rest of the western world. In the past, every state and territory had a different system, with different resources, different processes. These days, the sector is coordinated, nationally consistent and things are looking up.

Since a $151 million Federal Government national reform package was announced in 2008, donor numbers are on the rise. Earlier this week it was announced that so far this year 416 Australian lives have been saved or improved by donated organs from 141 deceased donors.  This represents the highest donation and transplantation outcomes for the same period since national records began. It’s a 19 per cent increase on the same period in 2010.

Last year Australia achieved an historic 309 deceased organ donations and 931 transplant recipients. The 2010 deceased organ donation rate represents a 51 per cent increase on the average of the nine years to 2008 and a 25 per cent increase on the 2009 outcome.

The sustained increase in organ donation in Australia is something that the families of organ and tissue donors should be proud of. It’s an extraordinary thing to see people think of helping others at the most difficult moment of their lives.

Whilst this improvement has been positive there is a very long road ahead. Some of you reading this might be wondering why Australia doesn’t introduce a presumed consent ‘opt out’ system, so I’ll contribute my thoughts on this now.

While some of the world’s best performing countries, like Spain, Belgium and other European countries do operate under an ‘opt out’ system, their success is not attributable to the ‘opt out’ model.  It has more to do with the many clinical systems and resources they have in place that ensure that every potential donor is identified and the family of the donor is given the opportunity in a supportive and caring environment to confirm that their loved one wanted to donate and that they support those wishes.

Whether a country operates an opt-out or an opt-in system, the consent of the family is always sought – just like in Australia.

It’s a debate that has raged for many years, and I believe Australia has done its homework and our efforts here are based on what has been shown to work overseas, rather than be distracted by side issues which don’t really make a difference. We believe we have found the right balance between individual and family rights and community need.

Right now there are 1602 Australians waiting for a transplant and to receive a new chance at life.

That’s why I’m urging Punch readers to go home today and tell the people they love their wishes regarding organ and tissue donation.  I’m not saying it’s the right decision for everyone. I always encourage people to do their research, find out more and make an informed decision.
 
To find out the facts and to have your questions about religion and the organ donation process answered, visit www.donatelife.gov.au

53 comments

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    • Septimus says:

      05:40am | 10/06/11

      It should be the opposite in this country.  Donation should be mandatory unless you hold a card saying you don’t want to donate.

    • Joan says:

      06:51am | 10/06/11

      Hands off my body. Chop , slice, dice and dish out a loved one by choice only.

    • Septimus says:

      07:09am | 10/06/11

      That would be the card saying you don’t want to donate…(rolls eyes, whistles)

    • acotrel says:

      07:58am | 10/06/11

      @ Septimus Donation of organs from lazy people should be compulsory?

    • Septimus says:

      08:39am | 10/06/11

      Well those organs have had less use acotrel!

    • Anne_N says:

      08:58am | 10/06/11

      “Donation should be mandatory” - isn’t that an oxymoron?

      A donation is a gift, something you give freely, for nothing more than warm fuzzy feelings of doing something altruistic.  That’s the only ‘payment’ for the original owner of the organs (and their family).  And that’s a good thing, I don’t really want to see organs being bought and sold.  If it is to become compulsory, how will it affect a donor’s feelings about the good thing they are made to now do?

      And you still have the obstacle of a very very small number of deaths being suitable for organ/tissue donation.

    • aliquis says:

      09:01am | 10/06/11

      Septimus, did you not just read what Dr O’Callaghan explained about opt-out systems? It doesn’t matter if organ donation is “mandatory”, the family’s consent will still be sought and and any objections will be respected - meaning that donation will not go ahead.

      The point is, go home and talk to your family. How hard is it? How many times do people have to see/hear the ads on TV telling you to do so before they will? Just one sentence “I want to be an organ donor” will stick in their minds, even if there is no lengthy discussion. You don’t even need to register if you’re that “lazy” as acotrel put it (and even if you are registered, your family can still override it and say no, so again, you need to talk to your family - very few families will override a wish that they knew a person had ).

    • Nick says:

      10:01am | 10/06/11

      Septimus, that’s immoral. Although I’m a donor myself and pretty pleased with myself because of it, and finding the decision relatively easy to make, religious beliefs often conflict with a person’s sense of objectiveness. I can fully understand, also, the people who want their bodies to remain their own.

    • Septimus says:

      10:09am | 10/06/11

      Anne N, Aliquis,

      The biggest issue is not enough donors are registered.  If you make everyone a participant unless they don’t want too, then the ones who don’t really care or are too lazy to sign up will be included.  The more ‘in’ the system, the more people live.

      That is the problem, people are too lazy to be involved.

      (I am registered, I carry my donation card in my wallet)

    • Septimus says:

      10:36am | 10/06/11

      Sigh!

      Let me get my big crayon out.

      Nick…people can opt out…most are indifferent…most don’t do anything about it because they don’t care to do the paperwork…the more you have in the system…the greater chance at life…since people can opt out…it’s hardly immoral and hardly different from the present system.

      Don’t make me draw you a picture.

    • Peter says:

      10:57am | 10/06/11

      Septimus I agree 100%. In this country you have to ‘opt out’ of receiving annoying telemarketing calls and ‘opt in’ to be an organ donor. This is arse about IMHO.

      Everyone who dies should be considered to be an organ donor unless they have chosen to ‘opt out’. Of course those who choose to ‘opt out’ should be excluded from ever receiving a donated organ should the need ever arise.

      The other thing that needs to be changed immediately is the next of kin having the right to overide a deceased persons wishes to be an organ donor.

    • aliquis says:

      12:11pm | 10/06/11

      Septimus, it doesn’t matter if you are registered or not, the final decision rests with your family and nothing will go ahead without their consent. That was the point I was trying to make - talk to your family. Regardless of whether the system is opt-in or opt-out, your FAMILY will have the ultimate responsibility of what happens to you.

    • Septimus says:

      12:37pm | 10/06/11

      Aliquis,

      You said it yourself ‘very few families will override a wish that they knew a person had’...the more in the system, the less likely a family are to rule against it.

    • RyaN says:

      01:22pm | 10/06/11

      @Septimus: if the government decided they own my body and made it an opt-out system, I would definitely no longer be a donor and I would take the time and effort to make sure that everyone I know does the same. How offensive that you think you can dictate that you have the right to take peoples organs without consent.

    • aliquis says:

      01:55pm | 10/06/11

      Septimus, I’m not discounting the value of registering as this does send the family a clear message. However, talking to one’s family is even more important than that - it saves the family having to be told at the time of a loved one’s death that they were a registered donor. If they know a person’s wishes beforehand as a result of a conversation, this is not new information and the decision is a lot easier for families to make at a very traumatic time.

      Registering to donate should ALWAYS be coupled with a family discussion. People should not assume that a registration guarantees that their organs, eyes and tissues will be donated. Again, this would be the case even in an opt-out system.

    • Septimus says:

      02:12pm | 10/06/11

      Yes RyaN, don’t save people’s lives, take them with you and burn them instead.

      “How offensive that you think you can dictate that you have the right to take peoples organs without consent.”

      It’s a suggestion, you wanker!

    • RyaN says:

      04:14pm | 10/06/11

      @Septimus: then keep your fascist suggestions where your filthy mouth should be, in the toilet.

    • Septimus says:

      05:25pm | 10/06/11

      RyaN

      Off your medication I see, if you can’t have an intellectual conversation without a ‘tanty’ don’t come here.  Now throw yourself on the floor, kick your feet and hold your breath.

    • RyaN says:

      09:11pm | 10/06/11

      @Septimus: sure mate, at least I am not on here with some classless comments acting like a fascist.

    • RyaN says:

      09:20pm | 10/06/11

      @Septimus: “It’s a suggestion, you wanker! ” intellectual indeed, you deserve ridicule since clearly intellectual seems difficult for you to grasp.

    • TC says:

      01:03am | 12/06/11

      No problem RyaN take your organs to the grave….I do hope that you stick to your morals and refuse any organs if you are in the unfortunate position of needing one yourself. 
      For me it should be an opt out system and those that are strongly against it have the right to say no…but they also forfiet their right to an organ if they need one…or at least be but at the bottom of the list.

    • Septimus says:

      09:20pm | 12/06/11

      I dumbed it down for you RyaN and yet you still struggle.

    • deb says:

      08:01am | 10/06/11

      My husband and I both told our doc to donate our organs.Do not resusitate,we dont want to be vegs on the system.
      If a body is brain dead,turn off life support! Harvest organs,simple as that.

    • Nick says:

      10:04am | 10/06/11

      I’d rather die than be irreparably mentally damaged. Or physically damaged. I couldn’t handle being not able to grasp the situation around me or to have full control of most of my body.

      Besides that, I’m curious about death. Sometimes i think i’m dying in my dreams, and i get this feeling which is not only acceptance and curiousness, but excitement. Certainly i don’t want to die and i’d fight tooth and nail for my life, but when the time comes, i’ll be going straight, without hesitation, into that light.

    • Stephy says:

      08:56am | 10/06/11

      Okay, I’m not too sure it’s possible to donate your loved ones organs after they’ve died without them having already signed up beforehand. My mum and I are going through the process now of trying to find out if it’s possible to donate my gran’s organs once she passes on as she’s had two major strokes and can’t speak, move or eat (well, she can just eat). She’s in no condition to sign the papers for organ donation but she’s expressed the wish to my mum before she had the stroke that she’d like to be a donor. She just never got the paperwork in. The nurse at her nursing home believes she can’t be a donor without it being all official. So if it’s true, why can we veto a loved ones wishes to donate their organs, but can’t offer them up if they haven’t applied after they’ve died?

    • aliquis says:

      03:26pm | 10/06/11

      She doesn’t need to be registered, if your mum is her next-of-kin and she gives her consent then that is fine, as long as your Gran never expressly objected to organ/tissue donation.

    • acotrel says:

      09:04am | 10/06/11

      I’m going to donate my brain when I die.  Tony Abbott is not going to get off so easy!

    • dovif says:

      09:18am | 10/06/11

      I agree you should donate your brain, perhap testing your brain will find a cure for the blindly supporting an corrupt, incompetant, lying government disease, that ALP supporters seems to have

    • Joan says:

      09:31am | 10/06/11

      Sure you got one Acotrel…. do you hear a rattle in your head when you shake it?

    • majority says:

      10:09am | 10/06/11

      @acotroll, great idea!! It could be used to operate a Walk-Don’t Walk pedestrian crossing.

    • Tom says:

      10:10am | 10/06/11

      @dovif, no way, the ALP will locate the “acetrol” virus and spray it over all capital cities to ensure that all Australia would be “blindly supporting a corrupt, incompetant, lying government disease, that ALP supporters seems to have.”

    • acotrel says:

      11:38am | 10/06/11

      Thanks for the laugh, you’ve brightened up my day.

    • AnthonyG says:

      11:01pm | 10/06/11

      Can you also donate a microscope so they can find it. ahahahahahahahha If Ikeep this up I’ll be nearly as good as Nossy

    • acotrel says:

      07:26am | 11/06/11

      @AnthonyG I really like the ‘microscope’ comment. Good work!

    • Richard says:

      10:58am | 10/06/11

      No one is touching my organs. Its so disgusting. Genetic engineering new organs that are a DNA match to the patient is the way of the future, not this macabre swipping and swapping of people’s organs. How sick is it for people on the transplant list to be sitting around hoping for other people to die so their organs can be harvested. Honestly, I thought we were more enlightened than this as a species.

      Death is not the end, it is merely process of transformation. When your time is up, when your organs give out, just let go gracefully. Don’t pathetically cling to life like an evil witch who has to suck the life out of others to stay alive.

    • Peter says:

      11:50am | 10/06/11

      Richard,

      I wonder if you’d be so flippant about “just let go gracefully” if it was your young child who was in desperate need of a donated organ.

    • Marnie says:

      12:58pm | 10/06/11

      Organ donation is a last resort for the very ill, and it happens to sometimes save people’s lives. I;m wondering…. Have you ever seen anyone you love suffer and wait hopelessly for a cure?

      Maybe you should go and talk to someone who was lucky enough to receive an organ and ask them how it felt to suck the life out of their donor. I’m sure they would be really happy to finally see the light.

    • Jordan Rastrick says:

      01:54pm | 10/06/11

      I’m sure Richard also eschews anti-biotics, surgery, sanitation, mechanized agriculture, running water, and all these other disgustingly unnatural means of life preservation that humans have developed over the years. When its a caveman’s time to die its a caveman’s time to die, even if he’s 30, right?

      Or maybe this is just another case of conflating a “that’s gross” reaction with “that’s immoral”? Which is normally just silly, but you start advocating other people should die to appease your squeamishness, it slips into more dangerous territory….

    • Jeremy says:

      03:04pm | 10/06/11

      “How sick is it” Richard, well to tell the truth the thought never entered my mind. I was sitting on the dialysis machine for 15 hours a week wasting my life at the age of 23, wishing I could have continued my studies at university. Wishing I could have been healthy enough to continue to play the sports I loved.

      Instead I had to deal with the one of the worst times of my life.  This only ended after some very generous family consented to donate their loved ones organs to help me, one of about ten people that could have received the “Gift of Life”  for that one donation.

      For that entire period not once did I sit there in the hospital thinking “wow that ambulance could be my ticket out of here”. Try going for a visit to your local diaylsis unit of your intensive care unit to see if those on the transplant are actually thinking of “organ harvesting”.

      And thanks Marnie

    • Richard says:

      07:14pm | 10/06/11

      Oooh you guys sure told me.

      Let me ask a question of you: yesterday I had a young guy in my clinic, only 20 years old, with terminal brain cancer. He is going to die, nothing can stop that now. While I was massaging his body, including his head, his skull misshappen and deformed by the disease, it was almost like I could feel the echo of all the emotions he had been through communicating through his muscles and sinews into my fingertips, and thence into my cognitive perception. For an entire long hour I shared with him at least some small part of his terrible plight. It was harrowing.

      Now my question is, if it was possible for him to receive a brain transplant, and thus cling to life, would you all agree that he should do it?

      I am going to suppose that you would say no, because without his brain, you would think there is no “self” to preserve, am I right? But the clincher is this:~ your “self” is not just your physical brain in isolation. Your “self” is in fact made up in totality of not just your brain, but also all of your organs as well.

      This may sound preposterous to you, so stuck are you all in your c1700’s Newtonian conceptions of mechanistic science. But my assertion is scientific fact, as proven by these studies: http://fohs.bgu.ac.il/develop/DB2/Heart memory/Pearsall, 2000.pdf and http://www.mindpowernews.com/OrganMemoryTransfer.htm among many others. I implore you to read them, they are quite fascinating. They show that tastes, personality attributes and even memories are altered after transplant, in a way analogous to the donor’s “self”. There is even a case were an 11 year old girl was raped and murdered, after which her kidney was transplanted to another girl, who then started having vivid nightmares about the attack, so realistic that she was able to provide an accurate enough drawing of the man to have him found, tried and convicted for the crime.

      This is no joke, it is science, and what it shows is that the human body is not just some machine that can have its own unique parts swipped and swapped with other unique human being’s body parts without consequence. It is macabre, and from my own personal spiritual perspective, highly immoral and inhibitive of the spiritual progress of the soul after death.

      It has nothing to do with me being squeamish, and if Jordan Rastrick had even read my first post he would have seen that I do not oppose the progress of medical science, in fact I look forward to the day that genetic engineering allows us to regenerate our own organs. But I just happen to think very deeply on these issues, and twist and turn them in my mind, instead of just accepting the conventional wisdom like the rest of you sheeple do.

    • Tc says:

      01:19am | 12/06/11

      Richard you may think deeply but that does not mean you are full of wisdom.  Nothing you have stated is fact, just theory.  I’m sure you’re young man really connected with you when you had a harrowing hour of massage, echos of his spent emotions…damn he must have felt bad for you.  Tell me, did you ask him to stop pathetically clinging to life when he had treatment, have you gone up to a mum and dad and called them pathetic for clinging to some hope for a terminal child or simply said…“don’t worry its merely a process of transformation….yes a painful, soul destroying one but chin up”.

    • Richard says:

      11:15am | 12/06/11

      Tc, you’re an insolent one aren’t you? I said that his terrible plight was harrowing (for him, obviously), of which I shared a small part of (its called empathy, ever heard of it?) with him during his massage session. You’re a real hater to try and turn this sad situation around into an attack on me. Or you just don’t like my flowery phraseology? Oh boo hoo.

      And its very nasty of you to suggest that I should have told him to stop “pathetically clinging to life”. He is going to die. Terminal brain cancer. You know what that means right? Its just a matter of time for him, not much longer either, unfortunately. If euthanasia was legal he might opt for that path, or maybe not, that’s up to him, none of my business.

      But he has come to terms with his mortality, at only 20 years old. And so must we all,eventually. Did you even read those studies I linked? I mean, you say they are theories, but then again so is gravity, so is evolution, so is climate change. All theories. So does that mean all those theories are invalid? Of course not.

    • Tc says:

      02:22pm | 12/06/11

      “Don’t pathetically cling to life like an evil witch who has to suck the life out of others to stay alive”  Is what I believe you stated and you claim I have no empathy.  I don’t really need to turn anything around as you are quite clear on your thoughts.  Perhaps that little phrase should be passed onto every person needing a transplant.  Yes I did read your articles (well 1 as the other wouldn’t open) and it was interesting and there might be something to it but to call it scientific fact and lord it over everyone due to 1 or 2 studies shows you have little knowledge of science and its methods (notice I have not said they are invalid just not fact, although some people do tend to grasp onto any theory that suits their purposes and consider it absolute truth).  And regarding the man with cancer, I wouldn’t dream of imagining what he has been through, my point was that I wondered whether you showed the sensitivity (or lack of) to him that you indicated in your initial post to those waiting for a transplant.

    • Jordan Rastrick says:

      11:01am | 10/06/11

      “While some of the world’s best performing countries, like Spain, Belgium and other European countries do operate under an ‘opt out’ system, their success is not attributable to the ‘opt out’ model.”

      Can the author or anyone else provide data to back this up?

      I was under the impression opt-out countries consistently and systemically outperform opt-in countries by a wide margin, and in fact far more of the difference in dontation rates between countries can be attributed to this than any other single factor. The behavioural economist Dan Ariely, for example, has cited European data on this issue in his talks about people often not having strongly fixed preferences.

      If its actually the case that an opt-out policy makes no difference, I’d like to see an argument backed by evidence rather than an assertion.

      I will admit to being troubled that the National Medical Director of the Organ and Tissue Authority seems to be blithely dismissing a measure that can apparently have a massive effect on donation rates and thus save many lives.

    • Anne_N says:

      02:24pm | 10/06/11

      Jordan,

      <<Some European countries with opt-out systems have higher donation rates than the UK. However there is no clear evidence that opt-out is the sole factor. The fact that Sweden has an opt-out law does not seem to influence the donation rate per million of population, which is lower than that of the UK…>>

      http://www.organdonation.nhs.uk/ukt/newsroom/statements_and_stances/statements/opt_in_or_out.jsp

      and

      <<At the San Carlos hospital the refusal rate for families last year was just 3%, a testament to the skill of the co-ordinators.

      It is not hard to see why this charismatic, persuasive surgeon is so successful in recruiting donors….

      Dr Rafael Matesanz has no doubt that it is the appointment of dedicated transplant co-ordinators already working as doctors in hospitals which has made the difference.

      “During the early 1990s we had a 30% refusal rate, at the moment it’s about 15%,” Dr Matesanz says.

      “Many countries try to increase organ donation through legislation. But a change to presumed consent doesn’t improve the donation rate”.

      http://news.bbc.co.uk/2/hi/health/7183798.stm

      and

      http://www.medscape.com/viewarticle/461787_3

    • Jordan Rastrick says:

      03:06pm | 10/06/11

      Thanks for the links Anne.

      I wish these sources and the ones espousing the other viewpoint both came with clearer references to studies and data on the issue; it now seems like there is pretty stark disagreement as to whether this policy makes a difference or not. It’d be worth comissioning more research to get a clearer answer, if the evidence is really that inconclusive.

      Unless it has close to zero or negative effect on donation rates, I still like the “Nudge” policy of a rather soft opt out - people signing up for ID have the “Yes, I’d like to donate” option as some sort of default on the forms, perhaps even with a brief compulsory section where people give a rationale for their decision, so that their thoughts are on the record for the benefit of their loved ones - and it is compatible with the Spanish model of having trained specialists talk to the families, which is both admirable and sounds effective.

      Ideally, you’d conduct a randomized trial, of both the “opt-out” ID forms, and (somewhat more difficult, but surely possible) the co-ordinator role in hospitals. Otherwise its going to be hard to control for possibly confounding factors like a really exceptional doctor (whose skills may not be replicable across a system), different demographics and hence cultural attitudes in different sectors, etc.

    • dancan says:

      12:48pm | 10/06/11

      Remove the need to donations and encourage development into organ cloning and organ repair via stem cells

    • Debbie says:

      01:51pm | 10/06/11

      My Aunt died while waiting for a kidney transplant. I am and always have been an organ doner, and have made sure my husband and all of my family know my wishes. Please follow the advice of this article, you have no use for any of your organs once you are dead and you might just save someone elses life.

      I agree the opt out model is the way to go in this country and is something we canseriously consider. Whilst there is much research going on into cloning and stem cells, it is years away from being a reality and in the meantime many people will die while waiting for a transplant.

    • Jenni says:

      07:48pm | 10/06/11

      When I die, they can do whatever they like with as much of my body as they like, including using it for medical research, or for medical students to practice on - I’ve made this choice *very* clear to all my family and friends, yet I have been told by my mother (who is my next of kin) that she may not abide by my wishes, because then she won’t have a corpse to bury/burn.

      As the system stands, there is no way for me to stop her from going against my wishes if I die before her, and I think that sucks.

    • RyaN says:

      09:29pm | 10/06/11

      No genuine Greenie who genuinely cared about the environment and the impending doom of climate change would ever be an organ donor, you wouldn’t be doing the planet any favours by saving that many lives, there are far too many people on the earth as it is, spewing out their carbon footprint.
      Clearly to be green you can’t be a donor.

    • Waiting For The Worms says:

      04:11pm | 11/06/11

      “Donation” is a good idea. A better one is for loved ones to receive some kind of payment. Don’t get me wrong, if that system was introduced - say 50K for a heart, 100K for a lung (50% off the second lung), there would be a whole lot of greedy relatives urging the Life Support Machines turned off - NOW!
      But, it would still have to be an opt in function. It would require regulation - oh forget it, I just killed my own argument by getting the government involved. Relative Donor Organ Payment Tax anyone?

    • Edward James says:

      05:33am | 12/06/11

      I have signed my licence to be a donor. Well as it is being revisited. I would expect the Federal government to be smart enough to offer donors a straight deal. They take what they want after my death as long as they pay to cremate the leftovers! Make that offer and I am sure the rate of body donors per head of population will go through the roof!  Edward James

 

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Real women like men who drink beer

Real women like men who drink beer

British comedian John Cleese calls them “beer fairies”.  It’s a euphemism for… Read more

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