Deceased Organ Donation

Much as we might all like there to be, there is no single quick fix to lifting New Zealand’s dispiritingly rate of deceased organ donation, according to Kidney Health New Zealand chief executive Max Reid.

With the release yesterday of the Ministry of Health’s discussion document, ‘Increasing Rates of Deceased Organ Donation’, attention has again been focused on whether New Zealand should introduce an organ donor register, as a number of other countries have.

“Australia and Spain are often cited as countries that operate a donor register,” Mr Reid says, “but in each of these countries, as elsewhere in the world, such registers form part of a focused, comprehensive strategy to lift and maintain organ donation rates.”

“The Australian government established a national Organ Transplant Authority a number of years ago. Since its establishment, both live and deceased organ donation rates have increased steadily. But while Australia has an organ donor register, this is but one of a broad range of initiatives that, together, have turned that country’s organ donation rates around.

“Of far greater importance than whether a country has a register or not, or whether a they adopt an ‘opt-in’ or ‘opt out’ approach to organ donation, is what happens at the bedside in an intensive care unit or emergency department. That’s where the critical conversations happen – and that’s where the difference is made.

“Having appropriate clinical staff trained and confident to have that conversation around organ donation with understandably distressed family members is internationally proven as key to increasing deceased donor rates.

“But for those conversations to have integrity and purpose, it is equally important that family members are aware of each other’s wishes in terms of organ donation. Whether an intensive care clinician has access to a driver’s license database or a donor register, each only provides an indication of a person’s intent to be a donor, not their consent. That is a critical difference, and the reason why ensuring your family – who are ultimately called upon to give that consent – are very clear that you wish to be an organ donor.

“However flawed the current driver’s license system is – and Kidney Health New Zealand acknowledges that the system as it stands is far from perfect – surely it makes more sense to look first to fixing what we have, rather than leaping to an entirely different approach. More important, still, is to see whatever means of registering donor intent as part of a much wider strategy that also involves significant promotion of the importance of being an organ donor, and discussing that intent with your family,” Mr Reid says.

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