Transplant

This past week there were two separate stories about liver transplants. The first was about the parents of adopted twins, both of whom need a liver transplant. The dad's liver is compatible - but he is only able to donate part of his liver to one of the children (CBC). Somehow he has to chose which of his three year old daughters gets part of his liver. The family are making a public appear for another donor. The second story was about the widow of a long term alcoholic who was told he was not eligible for a liver transplant until he had stopped drinking for six months. She is planning on constitutional challenge of the policy, stating that it wrong to discriminate against alcoholics because of their illness (National Post).

For the parents of the twins it is an impossible decision. No parent should ever have to decide which of their children will die. Their agony must be unbearable. Similarly I can understand the frustration of the wife who had to watch her husband die because of a medical rule, that while it may make some sense, denied her husband the opportunity to get better.  These stories are particularly sad at least in part because not enough people are prepared to donate their organs upon death.  If there were more organs available, I suspect the father of the twins would not be facing the decision he is, and doctors and hospitals would not be forced to decide upon who gets access to a limited number of livers.

There is however, a relatively simple and achievable resolution for both of these scenarios. Upon death, organ donation should be automatic. It makes no sense to me that people are dying because they cannot get an organ transplant while other people, who are already dead are being buried with what could have been a life saving organ. It make even less sense to me that a family member has the right to make this decision.

While there appears to be a fair amount of academic research as to why people neither sign a donor card and/or tell their family and friends that they wish to be have their organs used when they no longer need them, much of it is not available without expensive journal subscription. However in perusing some of the abstracts on Goggle Scholar it would appear that at least some people are reluctant because of a profound mistrust of the medical system (CriticalCareNurse). Indeed if one delves into the darkness that is the internet one can find sites that argue this point of view. Some blogs etc. clearly state that one should not sign a donor card because it means that the hospital will let you die so that they can harvest your organs (and make money) (Crawford).

(As a side point, it would seem to me that these sites that spread false information potentially kill far more people than do the sites that advocate radical extremism. Yet our government ignores the former while spending millions trying to track down the latter.)

People also appear to have some apprehension about who decides and when it is decided that a person is dead.  While I understand people's unease I suspect however, that for the vast majority of people who are dying, the decision is pretty obvious. Surely this is something that people who have some unease over this issue, can clarify with a doctor.

And finally there appear to be some people who do not believe in organ transplants because they want or believe they need to have all of their body parts still attached to them when they get to heaven. I wonder if that means that everyone who has lost their tonsils or their appendixes or had an amputation are ineligible to get past Saint Michael's steely gaze just outside the Pearly Gates.

We need to have a national discussion about organ transplants. I suspect that many of the reasons that people give for not signing the card have not been thought through.  I also suspect that if organ donation was automatic unless the person said no, that the vast majority of people would not bother putting in writing why they were refusing.

I also wonder if it was government policy that only those who agreed to donate would be eligible to receive an organ, if more people would sign the card.   If altruism does not motivate people, perhaps self interest would.