Organ Donorship: Take Me On – Giles Lennox

Welcome to Take Me On! This is a Bubble regular in which all pupils are encouraged to write a piece on a controversial topic in which they argue for their point of view. The idea is a person with the opposite view responds to the piece. I hope that this will encourage more debate in the school and a greater awareness not only on wider issues in our society but that people -shockingly- may have different view to you and the best way to respond is to engage in a discussion.

From Spring 2020, a drastic change to medical procedure will be occurring. The UK system for Organ Donorship will be changing from an ‘Opt In’ system to an ‘Opt Out’ whereby, unless you specify otherwise, upon your death, you will be eligible for organ donations. Under the status quo, you must opt into this system which many people have criticised for wasting thousands of healthy organs that could be used to help thousands of people. In this article, I will outline a few reasons why I support this decision on the basis of moral and practical reasons as well as rebutting a few ‘counter’ points.

A BBC survey found that 90% of UK adults support organ donation (and the NHS reports 96% of the population of the UK would accept an organ if they needed one) say they would accept an organ if they needed one. Yet only 30% of the population are on the NHS Organ Donor Register. This raises the critical question: if there is such a general consensus that organ donorship is such a popular thing, then why don’t the organ donor figures represent that? Whether people can’t be bothered to fill out forms or simply never get around to it, there shows a clear, gaping gap; one that allows for 3 people per day to die while on the waiting list. How as moral, compassionate beings can we allow for such a figure? So how does this all relate to the idea of organ donorship (more specifically an opt out system)? It’s true, money is one thing as it is replaceable and ultimately material. However, an organ is something completely different. It is part of you, irreplaceable and incredibly personal. Some say it would be wrong to simplify such a complex procedure that affects a variety of people. Bring the idea down to its basic form. It is the transferal of an organ from one body to another. It is a donation, a compassionate, conscious act in an attempt to help another person. In essence, it is a clear extension of charitable giving. The intentions are the same with one person willing to give up something that they possess that could help someone else and the outcome being that the act is beneficial to the other person. Needless to mention that this transaction occurs post-mortem, as in to say that the organ is only transferred when the donor is dead.                                                                                        

Respectfully, when you die, you are no longer in need of your organs. Therefore, it seems strikingly selfish to withhold something that could save someone’s life especially if it is something you no longer need. A change to an opt out organ system clearly plays to the intrinsic good within humans because it allows us to be charitable and kind which many would argue is a key human feature. The figures from the NHS and BBC show that the only real thing holding people back from organ donorship is laziness. Moving to an opt out system would eliminate the deficit created by this fundamental human flaw. An opt out system would go a long way in the attempts to better our society as it would make us far more responsible for each other. I can think of an act no more caring, loving and fundamentally moral than giving up a part of your body to possibly save the life of a stranger. It is for these reasons that many believe that the change to an opt out organ donorship system is the morally correct thing to do.

A possible negative is that it changes the country’s default position on organ donorship, by now assuming we are all people wishing to perform this seemingly altruistic act. However, some could very easily argue that an opt out system ‘takes’ organs from people. This view was highlighted by Dr Greg Moorlock who said “I think that the state would be more likely to be perceived as ‘taking’ if a hard opt-out system was in place, but as it stands, I think that soft opt-out is compatible with the idea of gifting.” His views align with the points stated above that the charity aspect of the current system and is replaced a ‘taking’ system. Some would even stretch to argue that this means the government essentially owns our bodies after our death! The status quo is a more compassionate way of donating, with people making the conscious choice to do so. To many, an opt out system preys on those who are ignorant/ unaware of the issue and uses their organs without their express consent and therefore cannot be supported on any moral ground. However, I would argue that this in fact is not the case to a large extent. The idea of charitable giving is still enforced because the person still has the opportunity to opt out. If the government completely removed this choice, then this argument would be understandable. Instead, the fact there is choice means people can still choose to compassionately donate their organs, just by not opting out of the system.

Now for the practical section. ‘Presumed Consent’ Legislation for organ donations was passed in Spain in 1979 and it is often cited as the key ‘success story’ of this system. Since that year, the figures show that Spain has gone from strength to strength and is now the world leader in organ donation. According to the National Transplant Organization, 4818 transplants were carried out in 2016, beating the record of 4769 from 2015.This is as a result of the continual increase in donors. 2016 saw 43.4 individual donors per million. This is an increase from 39.7 in 2015 and 37 in 2014. However, the key question is where these figures successful in reducing the waiting list number and essentially, saving lives. Spain reports that in 2016, the waiting list reduced from 5673 to 5477. In other words, 196 people were treated that year due to the success of this system. However, is there continual progress? In 2017 the Spanish Government reported that 6 people per day donated their organs after death and 14 transplants were performed daily resulting in 5259 transplants in that year. There are endless pages of figures detailing the increase in transplants and donors however, the message is clear from these few statistics released by the government. An opt out organ donation system works. Therefore, it meets the criteria of ‘practical’ set out in the introduction; more specifically, increasing the numbers of transplants and donors.

A practical problem is the current crisis of the NHS. It is estimated that the NHS trusts in the UK are in a combined deficit around £750 million. The NHS Staff Survey of 2016 found that 47% of staff said they disagreed or strongly disagreed with the statement “There are enough staff at this organisation for me to do my job properly”. So, you can start to see an obvious problem with our current health care system is hugely underfunded and undermanned. So how does this link to the opt out system? It is all well and good referring to how different countries have implemented this system, but the key question is: can it be viably implemented into England? It is obvious that introducing this system will come with some costs. There will need to be more space created to hold and house the increase of organs and a better communication system to oversee this process. These are just a couple of examples of some of the factors that need to be considered. They both will require a large investment to ensure that this system can be introduced effectively. The obvious question is, can the NHS afford it? Again, under the status quo (shown by the survey above) it is unlikely that enough of these people will be found considering that there is already a shortage. How can someone reasonably claim this system can be successfully implemented is there is not the financial and personnel support to do so? The NHS is in a clear deficit in these areas meaning that the practical argument for why we should implement this system is severely undermined because it is unlikely these problems will be overcome for quite a while. However, the fact that the government is proposing this change and is actively seeking to implement it means that they are confident that they have enough funding and staff to ensure it is effective. It would be irresponsible and frankly immoral for them to report that the change is due to take place if they know they can’t introduce it correctly.

I certainly will not be opting out of this new system and after reading this article, I hope you wont after! However, if you diisagree, please consider writing a response.

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