Nobody can predict when his/her time is up. But after
reading an article on the BBC website titled �Wales seeks organ opt-out powers,�
I�ll think twice about prolonged visits to the land of my birth if the Welsh
Assembly has its way.
To be fair, its motives for wishing to introduce a system of
�presumed consent� whereby doctors will have the right to remove organs from
the dying -- provided they haven�t expressly registered their opposition on a
register -- are beyond reproach. Wales simply wants to save more lives.
Apparently, an overwhelming majority of Welsh people say
they are in favor of organ donation but only 28 percent have submitted their
written agreement to the National Health Service. Last year, more than 150
waited in vain for a transplant and there are currently 500 sufferers on the
list. There will also be a further safeguard. Family members will be given the
opportunity to object.
There is surely no greater gift than donating a heart, lung
or kidney that will save a life, or a cornea that could brighten the world of
someone consigned to live in perpetual darkness. I greatly admire anyone who
goes out of his/her way to sign-up to this magnificent unselfish act and it is
certainly a shame that so few bother to append their names to the list or are
reluctant to do so.
Moreover, I suspect that the thought doesn�t even cross most
people�s minds as gifting an organ, no matter how worthwhile, is inextricably
bound to their own demise. So, in this case, an assumption of consent would be
expedient in providing more available organs.
There is no disputing the practical benefits which could be
massive. But, unfortunately, the issue is far from cut and dried.
Firstly, there will be a number of ordinary folk, who will
either not realize that they can opt out from the presumption of consent or who
might procrastinate about doing so. Then, there will be others who don�t have
family around them when they draw their last breaths, especially in a country
not known for its close family ties. The homeless, for example, would be
particularly vulnerable as would overseas visitors, bearing in mind that
medical personnel would need to make swift decisions and would not necessarily
have time to check someone�s nationality.
Secondly, it�s worth thinking about how such an assumption
might affect the decision-making of a doctor. Would he or she go the extra mile
to save a seemingly terminal older patient when a few wards away there is, say,
a young man urgently in need of a new heart? Most organs are taken from people
on life support machines. If consent were to be assumed, would those machines
be turned off more quickly? Would family members come under pressure to
prematurely consent to shutting down a loved one�s oxygen source? It�s worth
mentioning that the majority of transplanted organs are taken from people while
they are still technically alive; for example, those believed to be brain dead.
However, there have been instances where patients were
assumed to be brain dead and weren�t. One such is Zach Dunlap of Oklahoma, who
moved his foot and hand just as doctors were getting ready to remove his organs
and went on to achieve full recovery. And, earlier this year, a man from
Paraguay opened his son�s coffin hours after he was pronounced dead and found
him alive. In the event that child�s organs had been removed, such an act would
have been tantamount to murder.
Thirdly, there are religious considerations to be taken into
account. Whereas most Christian churches bless organ donation or take the view
that it is up to the individual, not all faiths are as clear on the subject.
Within Islam, there are mixed views. Some Islamic scholars say donating organs
following death is permissible. Sheikh Mohammed Sayed Tantawi, the grand sheikh
of Al-Azhar, is one. Others, such as Sheikh Khalfan Al-Esry of Oman, say it is
forbidden. Differences are mainly over what constitutes death. Almost all agree
that organs should not be sold for profit.
Judaism is similarly divided on the topic. While strict
Jewish law forbids the mutilation of or interference with a body, modern Jewish
scholars generally encourage organ donation to save lives but are less keen on
donation for research purposes. Ultra-orthodox Haredi rabbis, however, take the
view that terminating a life in the case of brain death is murder and insist
that all body parts must be returned to the ground.
Adherents of Japan�s ancient Shinto beliefs believe injuring
a dead body constitutes a serious crime, while gypsies are largely against
organ donation due to their belief in an afterlife. How would Welsh doctors be
able to ascertain an individual�s religious beliefs in such cases as road
accidents where time between harvesting an organ and transplanting is of the
essence? And how could they explain to a late arriving mother or father why
their deceased child had no eyes?
Lastly, presumed consent could well be the slippery slope
toward compulsory organ donation in the future, which I strongly oppose because
for two reasons: my body belongs to the Creator and not the state. Furthermore,
a gift of life should be just that . . . a gift. Anything else is theft. A
number of European countries, which have already instituted a presumption of
consent, don�t see it that way. On the contrary, they celebrate massively
increased rates of transplant.
There are other ways of achieving similar goals, such as
government media campaigns and discussion in schools and universities. GPs
could be asked to find out their patients� views and register them.
Alternatively, a mandated choice system could be introduced for anyone applying
for a driving license or passport whereby a short form could be sent to a
central organ transplant database to which all medical personnel would have
instant access. Foreign visitors and anyone without a fixed address should be
automatically exempted from being donor candidates.
Admittedly, if I were the one languishing in a hospital bed
praying for a heart while struggling to breathe I might have a very different
take on this. But I would like to think that even then I would be able to
retain a modicum of objectivity.
Linda
S. Heard is a British specialist writer on Middle East affairs. She welcomes
feedback and can be contacted by email at heardonthegrapevines@yahoo.co.uk.