Madam, – We share the concern expressed in the media about the 35 per cent decrease in organ donation in 2010 compared to 2009. The reasons for this are unclear but we do not agree that a failure by intensive care unit (ICU) staff to request organ donation is responsible. A detailed survey of organ donor recruitment in 2007-08 showed that organ donation was requested from 96 per cent of families of potential donors. We do not believe this changed in 2010.
The main reason that patients who are brain dead do not become organ donors is because families withhold consent (31 per cent in the 2007-08 survey). This is their right as representatives of the deceased patient and it would be unethical (and ultimately counter-productive) to pressurise families towards consent at a time when they are vulnerable and distressed. Consent for organ donation should be requested by staff whose primary responsibility is to the ICU patient and to their family.
The most common reason for withholding consent was uncertainty about the patient’s wishes regarding organ donation. We support public information campaigns, measures to increase discussion of organ donation and uptake of donor cards and positive publicity for transplantation generally. These campaigns should emphasise the benefits both for transplant recipients and also for donor families who can perhaps feel that some good has come out of their tragedy. – Yours, etc,