Time to talk about organ donation

It’s the season of giving, of family time, and of meandering conversations unhassled by the working week. It is also, alas, the time when sudden death often blights our holiday journeys.

This makes it a good time to consider our still poor rate of organ donation and how we can improve it.

The goodish news is our organ donation rate has improved, going from 38 in 2012 to 61 last year. That’s a big increase in percentage terms.

But it’s still fairly lousy in terms of deceased organ donations per million of population, the international measurement which allows countries to be compared. Our rate is 11.7 per million, about the same as the United Kingdom’s but well below Australia’s 15.5. And it is way below the international leader in the field, Spain, with 40 per million.

Late last year Parliament passed a law that made it much easier financially for donors. The law change provides 100 per cent of the donor’s earnings for up to three months after the operation, as well as childcare help if needed.

The law change removes one obstacle to better organ donation, but much more is required.

The main change needed is to persuade families to consent more often to allow the donation of organs of relatives who are brain-dead in our intensive care units.

It is here that Spain’s especially trained doctors and nurses seem to be having the greatest success.

Families have to make the decision in the midst of emotional turmoil. A loved one has been rushed to hospital after a dreadful accident. Shock and horror make it all too likely that families will say ‘‘no’’ even to the most tactful inquiry about organ donation.

Research suggests that families who have discussed organ donation before they face this terrible situation are more likely to agree to donation. If the person involved has clearly told their relations that they wanted to donate, the families usually concur.

That is why more family discussions about what might seem an unpalatable subject are so important. Former health minister Jonathan Coleman was right when he said last year that a better organ donation record will require a ‘‘culture change’’.

Coleman’s government passed a series of reforms last year aimed at improving our performance. One reform he declined to make, however, was introducing an organ donation register, an idea supported by some organ donor advocates and used by Australia and the UK.

An organ donation register signals to the family that the donor’s preference is serious.

At present, families can veto the donation even if the person has ‘‘donor’’ stamped on his or her driver licence. An organ donor registry would help overcome this disadvantage.