Hospitals must have enough staff to fulfil new organ donation legislation, says expert

Dr Catherine Motherway said organ donation has come a long way here over the last eight years. Photo: Ray Ryan

New legislation on organ donation must be supported by additional specialist staff in hospitals so all families are offered the chance to donate, one of the leading experts in the country has said. 

Dr Catherine Motherway, HSE Organ Donation and Transplant Ireland clinical lead, said it is not clear whether more donations will follow from the Human Tissue Bill.

“The bill may well assist some (staff) to approach families but obviously it is important that we have the infrastructure in place in all of the hospitals to support staff interacting with grieving families,” she said.

“And having trained organ donation personnel in each and every intensive care unit is a vital part of the infrastructure that we require to support families and staff in the hospitals.” 

Dr Motherway was formerly an Intensive Care Consultant at University Hospital Limerick and helped families with this emotional decision.

“Currently we have specialized organ donation personnel in each HSE region,” she said. 

She was the specialist for the Midwest region, and said a consultant in emergency medicine covers Cork and a specialist nurse covers other Munster ICUs.

"There is a plan to roll out more organ donation nurse managers so there is a presence embedded in, I would hope, all of the ICUs. That’s what they have in Spain.” 

Dr Catherine Motherway described organ donation as “one last huge gift” which can give grieving families some comfort. Photo: Ray Ryan

Organ donation has come a long way here, particularly over the last eight years, she said, with Spain an example of where Ireland could go.

“There is a very solid organ donation culture in Spain, and an enormously successful programme. That is predominantly due, not to legislation, but to their infrastructure,” she said. “They just have a really good system to ensure that everybody is approached.” 

The National Office of Clinical Audit (NOCA) currently publishes intensive care unit audits.

“There is a NOCA audit we do of all ICUs and there is an organ donation part of that. But there is now a newer audit—a potential donor audit—and we run a trial in six of the hospitals. We had organ donation personnel look at all of the deaths and see if there were any missed opportunities,” she said.

When asked if the new legislation will definitely lead to more donations, she said: “I don’t know that because I don’t think we have sufficient decent audit information yet.

Dr Catherine Motherway said: “The bill may well assist some (staff) to approach families but obviously it is important that we have the infrastructure in place in all of the hospitals to support staff interacting with grieving families.” Photo: Ray Ryan

“I think we are getting there. I think what will tell us that is the potential donor audit. It’s an absolute key in telling us how much potential there is and how much we can improve.” 

She described organ donation as “one last huge gift” which can give grieving families some comfort.

“I would consider it an utter failure of my contract with the patient and the patient’s family not to offer them the opportunity to donate,” she said.

“I do sometimes have to ensure that other training staff understand that. They maybe ring me and say ‘they’re very upset, I don’t think it is the right thing to do’ and I say ‘no, you have to offer it’. So it (the Bill) could potentially make it easier for some people.”