Elaine Loughlin: Eight years on, Government still dithers on organ donation
Elaine Loughlin On the Plinth
In intensive care when a person is declared brain dead, the next of kin will be approached.
While coming to terms with this sudden personal tragedy and processing this grief, the person's family will also be asked to make a massive moral and ethical decision.
Death is not a comfortable subject, neither is organ donation.
Introducing a long-promised soft opt-out approach to organ donation would not only ease the burden on devastated families but would also save many more lives.
As we mark Organ Donation Awareness Week, campaigners will once again urge the public to have a conversation at home with loved ones, but really the most significant change needs to come from the Government.
Successive health ministers, including the current one, have stressed the importance of an opt-out system and pinpointed it as a priority, and yet the legislation required to introduce this is nowhere to be seen.
It is eight years now since the then Government launched a consultation process with the view to bringing in soft opt-out organ donation. Eight years, how can that be categorised as treating something as a priority?
In those eight years around 240 people, or an average of 30 each year, have died while waiting for an organ transplant.
Ireland was ahead of many countries when it first committed to introduce a soft opt-in approach, however, since then many Governments have leapfrogged us to introduce the system which automatically assumes a person is in favour of donating their organs unless they have otherwise stated.
In December 2015, Wales became the first country in the UK to move to a soft opt-out system of consent to organ donation and saw its rate of consent jump from 58% at the time to 77% in 2019.
This resulted in an 18% increase in the number of deceased donors in 2019 compared to the previous year.
The reality is you are three times more likely to need a transplant than to be an organ donor.
Covid has impacted every aspect of our health system and last year 190 transplants were carried out here, down from 274 in 2019. This equates to a 30% reduction of these life-saving operations.
However, the transplants that were carried out, came as a result of donations from 90 individuals, 62 of whom were deceased donors.
Behind those figures are 62 families, who decided that their loved one's final act would be to give life to others.
Siobhan Brosnan, organ donation manager at University Hospital Limerick, recently explained how the system currently works when she wrote about her day in the .
Her involvement begins when an ICU consultant informs her that a patient’s brain injuries are irreversible and this devastating news has already been delivered to the family.
"We speak to the family again and raise the topic of organ donation. They have many questions which I answer and this takes sensitivity and time. I thank them and promise to keep them updated throughout the evening."
Later that evening she updates the patient’s family and tells them their loved one’s organs have matched with recipients waiting for a life-saving transplant.
"We have Covid-19 swabbing protocols to follow that determine that organ donation cannot take place until tomorrow morning."
The Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill is currently on the priority list of legislation. The Department is progressing the drafting of the Bill in collaboration with the Office of Parliamentary Council.
While this prioritisation is a welcome move, the Department of Health has no definitive timeline and hopes to secure Government approval to publish the Bill "during 2021".
When the law is eventually introduced, consent will be deemed unless the person had registered their wish not to become an organ donor after death.Â
However, it is proposed that even though consent is deemed, the next-of-kin will in practice always be consulted prior to removing any organ. If the next-of-kin objects to the organ donation, the donation will not proceed.
This new system would still give families a say but it would significantly lighten the weight of such a decision, especially in cases where the topic of organ donation was never discussed at home.
Mr Donnelly told the that the Bill is a "very important piece of legislation".Â
He said it is a priority for him and his intention is to have it published at some stage this year and then be debated in the Dáil and Seanad.
Yes, conversations will help, but a Government promise that was first made more than eight years ago would save many more lives.
We cannot simply continue to rely on what Siobhan Brosnan described as the "selflessness of families at the most difficult of times."
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- Radio na Gaeltachta went on the air for the first time, from Casla in the Connemara Gaeltacht with president Éamon de Valera addressing listeners in Irish.
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- The High Court ordered Mayo TD Beverly Cooper Flynn to pay an estimated legal bill of £2m punts arising out of her failed libel case against RTÉ. The Irish Examiner reported that she was facing "financial ruin and an uncertain political future" after she was ordered to pay the full legal costs of all parties involved in the record-breaking, 28-day trial which found that she had encouraged National Irish Bank customers to evade tax.
- Bertie Ahern resigned as Taoiseach. The Irish Examiner editorial said the announcement was as emotional as its timing was unexpected but even that great emotion and surprise were not enough to dispel an atmosphere heavy with inevitability.Â
- While the much of the details of the Government's announcement are reported on in today's Irish Examiner, the final decision will be made by Ministers this morning. Usually seeking Cabinet approval is simply a rubber stamping exercise, but previous moves to ease or indeed enforce restrictions have resulted in prolonged debate around the Cabinet table. Expect the usual set-piece announcement from the Taoiseach in the afternoon.
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- Last week the Committee on Media, Tourism, Arts and Culture heard pleas from hoteliers and publications to provide a target reopening based on vaccination levels. This week, those in the music and entertainment industry will make their case.
- The Dáil has previously heard how family carers are at their “wits’ end” over the lack of priority being afforded to them in the national Covid-19 vaccination programme. The Beacon Hospital scandal has cast this in a new light. It is in this context that Sinn Féin is bringing forward a motion on caring for carers.
- Finance Minister Paschal Donohoe is due to make a late evening appearance in the Dáil. He will be expecting questions from the opposition on the £610m (€709m) in interest that was paid by Ireland on the 2011 bilateral bailout loan it got from Britain.
- Children's Minister Roderic O'Gorman will take questions in the Dáil, which should also be one to watch.
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