Dead Or Alive: Cutting Issue For Organ Donors

The Age

Friday October 24, 2008

Julia Medew, Health Reporter

THE head of the federal health department is worried a Melbourne doctor's comments that not all organ donors are dead when their organs are removed will undermine efforts to boost Australia's donation rate.

Associate Professor James Tibballs, an intensive care specialist at the Royal Children's Hospital, told The Age this week that doctors could not be sure all brain function or blood circulation had ceased irreversibly when organs were taken.

He also called for brain death tests to be strengthened and for Australians to be fully informed of how organs are retrieved to ensure informed consent.

Department of Health and Ageing secretary Jane Halton said it was important the public had confidence in Australia's organ donation system so more lives could be saved.

"It is very important that we provide assurance to the community that they can have complete confidence in the system," she told a Senate inquiry.

"We have got a huge new investment, in relation to organ donation because we don't have the organ donation rate we should. And it is really regrettable, really regrettable, that people are putting into the public arena material which actually undermines that confidence."

Senator Jan McLucas, who is responsible for the Government's new $136 million organ donation reform package, also reassured the public this week that their organs would only be taken when they were clinically dead. Ms McLucas, parliamentary secretary to the Minister for Health and Ageing, said the Government was considering national guidelines on organ donation after cardiac death because of inconsistencies between the states.

The concern comes as Melbourne bioethicist Dominic Wilkinson, an intensive care specialist now based at Oxford University, yesterday backed Dr Tibballs for opening up public discussion about organ donation.

Dr Wilkinson said he did not agree with all of Dr Tibballs' arguments, but thought there was an unfortunate tendency for the medical profession to gloss over the details of how organs are retrieved because it could confuse or alienate potential donors.

"We think that it is important for individuals to give informed consent for their organs to be used after they have been declared dead. That means that they should know exactly what they are agreeing to when they sign on to an organ donation register," he said.

Medical interventions used during organ procurement include the use of blood thinning drugs and cannulas inserted into the femoral vessels to cool organs for transplantation.

These interventions are permitted in some Australian states when a donor is still alive, but consent forms for the Australian Organ Donor Register do not mention the details of them.

Dr Tibballs said donors were usually very close to death, with no chance of survival during organ procurement. He said he was not suggesting some patients could be brought back to live meaningful lives when their organs were taken, but rather wanted donors to know exactly what could happen to them so that they could give informed consent.

"If someone can't understand the arguments during a time of peace, how could they be expected to understand it when they are looking at their severely injured child or loved one in hospital," he said. With AAP

KEY POINTS

- Professor calls for stronger brain death tests.

- Health officials concerned about public confidence.

- Senator flags national guidelines on organ donations.

© 2008 The Age

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