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Opt-out not an option for organ donation

By ALEXANDRA BRADSHAW
AUSTRALIANS are well known for being a generous group of people. We donated $350 million to the Victorian Bushfires, $200 million to Queensland’s disaster relief and more than 5 million of us participate in voluntary work per year. Why then, when it comes to donating organs to fellow Australians, are the figures so low?

Last year, 14.9 people per million donated tissues and organs. This works out to be a figure of just .0015%. Canberra, with a population of 350,000, had just five donors.
A National Reform package was introduced in 2008 to help boost the dismal rates. The Australian Government gave an additional $151.1 million to the Donate Life initiative, used solely to help increase donation figures.
Janine Cunningham, Organ and Tissue Donor Coordinator for Donate Life Australia, said that donations rates are so low because they are still in their initial stages of awareness.
“We are on par with Germany and DonateLife in Australia has only existed for 18 months. In this time we have increased our rates by 2%. . . ,” she said. “Spain has had their existing policy for donation for 10 years hence their greater percentage of donors per million.”
An idea which, according to figures, is successful abroad is the opt-out system. This involves a process where an individual must actively ‘opt-out’ of being a tissue and organ donor, rather than the current system we have, which is to ‘opt-in’.
The chief executive officer of the Australian Organ and Tissue Donation and Transplantation Authority, Yael Cass, said, “As part of the development of the national reform agenda to increase organ and tissue donation for transplantation, the Australian Government carefully considered an opt-out consent model and concluded that there is no clear evidence that it contributes to achieving a higher donation rate. International experience shows that the key to achieving a sustained increase in organ donation is the implementation of a nationally consistent and coordinated approach to clinical practice reform to maximise identification of potential donors and consent to donation within the hospital system”.
The general Manager of the Organ and Tissue Authority, Elizabeth Flynn, said that although the opt-out system is good in theory there are “embedded ethical issues”.
“It does not fit with our clinical cultural practices”, she said “If we were to use a true opt-out system, families would not get a choice… ,” she said. This would be too distressing for families.”.
The system is currently implemented in Spain, but even there, families have the final word, similarly to the ‘opt in’ system. Family members will always have the final word, regardless of registration status.
“Families that have discussed and know each other’s donation wishes are more likely to uphold those wishes,” Ms Cass said.
Although there are over 5.8 million Australians registered to be tissue or organ donors, only 1-2 per cent of those who die are eligible to donate, due to the way in which they die. To be an eligible tissue donor, doctors must retrieve the tissue within 24 hours of death. To be an eligible organ donor, the donor must have died in the Intensive Care Unit of a Hospital.
“Such deaths generally occur as sudden traumatic events and that is why it is very important that families are prepared should the situation ever arise when they are asked to confirm a loved one’s donation wishes,” Ms Cass said.
New marketing tools and techniques are constantly being introduced in to the current system. There is now a clinical network of 160 specialist organ and tissue donation staff in 77 hospitals across Australia, community awareness and education program as well as a Family Discussion Kit, which includes ways to start the discussion, what to discuss and ways to become involved.
Just recently, it has been said that Facebook founder Mark Zuckerberg, will be introducing links to the organ donation registry as well as the option for an organ donation status in user’s profiles. This initiative has already taken off in America and the UK, and is only a matter of time before it reaches Australia.
With the inclusion of the ever escalating and always popular social media involved, awareness may just increase. Facebook has helped to spark conversation with so many world -wide trends, it is hoped that this idea proves equally as successful.
For more information on donation or how to become a donor, visit www.donatelife.gov.au.

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