Thursday, 23 June 2011

Guest blog by Oli Lewington

Today on the LLTGL blog we're delighted to have Oli Lewington's guest post on the current series on compulsory organ donation. Thanks to Oli for his views, we'd love to hear what you think.

The 4Thought Question: Should Organ Donation Be Compulsory?

This week, Channel 4’s strand has be focusing on the question of whether or not organ donation should be compulsory.

We’ve heard from Professor John Harris, who believes not only should it, but also that live donors should be “incentivised” to provide their organs (for example, with cash payments); from Derek House, a Jehovah’s Witness who believes that organ donation is fundamentally wrong and shouldn’t be allowed at all; and Colin Prior, who advocates presumed consent (the system that would make people opt-out rather than opt-in to being an organ donor) after losing his 2-year-old son while he waited for a heart transplant.

Tonight, you will hear my views - or as much as can be edited into 90 seconds. For the record, here are the salient points I tried to put across (we’ll have to see how much of it came across in the end!).


Firstly – and most forcefully from my perspective and that of many of the lucky recipients of transplant – is the emotional power of the knowledge that you’ve been given the gift of live, with the emphasis on ‘gift’.

I don’t know how it would feel my life wasn’t saved by a conscious choice, but rather the simple fact that my donor never opted out of the system.


Presumed consent removes the need for anyone who supports organ donation to talk to their families about their wishes. When faced with a coordinator asking you whether or not your loved ones organs can be used, how can you be sure of their wishes if you never spoke to them about it? What if you say yes, but they didn’t want that and just never got around to taking themselves of the register, to opting out?

No family in the world in that kind of pressure situation highlighted and exacerbated by grief, pain and loss will agree to donation if there is still doubt. Better to raise awareness as we are and encourage sign-up to the ODR than to risk losing organs because no one talks about it any more.


The Organ Donor Taskforce Report from November 2008 makes two key, fascinating and sobering, points:

Firstly, a switch of system would require an investment of £40million in a campaign to make sure everyone in the country new what was happening. And it does have to be everyone. No falling-through-the-cracks like the digital switchover or similar mass-market campaigns. We all have to know what will happen to our organs if we don’t opt-out.

Secondly, infrastructure: the NHS as it stands simply could not cope with the significant rise in the number of potential donors that a switch to presumed consent would bring. Sad, but true.

So surely the £40million would be better spent on awareness of the Organ Donor Register (ODR) and incremental improvement of the intensive care services, number of donor and transplant coordinators and numbers of surgical teams?


The Spanish organ donation and transplant system is held up - quite rightly - to be the best in the world. The numbers don’t lie.

But too many people draw incorrect conclusions from the fact that Spain has an opt-out system. Mathematicians will tell you there is a vast difference between correlation and causation.

Dr Raphael Matesanz, the pioneer held up as being chiefly responsible for the success of the Spanish system says himself:

"Many countries try to increase organ donation through legislation. But a change to presumed consent doesn't improve the donation rate".

That 3 people die every day waiting for an organ is unacceptable.

That I’ve been to the funerals of 5 friends under the age of 24 due to lack of organs is indescribably, unimaginably tragic.

That I was lucky enough to receive a transplant meaning that someone else waiting didn’t get theirs is hard to live with.

But there is more to this argument than simply increasing the size of the potential donor pool. We must see the bigger picture and continue to support the work of organisations like Live Life Then Give Life to sign as many people as possible to the organ donor register.

Oli Lewington is a friend and former founding Trustee of LLTGL. He is a writer, blogger, digital creative and social media specialist, working from his home base in a village near Northampton. In 2007 he received a life-saving double-lung transplant and never a day goes by that he doesn’t think about and thank his donor and their family for their courageous decision at the worst of times. Follow him on Twitter here.

1 comment:

Big Buzzard said...

Really well said, Oli.

I've also been lucky enough to have received a kidney transplant when I needed it - in my case as a living donor from a friend. It's looking likely that this will fail in the not too distant future, and I'll need another transplant. I support anything that will definitely improve the availability of organs for people that need them. I used to think that presumed consent might be the answer, but I was persuaded that it's not the magic solution, at least now now in the UK.

I was persuaded after hearing a Spanish health lawyer talk about the situation there, much as you describe. She said that it's not the law that changed things in Spain, but people's attitudes, partly in response to the government putting in place an extremely well organised system for making sure that wherever possible, families are approached with sensitivity and care about allowing loved ones' organs to be donated. The other thing that happened was that Pedro Almodovar's great film 'All About My Mother' was widely seen and talked about in Spain - and these issues are dealt with in the film in a very moving way.

My fear in the UK is that a change in the law would be characterised by much of the popular media as 'the state taking control of our bodies' and many people would be frightened into opting out, without really understanding the consequences. This could set back the cause of organ donation in this country for generations, and is a risk that is not worth taking.