Douglas Noble: Easter and transplantation

douglas nobleSally Slater last week celebrated the tenth anniversary of her life-saving heart transplant. Sally was only six when she had the operation and was pictured with Billie Piper after the operation. Now, at 16, she is turning her attention to improving health policy. In last week’s Telegraph (News Digest, March 29) she called for nationwide presumed consent on organ transplantation, so that others could have the same chance for life that she was given.

There continues to be a wide mismatch between available organs and those in need of them. There are currently 7980 patients waiting for a transplant, yet since 1st April 2009 only 2642 transplants have been performed.  The situation is plagued by historical paradoxes. People do want to donate in vast numbers (70% according to the King’s Fund), but only 28% currently have their names on the organ donor register. The chief medical officer (CMO) drew attention to this dire situation in 2007 recommending the government adopt a presumed consent policy, which has seen success in other European countries.

Meeting the need of the majority of people who do want to donate, the state responsibly facilitates this wish and reduces pressure on doctors and relatives après la mort.

There is a common libertarian argument against establishing Sally and the CMOs policy position: our bodies are not the property of the state and, therefore, it is we who have the right to decide their ultimate destination. There is strong reaction against the idea that we would all want to be organ donors unless proved otherwise.

I worked on the Oxford transplant unit in 2004 and was involved in numerous organ harvests for transplantation. Usually in the middle of the night at a small district general hospital in the Home Counties, the Oxford transplant team responded to the call and devotedly set out to retrieve pancreas and kidneys. As organs were retrieved in the operating rooms the mood was sombre and respectful. Liver and cardiac teams arrived from other hospitals to collect their respective organs. Some of the surgeons only ever saw each other in this context. Yet, thanks to the donors and the hard working surgeons, girls like Sally got a second chance – a chance for life. And not just Sally, in fact up to 5 or 6 more per donor.

Reading Sally’s story just days before Easter prompted me to consider the dilemma of organ shortage from a fresh perspective: does the position of presumed consent resonate with the Christian principle of self-giving which historically has underwritten our progressive liberal society and our modern values of human rights, dignity and equality.

Over the weekend millions of Christians in Britain celebrated the death and resurrection of Jesus Christ. On Good Friday, his death on the cross was remembered as an act of selfless love which provides forgiveness for the problem of human evil, and access to God for those who believe. The resurrection on Easter Sunday signifies the triumph of life and, as Bishop Tom Wright put it recently, the destruction of the last weapon of tyranny- death. Through the death of one man, comes the opportunity for life to many.

You don’t have to be a theologian to see how this event has reverberated throughout history. Countless others at home and abroad have given their lives for the benefits of others. The relevance to organ donation is clear: through the death of one person comes the opportunity for life to many. Is it not in keeping with the ethos of our society to facilitate a system which would continue to prioritise the near sacred act of donating and receiving organs?

Douglas Noblehas worked in surgery, emergency medicine, public health and for WHO . From 2006 to 2008 he was clinical adviser to the chief medical officer for England.

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  • Iain Yardley

    Douglas,

    Interesting thoughts.

    The comparison drawn between tranplantation and the Christian Easter message certainly has resonance, the death of one giving hope to many.

    However, Jesus’ sacrifice was a selfless act of giving, made freely by himself. Presumed consent can be seen to change organ donation from an act of “giving” to one of “taking”. Perhaps this means it jars rather than resonates with the Christian priniciple of self-giving and is why so many are uneasy with the concept.

    Iain