Would You Be A Donor?

Interview by Sandra Buol

Pulp: The Sydney University Surgical Society holds several events for DonateLife Week. Why is it important to raise awareness about organ donations? (Questions aims to inform generally about the situation of organ donations in Australia)

Shay: Currently, Australia is ranked as 17th in the world in terms of number of donors. Given our population size, around 1,500 lives could be saved each year if we reached our potential. At the moment, some Australians can wait for up to four years or longer for a transplant with many not making it to transplantation.

There are also many misconceptions about organ donation. A common one is that once a person registers as a donor, their decision is fixed. In Australia, the decision to donate organs is ultimately made by family – this means that even if they have registered as a donor, the family can override the decision. Having the discussion with family and making donation wishes known is so important. Studies and surveys have also shown that if families are aware of this decision, less distress is experienced by a person’s family at the time a donation decision is made.

In addition, because the University of Sydney has a vastly diverse student body made up of students from all over the world, international students should be included in this conversation. Although it is not possible to register on the Australian Organ Donor Register without a Medicare number, these students should still let their organ donation wishes known to family as it is possible to donate organs without being registered as a donor.

Pulp: One of the speakers at the Symposium the SUSS organised last Thursday talked about the ethical and moral imperatives of organ donation. What are some of the dilemmas that doctors, donors and organ receivers are confronted with?

Shay: Some potential donors hold the misbelief that registering as an organ donor means that doctors will not do their utmost to save their lives. Saving lives is the absolute priority of doctors, nurses and all health staff. Only around 2% of people in Australia who die in hospital can become an organ donor, as particular circumstances must be present in order for a patient to be medically suitable for organ donation.

The first priority of medical staff is to save the life of a person. Once it becomes clear that a person is not going to live, life sustaining therapies can be withdrawn if it is in the best interests of the patient to do so. When a decision is made to withdraw life sustaining therapy, a person may die straightaway or it may take a while for them to pass away. If the person or their family has consented to organ donation, and it takes a long time for them to die, then their organs may not be suitable for transplantation. Since death is inevitable, some donors and donor families have asked to speed death along or to go into surgery immediately after being taken off life support. However, the law maintains that death needs to take its course without any involvement from the treating clinicians for the benefit of organ donation. 

Donors and their family members may also be hesitant to make the decision of donating organs as they fear the disfigurement of the body. In fact, this is untrue as organ retrieval surgery is performed by highly skilled and professional medical teams who ensure that the surgery is performed with the same skill and respect for the person as any other operation. The surgical incision is closed following the procedure and covered with a dressing. The body can be made presentable for an open casket viewing if it is desired.

Sometimes, transplant recipients can have feeling of guilt once they have received an organ. This is because they are alive and someone else has died. But donation is a rare and greatly appreciated gift and transplant recipients and their families are very grateful for the opportunity to live a more fulfilling life and to be able to help their families and communities once again.

Pulp: More than 1400 Australians are on a waiting list – would an opt-out system (instead of the current opt-in system) be a better solution?

Shay: Changing the Australian system to an opt-out one might improve the current situation slightly but this is not certain. Overseas, many countries with opt-out systems, where everyone is presumed to be an organ donor, have lower donation rates than countries like Australia with an opt-in system. Even with an opt-out system, a person’s family will always be asked to confirm a donation decision and to consent to donation. A more feasible, effective change would be to improve upon existing processes to ensure that all potential donation opportunities are realised. This includes raising consent rates for donation, improving organ matching processes and broadening medical suitability criteria. Meanwhile, there has to be continual effort to encourage more people to register as donors.

Whether registered as an organ donor or not, the final decision will be left up to the families. That is why discussion is so vital to organ donation. Programs are in place to train medical staff about how to bring up the talk about organ donation to families, let them know all of their options, clear up any misconceptions they might have and, most importantly, support them through the difficult time whether they choose to donate or not. Furthermore, everybody needs to discuss with his or her loved ones if they do or do not want to donate their organs in the event of their death as to ensure their family knows their wishes. Being a registered donor definitely helps, but we believe it’s the dialogue among families and between patients and doctors that is really going to make a difference.

Pulp: The SUSS will have an information stall on Eastern Avenue the next few days. What can students find there?

Shay: Our volunteers will be equipped to provide information on how to register to become an organ donor. We will be handing out brochures for you to take home for yourself or for you to help spread the word to friends and family. Students can ask questions and test their knowledge about organ donation and transplantation through some fun games at the stall. We will also be giving out free DonateLife merchandise and popcorn!

Pulp: You’ve also organised a BBQ for Friday. Will there be any other events to raise awareness?

Shay: We held a Transplant Symposium this past Thursday where we heard from a transplant recipient and distinguished doctors. Our volunteers will be on Eastern Avenue 10.30am – 3.30pm all this week – drop by for a quick chat with us if you are interested to find out more about organ donation (or if you’re feeling like free popcorn)!