Laws of Eve | Donate an organ, save a life
Perhaps we have all watched enough hospital television drama to be conscious about some of the miracles modern medicine have made possible. Or, we might just have had front-row seats to witness the performance of that miracle on someone we know and love. In either case, the realisation that each of us might be able to facilitate that miracle is awesome.
Within this year alone, I have been close enough to know two persons who are the beneficiaries of kidney transplantations. In one case, it is a first-time experience, while in the other this is a second attempt. The newcomer is fortunate that her brother was a perfect match and was willing to donate one of his good kidneys to save her life, while the second-timer's success, after a hard-fought struggle, was only possible because a stranger who was committed to being an organ donor died tragically in a motor vehicle accident.
Although Jamaica's first kidney transplantation was performed at the Kingston Public Hospital in 1971, none of the procedures about which I have direct knowledge was performed locally. I also realised that I had no idea how to register as an organ donor so that I might be able to help to save someone's life.
During my research, I found that local doctors have long been appealing for Jamaica to establish a central database for organ donation so that Jamaicans can register their desire to become donors. (One media report stated that potential donors can register at any major hospital). Citing the fact that more than 500 new patients commence dialysis each year, and that dialysis is not the preferred method of treatment since it results in a poor quality of life and complications for patients, leading urologists and nephrologists in Jamaica rue the fact that so few transplants occur.
WHAT DO WE NEED TO DO TO ENCOURAGE ORGAN DONATION IN JAMAICA?
- Educate and sensitise Jamaicans about the advantages of organ donation, whether as a live donor or for harvesting of organs from a brain-dead person.
- While we have well-trained doctors to perform the procedures, people will need to feel confident that our hospitals are well equipped to conduct the screening of donors and facilitate their healthy recovery (in the case of live donors).
- Ensure that appropriate laws are in place to establish a reliable central donor registry.
- Enact appropriate laws to prevent the illegal harvesting of organs, so that organ donations are done altruistically and not for economic gain.
Below are two examples of jurisdictions that specifically enacted transplant laws that highlight some issues Jamaica will need to address in laws related to organ donation.
In the United Kingdom, approaches differ, depending on whether you look at England, Ireland and Scotland or Wales. On the one hand, in England, Ireland and Scotland, there is the opt-in approach through which a child over 12 years of age or an adult may be an organ donor and, on registration, that person's name is placed on a national confidential list of donors. On the other hand, the 2015 Human Transplantation Act in Wales adopted an opt-out approach, whereby all persons are deemed to consent to being donors unless they specifically express a decision not to be an organ donor.
In Canada, organ donation laws vary according to province. If lessons are to be learnt from Canada's experience, we need to closely follow the debates as to whether any incentives should be offered to donors (to even offset out-of-pocket expenses) and whether the wishes of a deceased person to donate his or her organs can be overridden by family members.
Much has been done by local pioneers, but greater public education followed by the enactment of local legislation is likely to yield better results.