Organ donation: a European debate

On the back of our 2011 Human Bodies report, I took part last week in a panel discussion at the 23rd European Students’ Conference in Berlin. This was a terrific event, gathering several hundred medical students from around Europe, looking at this year’s theme of ‘Transplantation and Implementation’. My session, shared with colleagues from Germany and Spain, was focused on ways of increasing organ donation for transplantation.

The discussion was facilitated by a very smart German journalist, Dino Trescher, and covered a lot of ground. But two particular things struck me. The first was the students themselves, who were very well informed, engaged, and ready to challenge orthodoxies and offer ideas. Some raised, inevitably, the question of whether paying organ donors, in order to meet the shortages in Europe, might be the most effective – and ethical – way of reducing transplant tourism and trafficking. And there were also some really interesting ideas about, for example, getting GPs to register the wishes of their patients not only as a [costly] way of signing people up for donor registries, but also as a way of ensuring that the decision is both informed and known and understood by the patient’s family members.

The second thing that struck me was the degree to which I and my co-panellists came so readily to agree on what were probably the most important issues in organ donation. And bear in mind that Spain has an opt-out legal system for donation and a ‘socialised’, nationally organised healthcare system, whereas Germany goes for opt-in organ donation in an insurance-based healthcare system where hospitals are largely private. So the three countries have altogether different arrangements

The first point of agreement was the high-level issue of maintaining public trust, both in the system itself and in the roles and practices of the medical professionals; and the second was the recognition of how important the ground-level details are of putting in place well-trained staff who are able to deal with families in the critical moments when the possibility of organ retrieval becomes apparent; coordination between different parts of the service; and administrative systems that make the processes efficient. Moreover – and I really enjoyed the way that we could connect principles to practice – there was also a clear recognition that these high-level and ground-level questions are so closely bound together as to be co-dependent. And that that is the case whatever legal or healthcare system you have.

And just in passing, I had an hour or so to spare, so I made my second visit to the Holocaust Memorial, near the Brandenburg Gate. This is the most impressive and powerful piece of public art I have ever experienced. I would recommend a visit if ever you get the chance.

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