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How Transplant Australia is supporting improvements in donation rates

The question has been asked about how we best help increase organ donation further in this country?

Transplant Australia supports the national reform program, which has over the past five years delivered real increases in donation rates.

Since 2009 there has been a 53 per cent increase in the number of deceased organ donors and 2015 is on track to record the highest number of donors ever in Australia. Between 2000 and 2008 the average number of donors was a little over 200 each year giving about 600 people the gift of life every year. This year we are on track to have more than 400 families agree to donation providing transplants for in excess of 1,200 people.

Is this enough? No, of course not and we cannot rest until Australia matches world’s best practice in donation.

First Person Respect

Our key strategic initiative is to help improve rates by advocating for ‘First Person Respect’, which is built on the premise that the decision of the donor is paramount.

To best achieve this outcome we still need to encourage as many people as possible to join the Australian Organ Donor Register and we also need to strive towards a community, clinician and family ‘norm’ that an individual’s decision is respected – so we honour their legacy. This is similar to the First Person Authorisation model used in all states in the United States. In Philadelphia this is part of the solution delivering donation rates in excess of Spain which is credited as a world leader.

We already know registered donors are twice as likely to go on to donation compared to those who have never discussed it with their family. To explain further, the rate of family consent from those families who have not discussed donation is 46 per cent but for those registered it is a little over 90 per cent. In other words families rarely over-rule their loved one’s decisions.

There will always be circumstances where it is too traumatic and emotional for the family. First Person Respect supports families because they are not being asked to decide about donation, they are simply being asked to honour their loved one’s legacy to save lives.

Other approaches

Transplant Australia welcomes active debate around organ and tissue donation and the various ways we as a community can improve rates and saves more lives.

We believe First Person Respect is the best path, compared to other models including opt-out donation. When we surveyed our members in 2014, which has informed our approach, their feedback to us included:

We offered members an opportunity to respond to the following statement:  An individuals’ next of kin should have the final say when that person hasn’t registered.

80 per cent agreed or strongly agreed that the family indeed should have the final say when that person had not registered. 10 per cent disagreed (assuming they therefore supported an opt-out model) and a further 10 per cent were neutral.

When we asked members to rate their response to this statement: The decision of an individual to give the gift of life by becoming a registered donor should be final.

The response was even more compelling with 90 per cent agreed or strongly agreed. Two per cent disagreed. Our members, along with the general community, do not like the idea that families can overrule a person’s decision to become a donor.

Looking ahead

We will continue to contribute to the debate and to advocate strongly on behalf of our members and those awaiting for a transplant. Transplant Australia has two of our directors on the Organ & Tissue Authority’s Advisory Council. We are also joining a Campaign Steering Committee to modernise the Australian Organ Donor Register so it offers a simple and easy online solution to encourage as many Australians as possible to sign up.

In these engagements, we are advocating strongly for a system which respects a person’s right to become a donor when they can speak for themselves, and have that decision honoured when they are no longer able to speak.

Increasing donor rates is our number one strategic imperative. We believe we can best achieve this by working closely with governments and the Organ & Tissue Authority as well as with community and others deeply connected to organ donation.

Australia should be proud of its improvements in donation. Importantly, we need to continue to instill public confidence in our donation system and that means speaking in the public about the recent successes. If we are negative we will only fulfil our own prophesy. And it is the least we can do in recognition of organ donors and their families who confirm this decision at one of the most difficult times of their lives.

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