Incentives wanted for NZ organ donors
Kiwis need to give a little more of themselves to help others.
And to incentivise organ donation, there are calls for the Government to help fund funerals, bump people up the transplant waiting list and even pay for live donations.
New Zealand has one of the lowest donor rates in the western world, with 8.7 donors per million people, according to 2010 figures from Organ Donation NZ. This compares with France's rate of 23.7, Britain with 16.4 and Australia with 13.5.
More than 600 New Zealanders are waiting for kidney donations alone. A total of 186 organ transplants were carried out last year - 118 of those were kidney transplants. There were also 205 tissue transplants including skin, heart valves and eye corneas.
An extra $4 million to encourage more donors was announced by Health Minister Tony Ryall this month. Half of that will go towards training and support for intensive care health professionals to identify potential donors and $1.75m to incentivise live donation. The remaining $250,000 will be for exploring the option of mixing and matching incompatible donor and recipient pairs.
Canterbury University economics professor Eric Crampton said organ donation was something New Zealanders didn't really think about, even if they ticked that option on their driver's licence.
"Nothing around the driver's licence scheme really helps to encourage an informed decision," Crampton said. Even if a person has indicated a willingness to donate organs, they need to be in a hospital intensive care unit when they die to be eligible, and next-of-kin consent is still required. "Doctors seem reluctant to assign a terminal patient to a scarce ICU bed in hope the patient's family will consent to donation."
Doctors still feel the need to ask for explicit consent from family at what is the "worst possible time", Crampton said. "It's no surprise that half of families asked decline."
Methods of incentivisation are effective in other countries, including payment towards funeral costs. That would also encourage people to discuss the issue with their family when making a will, he said.
Compared with the cost of long-term dialysis, subsidising funerals is relatively cheap. "WINZ helps defray funeral costs for the poor. Why can't we also defray funeral costs of those helping to save others' lives?"
Another effective measure in Israel is compensating live donors with up to 40 days' lost wages and expenses. Expenses such as travel are covered in New Zealand, but not wages. National list MP Michael Woodhouse has proposed a private member's bill to give donors the equivalent of 80 per cent of their earnings using the same formula applied to income support for ACC recipients.
New Zealand also has a private prioritisation scheme, LifeSharers, where members sign up for free agreeing to be donors. The agreement is that their organs will go to a member on the waiting list with a suitable tissue match.
In America, couples who have incompatible tissue matches can seek out another couple where one partner does match, through the National Kidney Registry.
"Suppose I wished to donate a kidney to my wife, but I'm not a good match for her, and you're a poor tissue match for your partner, but I'm a match for your partner while you're a match for mine. The National Kidney Registry looks for situations like this and builds chains of living donors," Crampton said.
In February there was a chain of 30 kidney transplants involving 60 people. "In New Zealand, it would be a great way of helping to increase live donation rates. I hope we move quickly to implementation."
NOW YOU CAN SAY YOU'LL SAVE A LIFE VIA SOCIAL MEDIA
Last week New Zealand became the latest to approve a Facebook initiative that allows people to state that they want to be organ donors.
The global scheme works to promote organ donation, by allowing people to create a "life event" on their timeline saying they wish to become a donor.
Family members are still requested to give permission when the time comes, but the Facebook initiative is helpful in promoting discussion of the issue, Facebook's Australia and New Zealand communications and policy manager Mia Garlick said.
A Sunday Star-Times reader poll showed overwhelmingly that families should not overrule the deceased if they have indicated on their driver's licence they want to donate organs.
From a sample of 1029, 87 per cent were adamant the deceased's wishes must be followed. Eight per cent said it was OK to overrule and 4 per cent didn't know.
"Your organs belong to you, not your family. If you have signalled that you want to be an organ donor then that wish should be honoured," was a typical response.
"I would be most upset if my family was to override my wish to be a donor. Perhaps we should all take time to discuss our wishes," wrote another reader.
"I'm absolutely an organ donor (but I'm not sure anyone would want my liver ...)"
A retired solicitor who administered many estates said it was wrong the law allows an objection by one near relative to prevent organ donation.
"The needs of many are more far important than the wishes, for whatever spiritual or other reason, of a surviving relative ..."
- © Fairfax NZ News
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