Organ donation

There has recently been the story of a woman who died who had, whilst living, signed up to donate her organs. He mother had problems with her kidneys and was awaiting a transplant. The daughter, everyone agrees, was quite clear that she wanted her mother to have her kidneys and was in the process of signing up to be a living donor. The daughter died before she could put this desire in writing. When she died, her organs were taken and given to strangers on the usual allocation basis of the organ donor registry. The mother therefore didn't get the kidneys.

This is an interesting ethical dilemma. On the one hand, there is broad agreement that medicine should try and save as many lives as possible, that's why we have a system of triage. On the other hand, we recognise the rights of living people to donate to whom they please, why does that right cease on death? Seeing as we do recognise that the dead have rights (that's why we have wills, don't allow medical experiments on dead people without consent and why digging up dead bodies is heavily regulated), why should the right to decide where ones organs go stop when you are dead where a clearly, undisputed request to the contrary has been made?

If people were never allowed to have a say in where their organs went after death, I suspect the number of organs donated would go down. Had the two men who received the daughter's organs in this case not received them, they may have died waiting.

All in all, what probably sways me in this particular case are a number of secondary considerations. The daughter, in this case, had a daughter of her own (Macie). The mother was the main carer of Macie. Now the daughter has died, she is the sole carer. I'm not a doctor, but various research programmes (ahem, House, Scrubs...) have taught me that organs can be rejected. The closer to donor and donee are genetically, the less likely rejection is. A daughter donating to her mother, therefore, suffers far less chance of rejection than the two men who received the organs. As the mother is also now the carer of Macie, the pendulum swings even further in her direction. To lose a mother is bad enough, to lose your guardian a while later, even worse.

The decision is difficult as it has to balance human lives, but in this case, I would have given the kidneys to the mother, not the strangers.