The UK's organ donation rate is one of the lowest in western Europe because grieving relatives are reluctant to allow such procedures, a study says.
Intensive care units approached families for 94% of patients
For every million in the population, only 12 donate their organs for transplant, a UK Transplant study in the British Medical Journal suggests.
"The biggest obstacle [to more donations] is the high proportion of relatives who deny consent," it said.
Researchers looked at all deaths in 341 intensive care units over two years.
The UK has a "serious shortage of organs for transplantation, as does almost every country", said the researchers at UK Transplant, the NHS's organ-matching organisation.
They described Spain's rate of 33 donations per 1m people as "exceptional".
The study looked at the possible number of donations from deaths in 284 hospitals throughout the UK.
The maximum achievable potential donor rate during the two-year study period was 23.2 donations per million population per year.
"Intensive care units are extremely good in considering possible organ donation from suitable patients," the researchers said.
During the study, families of 94% of patients who could have been organ donors were approached for consent to donation.
A total of 41% of the families denied consent.
Their reasons included that they did not want surgery on the body, they were not sure if the patient would have agreed or that the relatives were divided.
The refusal rates for families of potential donors from ethnic minorities was 70%, twice that for white potential donors (35%), but the age and sex of the potential donor did not affect the refusal rate, the study said.
The study concluded that when the Human Tissue Act comes into force in September 2006, "the wishes and consent of the individual will be paramount".
"This may, in time, address this aspect and emphasises the benefits of increased registrations on the NHS organ donor register."
Are you happy to donate your organs? Do your family and friends know? Have you been asked for consent to donate a relative's organs? Read a selection of your comments below.
I am not an organ donor as I believe I came into this world and will leave with what's left. I would give my organs to my children/spouse while alive and certainly after death but I am not just handing them out to anyone because the public/medical profession think I ought to, like some sort of recyclable bottle that is in the public domain.
My wife and children are donors and in the event of their deaths I would respect their wishes and consent to organ donation. However I am fed up of being made to feel like some sort of social pariah because I choose not to donate. The argument that I don't need them is hollow. When I die I don't need my estate but nobody tells me I have to give it away to a more deserving cause than my family. Yes encourage donation but stop this subtle moral blackmail.
Ian Davidson, Amesbury, Wilts
The best thing to do is to talk with your family about this subject and agree on a common course of action with donation. As a result, all my family have agreed to donate organs in the event of my/our deaths. This will save lives. The spirit is the most important thing not the body which will only crumble to dust anyway.
Tom Hunt, Leeds, UK
I have made it known to my husband on many occasions that I would like any of my organs to be used for donation following my death. I carry a Donor Card and am registered direct with the Donor database with a link to my Boots Advantage Card. I can understand why it must be so hard for families coping with the news of their loved ones death to suddenly and very quickly have to make a decision regarding organ donation, so I would like to see the scheme overhauled. Anyone who registers on the Donation scheme should be sent a consent form on a regular basis to update their details and wishes, perhaps every couple of years? Then in the event of death, families should not be put in the position of having to make a decision. Sure they'll be admin costs but this should prevent a lot of heartache for all concerned and provide the opportunity to save many more lives.
Sue Brown, Alness, Ross-shire
I am more than happy to donate my organs and that of a relative's however, the problem I have is that my husband is not too happy about the idea.
Kathy Clark, St. Andrews Scotland
Once dead we don't need the parts so why not help somebody who needs it?
Yet another report from the medical profession in effect promoting an "opt out" system of organ donation. This kind of attitude makes the whole system no better than auto breakers. Perhaps a bit more respect for people and their wishes may be better than authority and compulsion.
I think everyone should donate their organs. When you die your body is burned or buried in the ground and left to rot. What a waste that is if parts could be used to save another life or give someone a better quality of life.
Kieran Wareing, Watford
The request to families to donate their loved ones organs comes at a time when it is probably the last thing they want to think about. However, there should be more of an open campaign to raise peoples' awareness about this subject. I would have no hesitation in allowing my families' organs to be used at the time of death. It would be a totally heart rendering decision to make, but I know my husband would want it and that is why we both carry donor cards and we both know what the other one wants. If there is a more open campaign about this, then people may not be so afraid to make a decision at (possibly) the hardest time of their lives.
Samantha Szumski, Sheffield
I think the law is wrong to allow relatives the chance to overrule loved ones decisions. If you carry a donor card, no one then has the right to say no on your behalf.
Jane Slater, Luton, England
We lost our 68 year old mum very suddenly to a brain haemorrhage three days ago. We are all so comforted that her kidneys and liver were transplanted into others. We know that some of these people are younger and with families, and have been waiting for years for suitable donors. It makes more sense of everything. Mum had never made her own wishes in this respect clear, but we are sure that she would be pleased with our collective decision.
Karen Richards, Oxon
I carry a donor card and my family know that I want to donate my organs when I die. Quite frankly, once I'm dead you can do what you want with me as I won't know about it! However, it would give me great comfort to know that my death can help someone else. My father died 12 years ago needing a heart transplant and I know how awfully painful it is watching a loved getting worse each day when you can't do anything about it but someone else could. That's helped me make my decision. Those people who are against donation should consider whether they would accept a donated organ if they were seriously ill - if the answer is yes, they should appreciate the need to donate.
Kay, March, Cambs
Well, I've already agreed with my wife that once I've died they can take my entire body - I'll no longer need it as a vessel for the soul or spirit or whatever else made it me, and if it can benefit others whether for transplants or research then it'd make me very happy to think I'd been able to help even after death. However, being only 36 I'm not planning on relinquishing it anytime soon so they can wait a while for it!
Deryck, Scarborough, UK
I think one has to be sensible about this and the wishes of the Donor must be taken into account. I will not become a donor on religious and moral grounds, however when my own Mother died it was her wish to donate her organs, and I had no problem ensuring her wishes were adhered to.
Bob Hutchins, Leighton Buzzard, UK
I am a registered donor my relatives should not have a say. It's up to me change the law.
David, London, UK
I am more than happy to donate my body for transplant or research but it would be nice to be assured that any remains that are of no use will be returned for cremation and dispersal in accordance with a request in my will. No mention was ever made of the disgrace of surgeons having to remove organs from babies at, for instance, Alderhay, that they considered would assist in future control of illness, or that it was necessary to do so because they knew that they were unlikely to obtain permission to do so. The farce of parents holding separate funerals for removed organs in little boxes makes one wonder whether those people would like to retain and store body parts removed in life saving surgery to reunite them with a body when the patient finally dies! It makes me ashamed to be British when I read about such nonsense.
Ian Aitchison, Elgin, Scotland
It has to be the greatest gift of charity anyone can give in their life (and the last). What's more the difference it can make to the quality of life to those receiving is probably far higher than the odd cash donation to a charity anyone can make in a lifetime. Best of all from the donors point of view, it's not as if you're going to miss it!
I have a special needs son, who unfortunately stops breathing on a regular basis. I have already spoken to the Transplant Co-ordinator about donating should we be unfortunate enough to lose him. In the last two months however, my son has unfortunately needed a corneal transplant himself for which we are immensely grateful to the donor, however, this means that my son will no longer be able to donate any organs. I think there should be a huge campaign to encourage more organ donation. I have also seen the other side having spent many months in hospital wth children desperate for organ donation. Some have been fortunate, some haven't. I just wish people would put themselves in another person's shoes and stop being selfish. If I could prevent another family suffering then I am 100% for it. I have seen and felt the pain and anguish of the possible death of someone close and if I could help stop their suffering, I would.
Mrs Laura Powell, Ash, Surrey
The family have no right to override the wishes of a competent adult whilst they are alive. Why should they gain the power to deny one of the patients last wishes once they're dead?
Anon, Cambridge, UK
In Australia we have a section on our drivers' licence where we can identify what category of organ donor we are based on which organs we are prepared to donate. My family know my wishes but I think it's better for everyone involved if I take responsibility for that decision away from them.
Liz Pfahl, London, UK
Of course any parts of my body may be used for others, but I know that, although they will agree as I have made my views known often & clearly, some members of my family are unsure as to whether they would otherwise have agreed. One way is to put it clearly in your will, carry a donor card at all times, make sure it is in any piece of documentation that could be seen when the time comes. It is understandable that families hesitate when presented with grief, please make sure they know that this is what you want.
Rosemarie Tomes, Mansfield, Notts
I cannot understand the way that we have become so precious about dead bodies and human remains. I have made strict instructions that all of my organs should be available, if possible, for transplant. If they cannot be used then my body should be retained for medical training or whatever if possible. As a last resort my remains should be disposed which ever way takes up the least space. Once dead a body is no more than a lump of inedible meat unfit even for feeding livestock.
Ian, Gloucestershire, UK