Life and death decision

Nick Watson Producer Politics Show West Midlands

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Is this card along side your credit cards?

Hundreds of people die every year in the UK waiting for organ transplants because there simply are not enough people out there carrying donor cards.

The figures are quite shocking. According to the Department of Health more than 400 people die annually waiting for a new kidney, heart, lung or liver.

Around 8,000 people in the UK currently need an organ transplant but only 3,000 transplants are carried out each year, so Health Secretary Alan Johnson has decided to act.

He has asked the Organ Donation Taskforce to consider whether all adults should be automatically included on the organ donor register.

Noble goal

I want to see organ donation and transplant rates start to rise and match the rates seen in some other European countries Alan Johnson, Health Secretary

The proposal is known as "presumed consent" and would consider everybody as a potential donor unless they had registered an objection or "opted out" before death.

"I want to see organ donation and transplant rates start to rise and match the rates seen in some other European countries enabling us to save many more lives," said Mr Johnson.

It is a noble goal but it is an issue fraught with complex moral and ethical dilemmas and arguments - not least of which are the rights of the individual and those of the family of the deceased.

The British Medical Association support presumed consent and have called for a full public debate to move towards a new system - which they say will save hundreds of lives every year.

Increased demands

"The current opt-in system of organ donation is unable to meet the increasing demands placed upon it", states the BMA's website.

It continues: "The time is surely right to consider a review of the current organ donation system and look at new ways to improve donation rates."

The BMA supports a so-called "soft" system of presumed consent in which relatives of the deceased could exercise a veto in certain circumstances.

However, some medics want even tougher rules like those adopted in Austria where there is a strict opt-out system with no role for relatives at all.

Tireless campaign

Our lives in their hands - but they could do more with more organs...

On the other side of the debate, David Nix, of the Birmingham-based Donor Family Network, opposes presumed consent.

Mr Nix set up the organisation with his wife, Jane, after the death of their 21-year-old daughter Rebecca in a road accident in the United States in November 1996.

Organ donations from Rebecca, helped a remarkable 74 people, including two people who regained their sight.

Since then, David has campaigned tirelessly to persuade people to join the NHS Organ Donor register.

Required referral

So why is he against this apparent attempt to increase the number of organs available for transplant?

"I want to increase organ donation," he said, "but I do not think presumed consent will increase it.

"I don't want anybody to die as a result of waiting for a transplant but I think this plan is a smoke-screen. There's not enough IT beds and not enough trained personnel and that's what's needed," he added.

Mr Nix favours the American system of "required referral" where families are closely consulted and which, it is claimed, means it is less likely that opportunities for donation are overlooked.

Our reporter, Katie Inman, has been speaking to transplant patients, the families of donors and medical ethics experts.

Also in the programme ...

As plans to introduce some sort of road pricing or congestion charging scheme in the West Midlands resemble a car crash between political expediency and public hostility the inevitable row about who is to blame begins.

The story so far: Birmingham and Manchester are seen as the best hope big cities to trial some form of scheme in return for lots of lovely government lolly to fund exciting transport schemes... like the refurbishment of New Street station for instance.

After many months of feasibility studies, naval gazing and head scratching, it all goes quiet in the West Midlands as a Downing Street petition against road pricing is signed by a whopping two million people.

Those who claim to be leaders should surely show some leadership, as Ken Livingstone has done in London. Dr Lynne Jones MP

Kryptonite

Manchester soldiers on with its plans but in the West Midlands road pricing is regarded in the same way that Superman regards Kryptonite.

Birmingham Selly Oak MP, Dr Lynne Jones, recently wrote a damning letter to Stella Manzie, Transport Co-Lead Chief Executive of the West Midlands Metropolitan Districts Group and Chief Executive of Coventry City Council.

Dr Jones condemns among other things the dense language of the difficult-to-read Transport Investment Plan.

Lagging behind

"Your so called 'common-sense' approach simply puts off the most important issue... the need to develop congestion charging/road pricing in order to pay for the investment needed", she wrote.

And of the way in which the issue had been presented to the public she had this to say.

"Those who claim to be leaders should surely show some leadership, as Ken Livingstone has done in London. Is the West Midlands to again lag behind, letting Greater Manchester steal the lead?"

Ouch! Over to you Stella and co.

Our transport correspondent Peter Plisner has been picking through the wreckage.

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