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Prioritising existing donors to receive organs would boost donation from ethnic minorities

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5036 (Published 20 August 2013) Cite this as: BMJ 2013;347:f5036

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Re: Prioritising existing donors to receive organs would boost donation from ethnic minorities

In his article Adnan Sharif advances an argument that the prioritisation of individuals who have already donated an organ or who are on the organs donation register (ODR) will improve organ donation rates among ethnic minorities. This reciprocity-based system of organ allocation is already in place in Israel which has seen an increase in organ procurement with a reduction in waiting times since its inception.

This is a system that would move us away from organ donation as a 'gift' to a system with reciprocity and obligation as its tenets. This may appear initially appealing: the system appears to have an innate 'fairness' about it. On further scrutiny however I believe there are serious and fundamental difficulties with this approach.

The donation of organs is prohibited by some religious and spiritual philosophies. Would this not be a form of discrimination? To what extent do we choose the religious group to which we belong?

Poorly educated members of our society from poorer socio-economic backgrounds are less likely to become members of the ODR. Should we permit the prioritisation of organs to those who are likely to be better informed?

Why should an individual be penalised for being poorly informed? Is there not a collective responsibility in society for the ignorance of those who choose not to join the ODR? The challenge of apathy

Competing interests: No competing interests

06 September 2013
Christopher J Mowatt
Consultant Intensivist
Worcestershire Royal Hospital
Charles Hastings Way, Worcester WR5 1DD