I rise to speak on the Human Tissue Amendment Bill 2020 which is being debated today, and I applaud the Government for bringing this to the House, as organ donation is something our party and party founder Derryn Hinch have always campaigned for.
I’ll start from the outset by saying I personally would like to see an opt-out system where everyone is an organ donor by default but can be removed just as easily as it currently is to opt-in. There are a hundred and one questions and details that would need to be dealt with before this idea could become a wholesome proposal, but I think it’s something worth thinking about; only 1 in 5 Victorians have registered their organ donation wishes. In my eyes, this is shamefully low.
In 2017, 465 organs were donated to save the lives of 389 recipients – Victoria was the best-performing state that year with these figures which is fantastic.
But we’re here to really talk about something that isn’t usually discussed when the talking about ‘organ donation’ and that’s the associated procedures that need to take place when organ donation is necessary. A person declared medically deceased doesn’t just have their organs extracted without certain processes and procedures being conducted first.
I’m not a doctor, but from what I’ve discovered through research for this Bill, there are two types of ways you can be declared dead; cardiac death and brain death. This is very morbid, but it’s important to the debate.
Brain death can occur when blood is still pumping around the body, which means the organs are usually being kept alive and family can take their time to say goodbye without inhibiting the viability of organs too much.
Conversely, with cardiac death, due to the limited blood supply, organs can be unviable quite quickly and the reason behind the urgency to obtain consent from the deceased’s family members.
With the latter, it’s important that for organ donation to occur, blood samples are taken in some circumstances as part of the process and in others, for medications to be given to increase donation viability as well. And it needs to be done with urgency.
This Bill addresses an issue here, where the Medical Treatment Decision Makers Act’s definition of medical treatment was interpreted narrowly so as to exclude ante-mortem procedures. As you can see, these procedures need to happen for some organ donations to happen.
There is a slight issue I see in this Bill though, and as Mr Limbrick has rightly point out in this place, there is no mandate to ask a patient’s medical treatment decision maker for permission to conduct ante mortem procedures.
Section 24E(b) basically says that if the patient hadn’t expressed objection to the procedures in their lifetime, the doctor could make decisions on behalf of the patient if a decision maker can’t be contacted. I will however acknowledge – very importantly – that this clause is only relevant to those who are on the organ donor registry, so the assumption is that they have signed up to be an organ donor of course.
In a country where Medical Treatment Decision Makers and next-of-kin have ‘the last say’ about their loved one’s donation (which has its own set of problems), clause 24E has the potential to skip this step entirely and can be interpreted very broadly. For example, if the medical treatment decision maker is overseas traveling (when we are finally allowed to travel overseas) or if the patient’s decision maker is elderly and doesn’t have access to a mobile phone, it could be easier to just proceed with the ante mortem procedures.
Mr Limbrick’s example of the patient being a member of the homeless community is also very pertinent, where there may be no family to contact. In these instances, I make the point that it’s imperative that future material in the organ donation opt-in process shows prospective donors exactly what could be involved, including ante mortem procedures.
But again – and the reason we won’t be supporting the LDP amendment today – is that consent has been given by this individual in their life to sign up as an organ donor via the registry.
And as I’ve stated earlier, the overarching problem for organ donation is that there simply aren’t enough donations happening. This comes down to three things;
Circumstances where those who are organ donors need to be in some unfortunate circumstances where their organs can actually be donated.
For this unfortunate person to have healthy organs to be transplanted.
Having enough people signing up as organ donors and really importantly, for those people to make their family aware of their wishes.
And this is quite simply our point of view that if your medical treatment decision maker can’t be contacted, shouldn’t your wishes as a person who has signed up to be an organ donor be taken into consideration above all? Currently, in this situation, the patient would be unable to commence ante mortem procedures and their organs would become unviable, even if you’d signed yourself up to be on the organ donor registry.
This view is on the proviso though, that every channel possible is exhausted in trying to contact family and next of kin before decisions are made.
And I think as parliamentarians this serves as an opportunity for us to advocate to the Federal Government to consider an ‘opt-out’ system.
Derryn Hinch – a recipient of a life-saving organ himself – agrees that organ donation should be taken up by more Australians and we hope this Bill does exactly that.
In summary, we will be voting for this Bill, but we preface this on every effort being made on medical professionals to contact medical treatment decision makers to conduct ante mortem procedures. And Victorians would expect this is the case too.