Fri, Nov 09, 2007 page4

• Donations hit record low

  LACK OF ORGANS Surgery professor Ko Wen-che said the best method would be to allow people to indicate their willingness to donate while they are visiting hospital

  • By Wang Chan-min / STAFF REPORTER
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  Although the number of carriers of registered donor cards has increased over the past three years, organ donations after brain death have dropped to a record low. Experts said that no benefits have been felt in the three years since the willingness to donate organs was added to the details held on National Health Insurance (NHI) cards.

  The Organ Procurement Association (OPA) believes the reason for this lack of success is related to the registration of the willingness to donate on NHI cards as a footnote.

  OPA secretary Wu Ying-lai (吳英萊) said while the number of individuals consenting to donate organs and applying for donor cards has increased on average from 200 to 500 a month -- with the number this month expected to be as high as 700 to 800 -- the number of organs harvested at brain death is at a new low.

  The are nearly 50,000 people with donor cards. However, because the cards must be carried in order to inform family and medical staff to the holder's wish to donate in the event of death, the effect of the sign-up has been limited.

  In Europe and the US, legally binding donor cards are often printed on the reverse of driver licenses. After an evaluation, it was decided to add the wish to donate as a footnote on NHI cards. Wu said that although the number of NHI cards with consent to donate notes has increased to 40,000, the scheme has been largely ineffective.

  Medical personnel are largely unaware of the function of the footnote on NHI cards and the information cannot be accessed by many hospital computers, Wu said.

  Taiwan Organ Registry Sharing Center (TORSC) deputy executive officer Liu Chia-chi (劉嘉琪) said in many hospitals, only the payment/registration department computers are able to access the consent to donate notes on the cards. Although most people carry their NHI card, in the event of brain death it is unusual for medical staff to use the card to identify donors. Ultimately, hospital procedures must be improved before the addition of donor information on NHI cards become effective, Liu said.

  The process of adding the consent to donate to NHI cards has also been criticized. The procedure requires people to fill out agreement forms, either in writing or on-line. These are compiled by the OPA, which transfers the information to TORSC, which then reports the data to the Bureau of National Health Insurance for verification and registration. It is a time consuming and labor intensive registration process.

  National Taiwan University Hospital surgery professor Ko Wen-che (柯文哲) said the registration of donors on NHI cards is unnecessarily troublesome. He said the best method would be to allow people to indicate their willingness to donate during clinical appointments or while they are visiting a hospital.

  Allowing the public to choose whether if they wish to become a donor is known as the "opt-in law" and has been implemented in Taiwan, the US and other countries, he said. In countries where organ donation is more the norm, however, the so-called "opt-out law" dictates that individuals are required by law to donate organs, unless they indicate otherwise, he said.

  Countries practicing the "opt-out law," such as Spain, Singapore, France, Italy, Sweden and Greece, among others, have some of the highest organ-donation rates in the world, Ko said.
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