The rules of life and death

Yes. I agree but the report says;

"She had also told her mother she would be prepared to be a "living donor", but had not begun the formal process."

We may never know if this is correct.....but if it is?

In effect you agree to give up a kidney (it's one of the few things you have two of) so that another, who can be a relative, will benefit.

Medical science can be an harsh thing at times, and decision making either by coordinators, doctors or family members can have possible drawbacks at the moment of want or in the future.More so I suppose, if it concerns a family member.

I was reading an article the other week, regarding instructions of 'Do not resuscitate'. It is now under consideration as to whether a doctor or someone in a similar position as the legal authority to sanction this act.

There is a priority list for a good reason. Those at the top are at deaths door, some die before a suitable donor is found. Would it have been prudent to ask the mother who she would choose to die so that she could jump the queue? I think not.

There are moral issues at the heart of this and that will always create debate but lives are also at risk.

in the Bristol headquarters of the National Organ Donor scheme, and with an organ transplant team in a Bristol hospital. I was writing a feature article about donating organs, and I saw at first hand how these people work. It's a fascinating and very impressive process, and involves coordinating teams of people in hospitals all over the UK, and beyond - we share organs with European countries, too.

Decisions about recipients are made based on tissue-typing and medical priorities, and I can well understand how a system whereby people could choose the recipients of their organs just wouldn't be workable. It's an emotive issue, no doubt about it, and during my time in the centre, and later, at the Bristol hospital I met and talked to the parents of young people who had died following accidents, and whose organs had been used. I also met several recipients of kidneys,hearts and lungs.

There's a good deal of care and sensitivity evident in the way the medical teams work as they deal with both donor relatives and recipients. It's both hard and emotionally-draining, and I wouldn't have their job for the world.

has said that it acknowledges a need to consult with medical professionals and others on this issue, and that there might occasionally be very special circumstances which would justify bending the rules.

The problem is that it would be quite impossible to have a system whereby donors could select recipients in advance. One of the results of such a system might be - probably would be - that people would be less likely to become donors if told they couldn't choose to give organs to loved ones or friends. In truth, situations like this are extremely rare.

On balance I'm in favour of leaving it as it is - let medical professionals make decisions based on clinical priorities and tissue-typing.

This is understandable an emotive issue and when I first saw the report in this mornings news, in my typical knee-jerk reactionary way I was outraged and thought the organ should have gone to the mother

After thinking about it calmly I realised that the way they do it is the best way.

The much sought after organ goes to the person with the greatest need and that must be right, although it is very understandable that a daughter would have chosen to donate to her mother and of course this is what would have happened had she not died.

It's perfectly possible for someone to become a living donor, the issue is clear there.

Is there a difference where the will of the dead person, made when alive, should be followed? I realise in this case it was not an issue but should people be allowed to bequeath their body parts to a relative assuming there is a medical need?

I'm not sure the decisions are based fully on "greatest need" although I imagine there will be some at deaths door who will be given priority.

I think it's more about priority on your position in the waiting list and moving up the list.

"you will want to ensure that every transplant has a high a probability of sucess as possibility"

Precisely - that's why the present system works well; decisions are based on clinical assessments and tissue-typing. I don't think that the people involved find themselves confronted with moral dilemnas (or dilemmas, depending on your preference) at all - certainly the people I spoke to, both in the transplant co-ordination centre and in the medical retrieval and transplant teams didn't. Transplant surgeons have a list of waiting recipients, and they are offered organs by the transplant centre if the database shows that one of their patients might be a suitable match. The patient most likely to be a good match is contacted and told to start travelling to the hospital.

The system swings into action, and cross-matching and patient preparation takes place. Nobody IO spoke to - and I spoke to pretty well everyone involved - told me that they had any moral issues at all. Patients needing organs are given them as and when they are at the top of the list and a suitable organ becomes available. It's a fair and effective system.