Organ donor system reform: ‘If we’re going to make this change, we should do it with a clear head’

Greg Foley, who has been saved twice by donors, says there is a lot of ‘woolly thinking’ around the organ donor system

Having spent a cumulative two years on the transplant waiting list, Greg Foley knows what it is like to have your life depend on the generosity of others donating organs.

Despite this lived experience, he wonders if it mightn’t be better to “let sleeping dogs lie” by sticking with the current organ donor system rather than introducing an “opt-out” system, as the Government proposes.

Foley, who has cystic fibrosis, received a double-lung transplant in the UK 20 years ago and considers himself “extraordinarily lucky” to have survived so long.

“I was 39 when I got my new lungs. I don’t think I would have made 40. I was getting frailer by the day.”


Unusually, he knows who donated the organs – a young man who was knocked off his bike on a winter’s morning -, having worked this out through a series of connections. “When you know that, you realise what a big thing it is for people to do. I do worry about the trend to normalise it, and to say organ donation is a no-brainer. It’s not, really, it’s a massive thing to do at a time of real trauma for people.”

“No matter what system is used, it will be the family’s call whether to donate or not. Only a few countries have introduced a hard opt-out [where familial wishes could be overruled] but I don’t think anybody would be in favour of a system like that.”

The 59-year-old lecturer needed a second transplant in 2011 when his kidney gave out. The transplanted organ failed last year so he is back on dialysis.

Foley is critical of what he sees as “woolly thinking” on the issue. “A lot of people are under the impression that you have to have a donor card in order to donate. That’s not the case.”

Under the current “tacit” system, “everyone is a potential donor,” he points out. “The whole population is available but ultimately it’s the family’s decision. The new system won’t change that.”

“There’s a presumption around the new proposals that not many people will opt out but we don’t know that.” With mis- and dis-information growing online, the new system could fall prey to “conspiratorial thinking” and a higher than expected number of opt-outs.

The main determinant of whether a country has a successful transplant programme is the existence of a proper infrastructure, Foley points out.

“Who knows, maybe this will work by causing a psychological shift in people. But if we’re going to make this change, we should do it with a clear head.”

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times