It may be just what the doctor ordered – but it's not for me

Having to opt out from organ donation may sound sensible, but there is a very real danger of abuse, says SHEENA McDONALD

FOR more than 30 years, I have carried some form of organ donor card in my wallet. Now I'm considering wearing a wristband or locket – or even getting a prominent tattoo – indicating my unwillingness to donate any organ without the express consent of my husband or nearest relative. So why have I changed my mind?

When there is a critical need for potential donors in the UK, and an estimated 1,000 people die every year while waiting for an organ donation, have I mislaid the ethical dimension to my being a responsible member of society?

No – but I am deeply concerned by the current debate about changing from an "opt-in" system to one of presumed consent. When this notion was first aired last year, I was astonished that the British Medical Association and the Royal College of Nursing backed the idea. It was apparently the Prime Minister who called for the change.

Did he think this would win him popular support? Perhaps. A UK-wide ICM poll for the BBC suggests 66 per cent of us already support presumed consent – and that's before the Westminster-appointed Organ Donation Taskforce publishes its follow-up report to Organs for Transplant produced in January this year.

That report was a creepy read. It made 14 recommendations for improvements within existing legal frameworks.

Here's No 5: "Minimum notification criteria for potential organ donors should be introduced."

Why? I can understand that the fresher the retrieved organ is, the likelier it may be used effectively – but couple that with No 10 and your blood runs a tad cooler: "A UK-wide network of dedicated organ retrieval teams should be introduced to ensure timely, high-quality organ removal from all heart-beating and non-heart-beating donors."

So I welcome this week's survey of doctors across the UK produced by the Intensive Care Society, which demonstrates that there is a sharp difference of opinion in the medical profession about presumed consent. The consultant who conducted the survey says: "In intensive care, patients are often admitted suddenly and the families have to come to terms very quickly with the fact that someone may not survive.

"It is very important in this situation that we have their trust, that what we are doing is going to be in the best interests of the patient."

I know. I was that patient. And I am living proof that "doctor knows best" is a hollow sham of a claim. It is coming up to ten years since I was in an intensive care unit in London, having suffered a very severe head injury. I remember nothing of the incident but have read my extensive hospital notes and been told by shocked family members how I looked – they talked of an unrecognisable swollen head.

My brother came to see me the next day, so I asked him what he saw. He said I was in a coma and my head "looked like a big, blue pumpkin with a hole in it", while my eye was "not where it was supposed to be – halfway down your face". I have no recollection of the weeks I spent there, nor of the subsequent weeks and months.

Because of the length of time I suffered post-traumatic amnesia, I was not expected to recover to being much more than a happy, harmless, walking idiot. My consultant neurologist was utterly astonished and incredulous to be told a couple of years later that I was earning a living presenting live current affairs radio programmes for BBC Radio 4.

The textbook, based on professional wisdom, refused to allow such a degree of recovery. And yet there I was – here I am! – walking, working … and not very happy.

You see, the principle that "doctor knows best" risks corrupting the best-laid plans of task forces and politicians. The zeal to demonstrate the statistical efficacy of establishing "dedicated organ- retrieval teams… (to ensure] timely high-quality organ-removal from all heart-beating… donors" strikes me as a mandate for significant potential abuse.

Scotland has its own Human Tissues (Scotland) Act 2006. If the rest of the country adopts presumed consent as the norm, I trust Scotland's devolved policymakers will listen to the Intensive Care Society's misgivings. It is, after all, "dedicated to the delivery of the highest quality of critical care to patients" – and that is what I received.

And remember Edinburgh's own personification of medical omniscience: one Dr Robert Knox, immortalised by Osborne Henry Mavor, aka James Bridie. Organ retrieval in the 1820s was in its very early stages, of course – but Williams Burke and Hare were the dedicated team of their day.

• Sheena McDonald is a writer, journalist and broadcaster. She presents the Need to Know programme on Teachers TV.