It's not good and it's not right

7/19/2007 09:46:00 pm / The truth was spoken by Rich /

OK, so it’s been a while and I’m afraid it’s about time I knocked out something serious. I say serious, it’s not really serious, because I long since abandoned the idea of taking life seriously, but this will be one or two observations on an issue that has had me and others thrashing around in throws of indecision and woe for quite some time.

Initially I was going to advise anyone not directly effected by this subject to ignore this post and wait for the next one which is bound to be a little more light-hearted. But a recent proposal by the Chief Medical Officer Liam Donaldson has given everyone a vested interest in the subject, so even if you’re not waiting for an organ transplant or don’t know anyone who is, you might still want to read on. Unless of course you’re in a good mood and a light-hearted mood, cause this can read a little depressing.

Let’s start at the very beginning, a very good place to start. This Donaldson character, who is ginger, wants to introduce an opt-out system for organ donation in the UK, which would make every UK citizen an organ donor unless they opt-out. It’s a system other countries have used, including Spain and Sweden. In the former case it has successfully increased the number of organs available, while in Sweden it has been reduced.

Advocates of the system claim that surveys suggest that the vast majority of UK citizens would like to offer up their organs for donation. The actual percentage of the population actually carrying donor cards in this country (20%) does not reflect this claim.

My feeling is, that the answers people give to High Street questionnaires very rarely reflect their true sentiments. People give answers that show them in the best light. At best it’s not the most solid of foundations on which to build an argument for such a contentious issue, at worst it’s plain ridiculous to base a campaign on answers to surveys given by people exiting Argos with some bargain floor lamps under their arm.

I tend to think that the reason people don’t carry donor cards, is quite simply because they don’t want to. The idea of being carved up posthumously is only slightly less undesirable than being carved up alive. It’s really not difficult to register yourself, so I think the fact that people are not signing up, is not down to ignorance of the system, just an aversion to it.

Quite right to. It’s not a coincidence that the only people who campaign for this sort of thing are people who are in desperate need for an organ themselves or have immediate family members on transplant lists. If they didn’t, they’d be like the rest of the country and not care. People will champion the prevention of animal cruelty measures without having pets themselves, because morally we all see this as wrong.

Organ transplantation is a little more subjective and I don't think it's appropriate to preach to people one way or the other. It’s always irritated me that this campaign, (campaign really being a euphemism for harassment), is undertaken by people who previously didn’t give a shit about the subject, but suddenly because of a change in their personal circumstances have decided it is the most crucial of issues.

"Compulsory-donation" is a contradiction in terms. Donation by definition is a gift; a voluntary offering. Once organ donation becomes compulsory it is no longer a gift. The state does not own your body, and in my opinion should not have the authority to make these kinds of demands.

I would actually like to see an end to all organ-donation. I think it is about as wrong an idea as the medical profession has come up with to date. Worse even than the quacks who felt they could alleviate the pressures of a headache by drilling a hole in the patient’s temple.

I chose to decline a lung transplant for a number of reasons: first of all, the idea of having someone else’s lungs in my body appalled me. I used to joke that I was bound to end up with a Tottenham supporters lungs in my chest, but at the time I was only half joking. The idea kept me awake at night. More disturbing though, were the physical and emotional burdens life on the waiting list and life post-transplant places on the individual.

I couldn’t see how it would be possible to life on such a perpetual knife-edge. We all have little diversions and issues in life: flat tyres, lovers tiffs, spilt milk, car insurance, bad hair days etc etc. These little diversions are absolutely necessary for us to live. Without them, all we’d be left with are the enormous philosophical issues about mortality and life and we’d be so weighed down by them that we wouldn’t be able to lift ourselves off the sheets in the morning or even see the point of doing so. We call it complacency but it’s just the small change of life’s currency.

This is how I came to see life on the transplant list. They give you a beeper and it can go off at any time of the day or night and you can’t travel beyond a certain distance from the transplant centre. How are you ever supposed to forget it’s there? How can you live any semblance of a normal life knowing that little beeper can go off anytime? And once it does, life as you know it is over. Or, your life is over.

The operation will either change you profoundly or you’ll not survive it and should you survive, you’re essentially back to living under the same pressures as with the beeper, as the possibility that your body will reject the new organs will always be present. How can you forget about that?

Of course, the beeper may go off and it’ll be a false alarm, so all the millions of thoughts and fears that went through your head will have to be packed away for the next time, that is of course if you’re not so shit scared you decide you don’t want to do it again.

When advocates of organ transplantation call for more awareness and education, they’re talking about awareness of how many poor souls require organs and how little are available. They’re not talking about awareness of what is actually involved in the transplant process and what a gruelling life and journey it can be for the individual and the family and whether it is actually worth the trouble.

I think there’s two ways you can reduce the deficiency of organs available. You can make more organs available by making registration easier, although it already seems pretty simple to me. And you can reduce the number of people on the list in the first place by educating those in need of organs on the processes involved more thoroughly, because I don’t think they do that. I’m talking about the whole naked truth, warts and all. I think people assume that death is not an option and sign up for transplant lists without making themselves fully aware of the implications and burdens they’re placing on themselves by living under those conditions.

I’m not suggesting people might be so shit scared as to rather perish naturally, just that, no matter how thinly you slice something, there is always two sides to a story and there is a fate worse than death. Everyone dies; you can’t prevent death. The one true certainty in life is death and I think people tend to try and ignore this most fundamental fact.

Under these circumstances Kenny Rogers’ Gambler had a point, if you are to die, the best you can hope for is to die in your sleep. Cystic Fibrosis is a pretty undignified illness, so I felt I owed it to myself to at least make my death as dignified as possible.

I decided that the “list” was no way to achieve this. I came to accept that when my lungs are no longer strong enough to sustain me, I should slope off to the blissful nothing from whence I came, naturally. I also felt that, to be fair, the world isn’t actually that nicer place that I should feel like fighting that hard to stay in it. Any place where George W. Bush can be the most powerful man is probably somewhere you don’t want to spend too much time anyway.

I think a more humane system for everyone would be ditch transplanting. It’s a brutal system for all involved. It’s physically appalling, emotionally disturbing and we’d all be better off without it. I’d like to see all further funding of transplantation stopped immediately and diverted towards stem-cell research. It’s only really religious crazies who oppose this field of research and I feel that’s even more reason to support it.

I don’t see transplantation as playing God, mostly because I don’t believe in God, if anything it’s playing at natural selection and I think we’ve proven time and time again, that we’re no good at deciding who should live and die. Are we Germany?

The problem with transplantation is that it’s assumed that once a person dies and their organs are slotted into someone else, that the transaction and consequences end there. Life is a little more complex and chaotic than that. It’s absolutely impossible to contain life in such a simple equation. Have these people not seen Jurassic Park for fuck’s sake?

Once you keep someone else alive longer than their initial allocation of time on this mortal coil, you change history. This person’s actions cause a cazillion reactions and interfere with the course of literally farsands or even miwyans of other peoples lives.

By “saving” one life, you may end up costing several others theirs. Now this is complicated stuff and I think it’s best left to natural selection to decide who lives and who doesn’t.

Stem-cell research on the other hand seems a little more compatible with natural selection. I mean, chopping and changing organs between each other seems to me to be fundamentally wrong, but if we have the power to regenerate ourselves from ourselves, well that must surely be the essence of evolution.

OK, I think that’ll be enough of this serious horse hockey. I’ve had this in my head for a few days now and I had to vomit it out before it did me some harm from within. Like farting really; dirty pants clean bottom.

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