‘Give organ donors transplant priority’: Doctor calls for new way of dealing with the problem of 'free riders'

The NHS should consider giving surgery priority to patients already on the organ donor register to address the problem of “free riders”, amid a “huge failure” in boosting organ donation rates among ethnic minority groups, an expert in the field has said.

Dr Adnan Sharif, a kidney consultant at the Queen Elizabeth Hospital in Birmingham, said the country needs to come up with new ways of dealing with people who do not donate organs but are willing to take a donation when they need one.

Figures show that ethnic minority people make up 10.8 per cent of the UK population, yet just 4.2 per cent of organ donors are from ethnic minority communities. This is despite them representing 24 per cent of the organ waiting list, according to Dr Sharif. He said there are only around 118,000 people registered to give an organ from black, Asian and other minority backgrounds.

“Relatives of non-white people are also less likely than white people to give consent for organ donation from loved ones who have died in appropriate circumstances for donation,” he wrote online in the British Medical Journal. The figure is 30.3 per cent giving consent compared with 68.5 per cent of white people.

“Simply pushing for more registrants on the organ donor register is not the solution because only a third of eventual donors are actually registered at the time of their death,” Dr Sharif wrote in a “personal view”.

“A new approach should be to tackle the elephant in the room: the problem of apathy or so called free riders – people who are happy to receive an organ but not to donate.”

Dr Sharif noted Israel’s approach to the issue, which is to give priority for organ transplants to previous donors or those registered to be donors. “The prioritisation approach raises ethical difficulties, such as coercion, religious constraints, or strategic behaviour, and translating such a policy to the UK would be fraught with challenges,” Dr Sharif said.

“However, developing a prioritisation system for organ and stem cell donation has inherent fairness for all – not just for minority ethnic people.

“Although it would positively affect the general population, it would also likely serve as an impetus for minority ethnic people, who will have an even longer wait under a prioritisation system if they do not commit.”

Dr Sharif said minority ethnic people cite “many concerns” about organ donation relating to distrust, or religious or sociocultural issues.

“But these concerns don’t seem to arise when the situation is reversed – to the receiving of an organ or stem cell transplant. That someone can be fundamentally opposed to donation but conversely be receptive to receipt is dissonant. One cannot, and should not, exist without the other.”

The numbers

118,000 The number of people from ethnic minorities on the donors’ register.

68 percentage of white people consent to their organs being used after their death.

30 percentage of people from ethnic minorities give consent for organ donation.