Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome all the presentations. We had the same discussion last week. While there may be varying views on how we approach this issue, it is important that organ donation be encouraged and facilitated, where possible. Many steps need to be taken.

Dr. Plant implied that we can profile the challenges that will be faced in the years ahead in the context of kidney failure and other conditions requiring transplantation. It is quite obvious that there will be difficulties associated with transplant surgeons. Perhaps talking about organ donation in isolation without promoting infrastructure and its development would mean the committee would be failing in its responsibility. Clearly, it is not just a case of organ donation; it is also a question of infrastructure and having personnel trained to approach families.

Does the doctor who was treating the patient who suffered from brain or cardiac death approach the family? Is that normally the case or is there a specialist nurse or staff member who has experience and training in approaching families with regard to organ donation? Does it happen on an ad hoc basis or are there structures and protocols in place? Does it depend on the consultant, surgeon or doctor?

I once encountered a family which lost a loved one and which was too traumatised in its grief to think of organ donation. The family has regretted it since. There are organs available every week that could be used but which are not used. We do not know why. We do not know whether there are cultural issues at play or whether we just do not profile, highlight and encourage organ donation enough. We do not know whether there is sufficient infrastructure in place. Much discussion needs to be held, not only on the legislative side. We must really promote the concept at Government level and throughout broader society.

When one sees the progress made in regard to the national paediatric centre, I have great confidence that action on the national transplant centre, on which I welcome the views, will happen very quickly.

As regards all-island based transplantation and harvesting, and on an east-west basis, is there a greater capacity for us? We are a small nation with limited resources so can we pool them on an all-island basis, in a structured way, including between Britain and Ireland? Surely there must be greater scope and potential to pool our resources in that area. In the coming years with the difficulties in which the State finds itself, I do not believe that the longer-term planning needed in the context of training transplant surgeons and other investments in infrastructure will happen as quickly as we would like. Therefore, there is the potential for co-operation in that area.

We are witnessing an international trade in organs, which is both illegal and unethical. It is disturbing and emanates from Latin America, Asia and parts of Africa. Clearly, the West is encouraging organ donation in whatever guise, be it soft consent, informed consent or opt-out. By encouraging people to donate organs it will surely assist in reducing the illegal trade. One would hope that is the case, although it may not be. As parliamentarians, we can do many things nationally and internationally in the European context.

I am intrigued how the system works at the coalface. For instance, in a hopeless case when all chances of survival are gone, who approaches the next of kin or is it done on an ad hocbasis?