Dr. David Hickey:

As far as I am aware, the concept of presumed consent is not practised anywhere in Europe. It is in the books, but it never happens that a family is sidestepped in this situation. If one person in the family is uncomfortable, the story is over because we do not want to cause more trouble and strife. The donor card is a useful vehicle for those who are looking after someone who has just died to bring up the topic. If the family is not interested in engaging, that is the end of it. While one could argue legally in favour of going down that road, people who have struggled to save somebody for three or four days understand the situation very well. The donor card is useful and the concept of presumed consent may offer a similar vehicle in making organ donation the norm rather than the exception. In a not insignificant number of intensive care unit cases, the topic is raised by the family. That is great for everyone who is looking after the patient because it is not necessary to initiate the request.

In terms of numbers, we have four full-time equivalents. All of our transplant surgeons also perform significant urology procedures. Some perform more significant procedures than others, but they have a second job, which is often very busy. These four full-time equivalents are involved in transplants and organ procurements, as well as looking after the national children's transplant unit, which used to be in Beaumont hospital but has been moved to Temple Street Hospital. Two of us are double jobbing in that regard. As Dr. Plant noted, we have half of the necessary numbers when compared with the United Kingdom and these are not blue ribbon numbers. We are way behind what we need. If a transplant surgeon is confined to working 48 hours per week and he or she happens to be on duty over a weekend in which a couple of donors become available, that is the week gone. Twenty might be an exaggeration, but it would not be a great exaggeration.