Feargal Quinn (Independent)

I thank the Minister of State for attending the House for this debate. The objective of the Bill is to save lives. Ireland has a rate of organ donation approximately half that of Spain, which has had what is termed a "presumed consent" system in operation for some years. There is no legislative framework in Ireland governing the use or withholding of consent in regard to the donation of body organs; the only other country that does not have it is Malta. This was highlighted in the report of Dr. Deirdre Madden on post mortem practice and procedures, published in 2006.

This Bill endeavours to tackle this issue by providing that consent would be presumed for certain permitted activities. In effect, the Bill would reverse the current position whereby one must opt-in to consent to organ donation and, under its provisions, if someone does not withhold consent, it will be presumed that person had consented. Such systems are currently operating successfully in a number of other European countries. I am advised that approximately 28 countries have some form of a system of presumed consent in operation.

I will attempt to explain the reason I am proposing this Bill; there is a personal background to it. I have known, as perhaps we all have, a number of people who have benefited from receiving an organ by the consent of the family of a deceased person. In some cases this has been the gift of life, in others it has improved their way of life. I will tell the House about the case of one young man, the son of a person who worked with me in Superquinn a few years ago. David Ryan was his name. He was 19 when he learned that the problem in his heart could only be solved by way of a heart transplant. He waited for a suitable donor and then after 18 months he and his family learned that a suitable match was available.

During the 18 months while they waited for a donor heart and during which time David got weaker, his mother, Margaret, contacted newspapers to highlight the need for organ donation. She ran a campaign with her colleagues and customers to promote the donor card scheme. On Good Friday 2000, when David was 20 years old, a donor was found and the operation took place. His mother, Margaret, told me of the joy when he was coming out of unconsciousness. She remembers it well - I talked to her again about it yesterday. David was unable to speak at that point but wrote "21 soon" to remind her of his upcoming birthday. Within two days he was on his feet, chatting, well on the mend and taking an interest in his new life. His mother described how even on that Easter Monday David watched the races from Fairyhouse on the hospital television and he appeared well on the road to recovery. His mother, other family members, friends and work mates were overjoyed.

Unfortunately, two days later, on the Wednesday after Easter, the transplant heart was rejected and David died on the following Friday. The medical advice was that the 18 month delay in waiting for the transplant probably contributed to his death. His mother, having had time to discuss it with David, was aware that he was happy to have his organs donated to help others. Margaret told me that she feels somewhat comforted in the knowledge that two people have a better life because of David's donation. His eyes went to two people, one was a 25 year old and the other a 75 year old man.

At the same time in the same supermarket, two others were waiting for organ donations. These two colleagues were seeking kidneys and I saw their health deteriorate. One was Karl Carter, to whom I also spoke yesterday. He has successfully received a good match and is now well recovered. The other person is now waiting for her fourth kidney and has to spend a great deal of time on dialysis.

All that occurred eight years ago. Since then I have taken an interest in the whole question of organ donation. I was impressed at the interest in the subject and the work done by Dr. Patrick Condon in Waterford. He initially drew my attention to the different levels of organ donations in various countries. I learned that the number of organ donations per head of the population is much higher in Spain than it is in Ireland. The figure for organ donation in Spain is almost double the figure here. Since 1979, however, Spain has had a system which is the reverse of the Irish one; it is called a system of "presumed consent". This means that when one dies and if one is a suitable organ donor, it is presumed that one's organs can be transplanted to another person unless one has made it known that one does not wish that to happen. It is not only Spain that has that system, different variations and versions of it operate in different countries. Thanks to the good work of the Irish Kidney Association and the Irish Donor Network, Ireland has a respectable rate of organ donation, well ahead of that of Britain, which like us does not have a system of presumed consent.

This subject is worthy of more open discussion. The Bill I have put before the House takes into account many of the concerns of citizens about the implications of such a proposal. Some 67% of the Irish population support organ donation. They are willing to donate their organs to help or save the life of somebody else, but only 29% carry a donor card and that is the percentage who have accepted a donor card. When I went to get mine the other day, I had to search for it because it is eight years since I had it. Some 600 people are waiting for an organ donation in Ireland and 40,000 people are waiting for one in Europe. In Britain three people per day die as a result of not having received an organ donation.

I mentioned Karl Carter, a young man, who got an organ donation. He reminded me yesterday that donating two kidneys not only saves the lives of two people, it saves the lives of four people because the two people who each get a kidney come off of dialysis and two other people are able to go on to it. It seems a shame that there are people waiting for an organ donation and transplant and are unable to get it because our law has not gone far enough to ensure what we are setting out to achieve in this Bill.

I will refer to some aspects of the Bill that deserve mention. The central part of the Bill is section 3. I will summarise what it states and not mention all the legal terms covered in it. It provides that all persons shall be deemed, unless they have withheld consent, to have consented to permitted activities for scheduled purposes as set out in the Act. They are important elements because some people are concerned about the provisions of this Bill, and I can understand their cause for concern. They may believe that the legislation can be used for various other purposes which might not be acceptable.

I spoke to one mother whose baby died very early on. She informed me that she would have loved to have thought that, in death, her child might have helped someone else. However, she also indicated that she would have been extremely concerned if her consent had not been requested, if something had happened about which she did not know or if, as happened in the past when there was no legislation in place to cover such circumstances, part of her baby's body had been sold to a company for use.

The Bill appears to be quite involved because it focuses, in clear terms, on matters such as permitted activities. The objective of the Bill is to assist doctors who identify possible donors in circumstances where such people's organs cannot be harvested as a result of delays that occur. Let us consider what could happen if a doctor could rest assured that he or she could harvest an organ and save a life without breaking the law.

In the Bill, the aim is to ensure only permitted activities would be allowed. On first reading the Bill, some people were upset by the use of the word "storage" because it seemed to suggest that the possible aim is the storage of bodily organs. That is not the intention. I understand that even if organs are only being kept overnight, the term "storage" must be used. However, the objective is that there will always be a recipient for an organ before it is harvested. It may be the case that the relevant provision may have to be tightened up to overcome difficulties in this regard.

Another term which gives rise to concern is "commercial use" but this is not used in the Bill. This term is purposely not used because it is not a permitted activity. It must be remembered that the Bill is almost back to front in nature because only permitted activities are allowed. We did not include the term "commercial use" because we could not find a way to do so. There is a need to be very careful when dealing with this matter because we would not want to restrict the transfer of organs, especially in circumstances where, for example, the air ambulance employed for the purpose was owned by a commercial concern.

To make the job of medical professionals hoping to encourage the donation of organs easier, the sanctions in this regard are expressed in the context of civil rather than criminal liability. The concept behind this is to ensure that people would not be accused of being involved in criminal activity.

There are many worthy aspects of this matter which deserve to be debated. The Bill has been put forward for the purpose of saving and improving lives. It may not be perfect and I am sure there are parts of it that could be changed. In that context, it could be amended on Committee Stage. The Second Stage debate in which we are engaged is to ensure people have open minds in respect of this matter and that the general themes are discussed. I hope the legislation will be accepted and that we will be able to improve it on Committee Stage to alleviate people's concerns. Those who expressed such concerns in the past would welcome the opportunity to ensure the Bill is improved. This debate will facilitate discussion of the legislation and the matters to which it relates. I urge the Minister of State and Members to keep an open mind with regard to the topic under discussion. I also urge the Minister of State to accept the Bill.