David Norris (Independent)

I welcome the Minister of State, Deputy Moloney, to the House and I welcome his useful review of the situation. I also very emphatically welcome the clear indication he gave of Government support for the general principles behind Senator Quinn's Bill. I compliment Senator Quinn on his initiative in producing this legislation. It is no easy matter to produce a Bill. This is a very important area and one in which the advised view of the Seanad can be useful. It is also an area of some little delicacy in certain aspects.

My brain is somewhere over the Mediterranean because I have just come back from Cyprus by a very circuitous route. I put that on the record partly because I am rambling but also because in reviewing the literature I could not help but notice that, appropriately enough, it was a Cypriot European health Commissioner, Markos Kyprianou, who launched a significant report in this area in 2007. Even a small and fairly remote country such as Cyprus, which is still very much an agricultural community, has, through the human experience of its people, witnessed the need for action in this area. One of the things that moved me about what Senator Quinn said — I did not actually hear it, but I read his script, which he kindly supplied me with about half an hour ago — was the story of Mr. David Ryan. No one could fail to be moved by the way in which Senator Quinn put a human face on this matter. Few of us who have not been placed in this situation could possibly comprehend the agony of being on a waiting list and waiting for a tragedy to occur to another family in order that that person might continue his or her life. I do not frequently concur with the views expressed by His Holiness Pope Benedict XVI, but I am glad to say — I am sure it will go to Senator Quinn's heart — on this occasion I can. Recently the Pope indicated that he had a donor card. He regards it "an act of human love" to give life to somebody after one's own death. It need not necessarily even be life. It could be the gift of proper eyesight, proper functioning in other areas or improved functioning.

Among the areas the Minister of State reviewed was the question of opt-in, opt-out and the third option which is mandated choice. This is one favoured by the British Royal College of Physicians. Under that option legislation would be passed that decisions would be required by law to indicate before death a person's position. That affects an entire range of areas. In this country where we do not have a mandated choice or an opt-out situation, a person could be killed tragically and that person may have wanted his or her organs to be donated, but the views of the family take precedence. I am not sure that is wise. While the sensitivity of the grieving family must be considered, I am certain that in a case where a person has clearly indicated he or she wants his or her organs to be used then that should have legal precedence. I welcome that the Minister of State has indicated this is what the Government would envisage subsequent to the passage of legislation.

We must also take into account the Madden report. I must say some of the communications I have received from Parents for Justice seem to have a slightly shrill tone, including suggesting that Senator Quinn should go back to the dictionary for a definition of the word, which is a kind of debating point. I am not sure it does its case any good by making this kind of point, although, of course, I have not had, nor am I likely to have, the experience of being a parent or a bereaved parent. I can understand that feelings may very well be exacerbated in such a situation. However, I have known a number of people who have had transplants. It came as an enormous surprise to me that the late dean of Christ Church was one. In speaking to him on one occasion I was quite unaware that he had received a heart transplant. For someone of my generation it is astonishing that medical science has progressed to this extent.

I note in his contribution, which I heard, Senator O'Toole used the word "harvesting" of organs. The Senator used the term in the neutral sense. However, in the wider global political spectrum the Senator would be the very person who would be concerned about the word "harvesting" because he and I were among those who raised the question of the Chinese Government detaining Falun Gong prisoners and using them as live organ banks so that they could be killed to order and their organs harvested. It is reasonable to include in this important debate from a humanitarian point of view our continued revulsion of using human beings as a kind of organ bank.

In the neighbouring island of Britain there was a campaign sponsored by The Observer newspaper — I am not sure if other colleagues have referred to it. It is interesting that the overwhelming number of Members of Parliament surveyed were in favour of precisely the type of legislation Senator Quinn has urged upon the House this evening. They were supported by a very significant range of professional bodies. The British Medical Association, the Royal College of Surgeons and the Royal College of Pathologists all came out in favour of the opt-out approach. That is very important because, as may well have been said, we must face the fact that ten people every day in the European Union die for lack of organ transplant availability.

In his speech the Minister of State referred to Spain. I wish he had been more specific. He simply said something to the effect that although Spain has a very high proportion of organ donors, the originator of the opt-out scheme was not convinced that it was responsible. I would like to know more about that. I would like to know precisely what he said and precisely what factors the Minister of State believes were important. Were they education, a television and media campaign or something else? The figures are rather stark. Spain is the highest with 34.6 donations per 1 million people and the lowest is Romania with 0.5 donations per 1 million. The Minister of State did not tell us where in this spectrum Ireland fits. It would be very useful for us to know.

We know there are a considerable number of these operations. In case nobody else has put them on the record I would like to do so. Since 1985 there have been 261 heart transplants up to March 2008. While that is by far the largest transplant number, I would have thought it is still comparatively small. Since 2005 there have been ten single-lung transplants and six double-lung transplants. Here again we come to the heart of the human matter. One of the most insidious diseases is cystic fibrosis. The only real relief that can be gained by a patient from this terrible disease is by a lung transplant. That there have been only ten single-lung transplants and six double-lung transplants since 2005 indicates a need for a great development here. Some 32 people are on transplant waiting lists for lungs. I again return to the appalling situation of people left waiting and not knowing whether they will have the possibility of life.

We must consider the matter in an overall European context. The Eurobarometer survey has indicated that 56% of European people are prepared to donate one of their organs to an organ donation service immediately after their deaths and probably would support this kind of legislation. We must have an informed debate and I congratulate Senator Quinn. There are risks, for example if proper procedures are not followed, of receiving into the body not just the health-giving organ, but also malignant organisms such as HIV infection, hepatitis C etc. There needs to be full and proper quality control and infection risk monitoring. Various types of bacteria, fungi, parasites and cancers can be transmitted. We have already referred to organ shortages and there is the question of organ trafficking, which apparently exists in Europe at a very low level and underneath the general radar.

We need to consider the legislation very carefully. I commend Senator Quinn on producing it. It would be useful to place it in a European context and review the debate that took place next door in the United Kingdom.