Jennifer Chandler holds the Bertram Loeb Research Chair in Organ and Tissue Donation at the University of Ottawa. She is also an associate professor at the Faculty of Law and a researcher in the Canadian National Transplant Research Program.
The public response to the appeal on behalf of Eugene Melnyk, owner of the Ottawa Senators hockey team, for a liver donor has been a heartwarming demonstration of the generosity of our community. Fortunately, it appears from media reports that there is a good chance he will receive a life-saving transplant in time.
But is it fair that he may receive a donation when many others are waiting – and dying while on the wait list for a transplant? This is one of the common themes in the commentary in the news over the past few days.
It is entirely understandable for those in desperate need to give up on the wait list for a deceased donor and instead reach out to friends and family, and even the public if they can, to find a live donor. But there is an inescapable unfairness in all such appeals for live donors. Those with larger families and social circles may have a better chance of locating a suitable donor. As for appeals to the public, those with wealth, fame, charisma or a particularly compelling story are likely to do better than those without such advantages because they are more appealing to the public or they have better access to effective mass communication.
Although some people are critical of public appeals for live organ donors, refraining from launching such campaigns does nothing to help anyone. In fact, it may actually harm people like Mr. Melnyk who hope to find a donor, as well as others on the waiting list.
First, public appeals to help one individual might indirectly benefit others waiting for a transplant. When the topic of organ donation and transplantation attracts the public's attention, as it has this week, more people tend to register their willingness to donate after death and to speak to their families about donation. This benefits everyone by increasing the availability of organs from deceased donors. It is important to remember that wealth and fame do not play a role in the allocation of organs from deceased donors in Canada, even if these factors might offer a platform from which to launch appeals for live donors.
Second, some of those who have come forward to help Mr. Melnyk may be willing to help one of the other Canadians facing a similarly desperate plight. So Mr. Melnyk's public appeal may well save the lives of others who are not as well-placed to command attention.
According to the most recent annual statistics from the Canadian Institute for Health Information, 374 Canadians were awaiting a liver transplant in 2012. In the same period, 111 people in need of a liver transplant died or were removed from the wait list. It is hard not to notice that in only a couple of days this past week, 2,000 people responded to the appeal on behalf of Mr. Melnyk, and more than 500 sent in donor applications. This level of support could go a long way toward meeting the need for liver transplants in Canada.
The ideal outcome in this case will be a successful transplant and healthy recovery for Mr. Melnyk and the person who donates to him, as well as – and just as important – spillover benefits for the many others awaiting a transplant. This could be in the form of increased registration for deceased donation and live donation from some of the many people who stepped forward for Mr. Melnyk.
It is in our hands as members of the public to help the many Canadians living among us who are desperately but anonymously awaiting a transplant. If we are troubled that the overwhelming response to celebrity appeals for live donors leaves these others unaided, there are steps we can take to help. Registering to donate after one's death is simple (it takes only a couple of clicks at beadonor.ca in Ontario).