Wednesday, 23 April 2014

Our best health technology sits waiting for us to use it

I like to read science fiction. I like the way authors create societies, and then put them under dire stresses, to examine how they react.

But in order to get to the meat of the plot, the writers have to solve certain unsolvable problems. That includes inventing improbable technology to achieve travel at light speed, for instance, or methods of prolonging human life to allow travel to the stars, while still having enough years in a character's tank to complete the story.

One of the common solutions authors use for the problem of longevity in space travel is the medical ability to regenerate body parts at will.

Mankind (in the real world) is a lot closer to organ regeneration than it is to interplanetary travel, but the barriers to the success of our best medical technologies is our own reluctance to use it.

We can't grow new hearts, eyes or kidneys at will in a lab somewhere, but we can prolong life for a whole lot of people using donated organs. Except that we don't.

In 2012, in Canada, there were just over 2,000 organ transplant operations performed, in total. That number, we are told, hasn't changed much since 2006.

In Alberta in 2011 (the most recent figures I could find) there were only 313. This is according to a chart provided by the Canadian Institute for Health Information.

The wait list for organ transplants in Alberta in 2011 was 785, the majority (475) waiting for a kidney — a relatively easy organ to transplant, once a suitable tissue match is made.

We know that too long of a wait for a new kidney drastically reduces the chances of success, for what is really a rather common type of transplant operation. So, every year, people withdraw from the wait list, while more are added.

In 2011, 21 patients withdrew from the kidney transplant wait list. Another 13 Albertans died on the list in 2011, of a total of 138 patients in Alberta who either withdrew or died on the wait list for all types of transplant operations in that year.

So, roughly speaking, one Alberta patient either dies or is withdrawn from the wait list, for every five operations performed. By any reckoning, that's a pretty dismal success rate, given the technology at hand.

Which makes it hard to understand why, in the last 10 years, the number of registered organ donors in this province has dropped by 40 per cent.

There are two main barriers to a person becoming registered as an organ or tissue donor. One, obviously, is making the decision while living, and making that decision known to the medical community.

The other is making the decision known to next of kin, and for them to allow tissue and organs to be harvested from you after you die.

Irrespective of any organ donor cards or whatever you have signed, once you're dead, your next of kin has final say over you. So, for this process to be honoured, your successors need to honour it, too.

That means — no surprise — they have to be aware of your intentions long in advance. For your sake, hopefully very long in advance.

The province want to make it easier for this process to begin.

The Alberta Organ and Tissue Donation Registry at MyHealth.Alberta.ca allows people to give their consent to donate organs and/or tissues when they die.

The process is as simple as can be made with a legal document. You go to the site, you fill in your name and particulars, you print the form, sign it, have it witnessed and send it back.

It would make things easier if your witness was also next of kin, but that need not be so.

The paperwork is easy. It's the discussion with family that's hard.

But it needs to be done. You as an individual are valuable while you are alive. You are also potentially vitally valuable to a suffering person after you die, if you decide to become an organ donor.

I've written before that other incentives — OK, financial rewards — for becoming an organ donor are considered distasteful by people with squeamish sensibilities.

I still maintain that some consideration (I'm thinking of covering cremation costs, for instance) could still be given. It's a lot cheaper to do that for a kidney donor, than to keep a suffering person on dialysis.

But it should amaze us all, given the technology we do have right now to extend the life of individuals, to heal them instead of endlessly treating their ailments, is not being used.

It's no wonder that science fiction writers simply invent the means for excellent health for a very long time. Relying on human co-operation and kindness seems to be just too much of a stretch.

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