Deciding who gets what
From Christopher Hen eghan Sir: Robert Gore-Langton ('Organ minders', 27 December) seems not to appreciate how offensive it is to suggest that a surgeon might make less effort for a patient with a donor card. Such an action would be very serious professional misconduct.
However, lest there be any residual concern, please be aware that there is no risk of such conflict of interests, as decisions to offer patients for organ donation are never made by transplant surgeons, so they are not in a position whereby their efforts or otherwise might influence outcome. Such decisions are made by those in charge of intensive-care units, and in the UK these are usually anaesthetists (90-95 per cent), sometimes physicians (5-10 per cent), occasionally A&E specialists or (non-transplant) surgeons. This separation of responsibilities is further ensured by the existence of the transplant co-ordinators, who organise the donation and distribution. This results in minimum contact between donor and transplant centres, and no likelihood of improper influence. It was nice to see such a positive article in these trying times, recognising that some efforts do bear fruit; a pity to spoil it with fanciful speculation.
Christopher Heneghan
Consultant in Anaesthesia and Intensive Care. Monmouthshire
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