Monday September 29th 2025
Christine Grahame MSP
Christine Grahame MSP writes her monthly column for Midlothian View
I recently had the privilege of leading a debate on the need for an increase in those prepared to donate organs on their death.
Now talking about death is always a difficult topic in any circumstance. One might say that it is grisly, and we in the western world prefer to avoid it. However, one death can save a life or allow a better life to someone else, and sometimes to many strangers.
The Human Tissue (Authorisation) (Scotland) Act 2019 provides for an opt-out, system of organ donation for transplantation. It applies to most adults aged 16 and over who are resident in Scotland, but it does not apply to everyone such as adults without capacity to understand the law, those who have lived in Scotland for fewer than 12 months before their death and children under the age of 16.
Otherwise, if a person dies in circumstances in which they could become a donor and have not recorded a donation decision—either to agree or to reject—it will be assumed that they are willing to donate their organs for transplantation. Even then, a person’s family will always be asked about their latest views on donation to ensure that it would not proceed if that was against their wishes.
That is where understandable difficulties arise. Specialist nurses must raise the issue of consent to use some of the deceased’s organs in the most distressing of circumstances. If a person has registered their wishes one way or another, it makes that discussion much easier.
Therefore, it is still better to register. Let me also stress that only 1 per cent of the population who die can be considered to become an organ donor—in intensive care and ventilated—so it is a niche set of circumstances.
The specialist nurse is one of a team of 23 who are based in intensive care units across Scotland supporting consultants and nurses who are having end-of-life discussions with families. They cover all aspects, from the initial referral from the intensive care unit team, to building a patient’s profile—bloods, electrocardiogram, chest x-ray, medical notes—organ matching, offering and placement; organising theatre; and organising for the national organ retrieval service team to arrive at the donor hospital. Time is always of the essence. They also provide a bereavement follow-up service for donors’ families.
There are currently around 600 people waiting for an organ transplant in Scotland at any one time, in urgent need of life-saving or life-enhancing organs, with the majority waiting for a kidney transplant.
One donor can save up to nine lives. I told the story of James Borland who died in February 2024 aged just 25. His mother chose to donate James’s organs, as she felt that that was right, as a kind and gentle young man. His heart, lungs and both kidneys, saved the lives of four people and has given his family so much comfort amid their grief.
So please register one way or the other.
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