Abstract

This paper explores the issue of organ and tissue donation and transplantation in Australia, from a historical and comparative perspective, and finally analyses attitudinal data collected in 2006. A recent survey of 1000 Australians revealed that issues surrounding death and dying, and decisions about organ and tissue donation remain areas of great sensitivity with Australians (Alessandrini, 2006). While there is widespread appreciation of the acute need for organs and tissues to be provided for such purposes, and most would expect to have access to transplantation should the need arise, there is resistance at another level to individual agreement to the practice of donation. Recent highly publicised efforts to raise awareness of the demand for organs and to concurrently improve the institutional trust required for people to agree, have resulted in temporary improvement in numbers of registrations on the national organ donor register. Levels quickly drop once the media campaign winds back. The impact of the most recent of these, ‘Zaidee’s Rainbow Foundation’, taking a longer term focus, is as yet not known (http://www.zaidee.org/). There is a range of perspectives available to examine this issue, but increasingly it is becoming a health policy problem, in a global political environment. In this context how does Australia compare, and why are other comparable OECD countries so much more successful in recruiting potential donors and achieving follow-through? Research has shown that levels of political, social and institutional trust are particularly low in Australia, and declining. There is evidence that this has arisen from increased alienation. Participative policy-making mechanisms to reverse this trend would be likely to address some of the fundamental issues and increase a sense of empowerment and social connection.