Helping people give the ultimate gift
David Anderson has a very demanding but rewarding role as an Intensivist and Medical Donation Specialist (MDS) in the Intensive Care Unit (ICU). Dr Anderson treats critically ill patients including those with serious injuries, life-threatening infections, severe burns or those recovering from major surgery, including heart and lung transplants. He also supports hospital staff, patients and families through the organ donation process.
There are currently 1400 Australians on the transplant waiting list. How do they deal with the wait for an organ that will save their life, knowing it might never come?
I can’t even imagine what it’s like to be suffering from an organ failure, and wondering every time the phone rings if this is the call. These patients are incredibly resilient and have been through so much already. You can give them the best chance of getting off the waiting list by finding out about organ donation, registering as a donor if it’s right for you and discussing your decision with those close to you.
What exactly is your role as a Medical Donation Specialist?
An MDS is an expert in end of life care and organ donation who is embedded in a hospital’s ICU team and provides advice, support and guidance on organ donation to other medical and nursing staff. Unfortunately, 10-20 per cent of patients admitted to the ICU will die, so intensivists also become expert at caring for patients and their families in end of life situations. The MDS role is part of the reason why Australia’s organ donation rate continues to rise.
Do you ever experience ethical conflicts/dilemmas between your role as the treating specialist and the donation specialist?
Not at all. Intensivists deal with complex end of life situations on a daily basis and organ donation doesn’t even enter our minds until it is clear that a patient has become brain dead or has no possibility of surviving their illness. It is important to have a clear delineation between the role of the intensivist to care for the patient and their family and the role of the MDS to assist ICU doctors and nurses in sometimes challenging donation cases. Organ donation is widely accepted in Australian society and most Australians would like to be organ donors so, from an ethical standpoint, there is really no issue with considering organ donation as a routine part of end of life care in the ICU.
How do you support a donor’s family during such a difficult time?
The role of the MDS is largely behind the scenes, liaising with various teams and supporting the ICU staff. I often support donor families, together with our amazing Donor Specialist Nurse Coordinators (DSNCs) who are really the front line experts allowing The Alfred to lead the way with organ and tissue donation.
What’s been the most rewarding moment of your role so far?
At The Alfred, we treat incredibly complex patients, including those who require specialised heart lung bypass technology (ECMO) to keep them alive. When these patients are dying and organ donation is being considered, it can be terribly difficult to negotiate the various issues that arise. The input of an Alfred MDS with both organ donation and ECMO expertise can be the difference between a patient fulfilling their wish to be a donor or not.
What is the most difficult part of your role?
Sometimes we have a patient who could have potentially been an organ donor but didn’t get the opportunity because the doctors or nurses looking after them didn’t consider organ donation or didn’t think that the patient would be suitable. Their cases are always sad because the staff involved didn’t really do anything wrong, they just didn’t know any better. A large part of my role as an MDS is providing education and feedback to different groups of doctors and nurses so that all dying patients and their families can have the opportunity to potentially help others by being an organ or tissue donor.
How many lives could be saved/benefit from one registered donor?
One organ donor could save or improve the lives of over a dozen people by donating their heart, lungs, liver, kidneys, pancreas, small bowel, corneas, heart valves, skin, bone, tendons and ligaments. What an incredible gift!
Are you a registered organ donor? What would you say to people who are unsure about registering?
Yes I am! If you’re unsure, it’s important that you make an informed decision that is right for you and then share your decision with your friends and family. Donating an organ is the greatest gift one person can give to another so it’s always tough when a family isn’t sure of their loved one’s wishes and therefore chooses to decline organ donation. It is so important for people to discuss their decisions around organ donation with their families. We know that when someone is a registered organ donor and their family knows about their decision, the consent rate for organ donation is 90 per cent, compared with only 60 per cent when the family are unsure.
The donate life website has lots of information to help potential organ and tissue donors make the right decision. Join the Australian Organ Donor Register today.