On how British news media might move on from framing the opt-out system as a silver bullet to the crisis of organ shortages

Mainstream news coverage of organ donation in the UK tends to emphasise the cases of families calling for the implementation of opt-out systems as a solution to the well-known problem of organ shortages and the long waiting lists endured by people with organ failure.

A recurrent frame in the coverage involves children and their parents campaigning for presumed consent laws to be enacted by politicians.

Well-known cases are captured in documentaries such as BBC Two's Heart Transplant: A Chance to Live, which was broadcast in May 2018 as the "Max Johnson and Keira Ball Law". This case had received significant levels of public attention, underpinned by The Mirror's campaign to change organ donation law in England. 

Broadcaster ITV has also been a fundamental provider of news content that promotes the opt-out system, visible in cases such as little Dáithí MacGabhann and Georgia Kirchin, to mention a few. 

Understandably, the families involved tend to express high hopes that an offspring's wait for an organ will end sooner when the opt-out framework is in place.

Frequently, such stories involve politicians playing with children who suffer organ failure, and policymakers supporting the premise that changing the law will result in better organ donation outcomes.

It would seem that media coverage of the opt-out system in places like Wales, Northern Ireland and England plays a significant role in promoting faith in the idea of such a policy as an antidote to the organ shortage crisis. 

Unrealistic expectations?

The news media role in promoting presumed consent resonates with findings in the Netherlands suggesting that unambiguous solutions of policy discourse in that country about organ shortages might result in unrealistic expectations, relative to clinical practices and experiences.

In Wales, increase in donation after brain death and circulatory death following implementation of presumed consent in December 2015 may have contributed to a favourable public discourse in England towards the policy. 

However, recent evidence from large scale comparisons across countries is that nations with opt-out systems have fewer living donors and similar rates of deceased donation, resonating with a trend that had already been identified nearly two decades ago. 

And as researchers claim, even successful experiences like that in Wales are relative and call for continued efforts to effect sustained improvement of donor behaviour over the long term. 

Moving beyond the opting-out system as a silver bullet frame

British news media adoption of presumed consent as a regular framing device of organ malfunction has its benefits in that it contributes to articulate the challenges of organ shortages in a way that is informative. 

As in the case of Max Johnson, such frame is frequently accompanied by reflections on the contribution of transplant science to improving the quality of life and the lifespan of people who suffer from organ failure. It is also potentially an antidote against the role of fictional misinformation in countering the benefits of expensive education campaigns that aim to improve organ donation and transplantation outcomes.

However, if the news media in Britain are to continue their tradition of campaigning journalism in Britain, there is a case to move beyond the frame of opting-out systems as an unambiguous solution to organ shortages. In a future post I will explore public discourse alternatives to do so.