NHS Blood and Transplant St Valentine's video is example of transformation in organ donation discourse

Talking about organ donation with one's loved ones has become a key component of public discourse as a feature of health systems' attempts to tackle organ shortages. 

Communicating verbally with relatives about one's wish to become a donor in the case of death is presented as a condition for presumed consent laws to be effective in their aim to increase the pool of organs available for transplants. 

A strong example of this discursive approach in a country like the UK is found in this NHS Organ Donation video, in which artist Adaya Henry encourages 'more people to have the conversation about organ donation.'

The video was prepared to coincide with Valentine's Day, a date in the calendar that is associated with heart symbols — traditional signifiers of love. The resulting equation of organ donation as an act of love also provides an ideal channel for news coverage.

For example, a BBC News article published on 14 February told the story of Michelle Crawford, a resident from Londonderry who expressed she sees St Valentine's as 'a second birthday' since this was the day when she received a life-saving heart transplant in 1992. 

From the "gift of life" to "show us your love"?

The notion that discussing one's wish to donate amounts to an expression of love puts into perspective how health policies and institutions articulate organ donation in terms of shortages that can be tackled through acts of love. 

In a way, the frame of love in the context of St Valentine's resonates with the somehow problematic "gift of life" metaphor that has for decades been used to promote collective awareness about the plight of patients on the waiting list. 

It makes sense to reflect on the expressions and ideas which are used in public communication about organ donation because this shapes how such a health challenge is collectively understood. 

Thus, while the "gift of life" can make a lot of sense to a person who has not had personal experience of organ donation or organ failure, it is loaded with complications for families who are asked to consent to donating the organ of a relative they've just lost, or with guilt for the patient who has benefited from someone else's death. 

Another problematic dimension has been opened with debates and implementation of presumed consent laws. Laudable as it may seem to parents hoping for a suitable organ to become available for their child, a well-intentioned policy can be perceived by both experts and sectors of the population as an act of violence.

Love: the way forward?

Since any approach to naming social reality will be fraught with tension and contradiction, societies need to change constantly as they try to find better ways to deal with such problems. Thus, careful threading, as opposed to "command and control nudging", is needed if a pathway forward is to be found.

In my view, the framing of donation as an act of love could be considered as part of an evolutive process that portrays organ donation as an individual decision grounded in one's better angels. 

This is arguably a valuable transformation, considering that, as Moloney and Walker found, the focus has moved from a discourse that in the 1950s described organs as spare parts that could be simply replaced by heroic surgeons.