The Race With Death

Twelve thousand people in Germany are currently on the waiting list for a kidney, liver or heart transplant. Tragically, many of them will die before the life-giving operation can ever take place. This organ shortage exists even though, according to official surveys, some eighty percent of Germans say, in principle, they would be prepared to become organ donors. In reality, just a fraction of them possess organ donor cards.

Last year, some 3,500 organs were transplanted, but more than twice as many people joined the waiting list. Burkhardt Topp from the Transplant Association says Germans are put off from helping others by a number of factors.

"I think that everything that is connected with death and dying is a taboo in Germany," he said. "And organ donation is obviously linked to that. If you think about this issue then you are also forced to think about your own possible death."

Scare Stories

Topp says that people are also worried by scare stories in the media about organ smuggling and organ theft.

"The theme of organ donation is made more difficult by everything that is somehow associated with the medical sphere and is not 100 percent upright," he said.

This insecurity has also been promoted by the long discussions here over what how to determine the time of death. Critics of organ donation argued that brain death was difficult to ascertain and that heart failure was the only reliable indicator. Lawmakers decided that transplantation could take place after brain death had been certified, but only if the patients were carriers of organ donor cards. And that only goes for some 12 percent of the German population.

In the majority of cases it is grieving relatives who are left to decide. Many have no idea what their loved ones would have wanted.

"The difficulty is that the topic is not talked about enough in the family," says Topp. "In eighty percent of the cases the family has to make up their minds about the question of organ donation. Of course, that leads to a very high rejection rate."

Opt-Out System

In Europe, Germany ranks in fifth place when it comes to the number of organ donors -- with 15 for every one million inhabitants per year. In the case of the top three, Spain, Belgium and Austria, the laws relating to donation are very different. There you have to opt out rather than opt in of the donor scheme. Everyone is a potential donor unless they lodge an objection in writing.

Professor Christoph Brölsch from the University Clinic in Essen thinks this solution is the only way of tackling the organ shortage problem here in Germany.

"I have been working on this problem for thirty years," he said. "I'll readily admit that I am extremely frustrated by the fact that we need to keep on persuading people of the necessity and the propriety of organ donation."

It is a situation that leads to a harrowing race with death. In Essen alone, there are 200 people waiting for a liver transplant. The reality in Germany is, says Brölsch, that forty percent of them will die before a transplant can ever take place.