Editorial | The Donique Anderson Act

The tragic case of Donique Anderson, the 26-year-old policewoman who died last week of liver disease, provides new and additional context for a campaign to lift awareness of, and support for, a robust organ donor registry in Jamaica.

Ms Anderson’s courage in the face of her illness has been lauded, including by the national security minister, Horace Chang, who called her “a fighter” and her death a “tragic loss”. He has promised her family financial support.

What Ms Anderson wanted desperately, however, was life. Her life!

In May, with the support of the Jamaica Police Federation and the diaspora community, Ms Anderson went to the United States, hoping to get on to New York state’s transplant wait list. She could not. There were questions about her status in the country, the costs and insurance. She returned to Jamaica. She died on Christmas Eve at The University Hospital of the West Indies.

Since Ms Anderson’s diagnosis in 2018, it is likely that more than one person among the nearly 110,000 people who died up to the end of 2022 would have been a match for a liver transplant. And someone, perhaps, might have been willing, in death, to be an organ donor – if they know of, or were sensitised to the possibility.

NOT UNIQUE

In this failure, Ms Anderson was not unique. Although precisely how many Jamaicans are in need of organ transplant is not known, several people, some of them, like Ms Anderson, young and full of promise, die each year from organ failure. Some might have been saved by a transplant.

It is not that these procedures cannot be done in Jamaica, or that it would be illegal to do them. A kidney transplant was first done in Jamaica more than 50 years ago, in 1970. Indeed, the island has had a Human Tissue Act since 1972, which allows people, orally before witness, or in writing, to agree to donate their organs “for therapeutic purposes or for purposes of medical education or research”.

This, however, has not led to any significant growth in organ donation, which, in part, has to do with cultural factors. Jamaicans tend to consider the body as inviolable, to, insofar as possible, be buried whole and intact. Significantly, too, there has never been a vigorous or sustained campaign, with strong regulatory arrangements, in support of organ donation. There are sporadic calls for such a campaign, like that of government parliamentarian, Michelle Charles, in the House during the State of the Constituency Debate.

Dr Charles suggested an approach tantamount to an opt-in scheme, in which inclined donors would have their intention registered in the proposed national identification information database and embedded national identification card.

“I would also like to see The University Hospital of the West Indies reimplement a transplant clinic here in Jamaica and train our new resident doctors as well,” she added.

ISN’T A PANACEA

While the details are to be crafted and refined, this newspaper supports the general thrust of Dr Charles’ suggestion, appreciating that organ transplant is not a panacea for diseased organs. Nor do we expect Jamaicans to be jumping queues and breaking down doors to register as organ donors.

Indeed, in the United States, where organ transplant is perhaps most advanced, despite more than 40,000 transplants a year being done, nearly 104,000 people are on wait lists. Eighty-five per cent of the people on these lists are hoping for new kidneys.

In England – where the law makes an opt-in assumption of organ donorship, unless an individual specifically opts out or a family member of a deceased person objects ­– just over 4,500 transplants took place in 2022-23 from 2,387 donors, including living persons. Nearly 7,000 patients were on wait lists, not including nearly 4,000 who were temporarily removed for various reasons, including the state of their health.

The larger point is that despite difficulties, organ transplants save lives. Ms Anderson, unfortunately, was not a beneficiary, but she can be an inspiration.

Having championed Ms Anderson’s qualities, perhaps Dr Chang, in addition to the support he intends to mobilise for her family, should lobby his Cabinet colleagues for an updated law to Human Tissue Act, which would establish a national organ donor registry wait list, with appropriate regulatory systems.