Monday, 15 June 2015

Two Sunday papers

This week's Herald on Sunday quoted me well in one piece on organ donation; I'm less sure what to make of the Sunday Star Times.

First the good. Amy Maas quotes me on New Zealand's organ donation shortfalls:
Organs from one child - like Leon - can save the lives of up to six others with the transplant of the heart, lungs, kidneys, liver and pancreas. It can also improve the lives of others with the transplant of eyes, skin and bone.
Dr Eric Crampton, an expert in the economics of organ donation and the head of research at the New Zealand Initiative, lauded Roberts' decision to donate her son's organs given the "horribly tragic" circumstances. "It is always uplifting when parents find the way to make the most of utter tragedy. And so we should celebrate their choice to help give life to others," he said.
Crampton said that New Zealand's rate of organ donation was a "national tragedy". "The Government has made some good moves to encourage donation by doing more to help live organ donors, but we still have one of the developed world's worst organ donation rates," he said.
Meanwhile, tributes to Leon continue from family and friends, who released dozens of colourful balloons at his June 3 funeral.
I'd also told Amy about Israel's priority system, but there wasn't room in the piece. I'm to have been on with Paul Henry on organ donation very early Monday morning (6:50!).

Meanwhile, over in the Sunday-Star Times, Adam Dudding didn't seem to like my take on coroner recommendations:
A young girl dies of an unpredictable complication of pneumonia. A coroner reports the usual, awful, clinical details – "oxygen saturation", "intro-axial haemorrhage", "brain stem death testing" – but something else as well: There are references to the "cold, damp" state house that Emma-Lita Bourne was living in when she fell ill late in the winter of 2014; to the buckets under the leak in the hallway ceiling of the South Auckland home; to the heater unused because of unaffordable electricity, to the older sibling with rheumatic fever.

And there is this line in the findings: "Whether the cold living conditions of the house became a contributing factor to the circumstances of Emma-Lita's death cannot be excluded."

It's an understated phrase, but the reaction was anything but. Since the publication of Coroner Brandt Shortland's report there has been an explosion of news coverage, breast-beating and finger-pointing, and fresh recognition that poverty in New Zealand is a real thing that kills people. Once again a coroner has lit a fuse then quietly stood back.

Telling the public what went wrong and what can be done better is in a coroner's job description, yet they're not always thanked for it. In 2013, Eric Crampton, a researcher at business thinktank the New Zealand Initiative, blogged a list of recent coronial recommendations, presumably so his readers could sneer at their wackiness ("warning labels on Coke"; "national manhole safety guidelines"; "hard hats when climbing ladders"; "mandatory high-vis clothing for cyclists"), then suggested coroners get training in cost-benefit analysis before making silly, expensive suggestions.
First off, all credit for that post should go to the University of Canterbury rather than the NZ Initiative; I was on faculty there until July of 2014.

The "Coroner Recommends" list came entirely from Google. But I put the blame for wackiness where it belongs: with the Act. Coroners have to point out anything that might reduce the chances of the occurrence of other deaths in circumstances similar to those in which the death occurred, regardless of whether the recommendations make any darned sense. Sensible coroner recommendations might be given more weight if there were fewer recommendations like wanting every farm house to be fenced off from the yard.


  1. Going to pull you up on Israel's priority system. You talked about this working well. Data shows otherwise. Israel has gone from 9.5 donors per million population (DPMP) in 2013 to 7.6 DPMP in 2014. NZ meanwhile has gone from 8 DPMP to 10.2. Source: International Registry in Organ Donation and Transplantation.

  2. It did really well in its first years, then dropped afterwards. Part of the problem has been a potential loophole in it where there remains potential for a family veto after you've been given the priority tick: Al Roth's done some work looking at that.