Intensive care unit staff were invited to indicate which of nine factors they saw as restricting organ harvesting in their own units. None were thought to be definitely important by even a quarter of those responding. Why then are more donors not being referred? Lack of training in how to approach relatives was thought definitely to be a factor by only 4 per cent of the doctors whose task it should be to make such approaches. Education and advice on transplantation would apparently be valued by only 25percent of the general public while 35 per cent expressed antipathy to the suggestion. It would be remarkable if training of those who see no need for it and education of those who do not want it achieved the desired aim of increasing the supply of organs for transplantation.
If organ supply is to be improved we need to know why all suitable donors are not being offered to transplant teams at present. Three questions which the authors could have asked intensive care unit staff might have provided interesting answers. 1. How many potential organ donors have you treated in the last year? 2. How many were referred for organ donation? 3. What were the reasons for non-referral in each case? If truthful answers were given we could at least discover the reasons why so many usable organs are currently wasted. We need to know the real answers to these questions so that effective recommendations can be made to increase the present inadequate supply of organs for donation.