There are plans to “get tougher” with grieving relatives who veto the wishes of those on organ donor lists and carrying donor cards. There have been 547 cases of blocked consent (one in seven) since 2010, which amounts to about 1,200 people missing out on transplants.

The idea is to stop asking relatives for formal consent and to give them, instead, a leaflet explaining how consent remains with the deceased. However, the relatives can still block the donation if they give their reasons in writing.

With ill and desperate people waiting for organs, sometimes dying during the wait, the instinct is to castigate these selfish, interfering relatives – why should they have “ownership” over the dead person’s body or the power to override their wishes? Yet is anything that simple?

When it comes to organ donation, my view of my own body is that they can chop out what they want and throw the rest on a skip. However, when it comes to my children, all thoughts of practicality, community spirit, even humanity, seem to slide away in a sudden, overwhelming, emotion-driven landslide. Suddenly, I’m “medieval”, distraught, a pinch-faced mother depicted in a dark, sombre painting of muddy oils, wailing over an open casket: “Leave my child whole!” This does not sound like the same person who just nonchalantly told you to harvest her organs and hurl her cadaver on a skip – yet I am the same person.

This seems to be the kind of thing that the NHS blood and transplant teams are dealing with – the scalding hot mess of human contradictions. Certainly, it doesn’t seem fair to automatically condemn vetoing relatives as heartless, meddling or stupid when they could be too grief-stricken and emotional to cope with respecting wishes in the moment.

Some might say, so what if they’re “emotional”? Are they as emotional as a child waiting for a lung or someone on several gruelling rounds of kidney dialysis a day? However, organ donation is a complicated issue at the best of times. In England, we have the opt-in system, with its appalling shortfall. In other countries such as Wales, there is opt-out (you register your wish not to donate organs), which, for some, raises concerns about the ethics of “presumed consent” and “state ownership” of the body.

In this country (unlike somewhere such as Switzerland), brain-dead donors aren’t given anaesthetic during the organ-harvesting process, which disturbs some relatives.

It’s a murky, little-discussed topic, so no wonder it breeds suspicion, fear, conspiracy theories and downright silly NHS organ-theft/grave-robbing hocus-pocus. Does anybody really think that a new hospital leaflet is going to deal with all this?

Perhaps it’s time to accept that donor cards and registers are just not enough on their own. In the absence of “opt-out”, could there be a binding co-signatory agreement between prospective donors and a chosen relative, to safeguard their wishes? It also seems increasingly clear that, while still alive, donors (though already so generous) need to outline fully the process (ventilators, brain death, harvestings, all the gory details), so that relatives are prepared and aren’t bombarded for the very first time at the scene.

We can’t complain that donors’ wishes in death haven’t been honoured if they haven’t been fully explained in life. While sympathies are justly with donors and recipients, it is nonetheless not right that bereaved relatives are alarmed and stressed at such a time. Beyond what’s right, it clearly isn’t productive.

It seems certain that until this bad timing issue is resolved, there will always be distraught relatives who’re simply unable to cope with the idea of organ donation in the moment. Never mind “get tougher”; getting relatives prepared seems key.

The one where they’re no longer on a break…

Facebook Twitter Pinterest How they were in 1994. Photograph: NBCUPHOTOBANK / Rex Features

It could be a case of Friends Reunited. The cast are said to be trying to get together again for a two-hour special to honour director, James Burrows, though logistically the ambition might prove too difficult to pull off.

Perhaps that’s a blessing in disguise. How would a reunion of television’s ultimate friendship group pan out in reality? Friends was often extremely funny. The episode featuring Ross and Monica frantically frugging for camera-time on a dance show remains one of the finest examples of physical comedy I’ve ever seen.

However, it ran mainly on a specific brand of American innocence. While the series survived 9/11, from the time it stopped (2004), the world has got yet darker. How could the middle aged characters fail to reference that? Even the smaller details wouldn’t work so well – these days, in Central Perk, everyone would be fretting about the calories in a cappuccino. Gunther would be in prison for stalking.

So, even though a Friends reunion sounds interesting on paper, things could get tricky very quickly, to the point where you could say, Ross-style: “Er, guys, haven’t we all been on a pan-global, socioeconomic, psychocultural break?”

The vanishing of the vulnerable



Facebook Twitter Pinterest Former Labour minister Frank Field who has warned that up to 1.5 million benefit claimants may be facing destitution after disappearing from the welfare system. Photograph: Anthony Devlin/PA

Former Labour minister Frank Field has drawn attention to people who are disappearing without trace from the welfare system. About 1.5 million people leave the welfare system annually, many for perfectly understood reasons, including finding work or moving abroad. But there are others who simply vanish from the records, appearing to be neither working nor receiving benefit payments.

Field, who chairs the Commons work and pensions select committee, believes that significant numbers of people are being hit by sanctions and penalties after failing to comply with new, stricter government job-hunting conditions. He feels that the social security system is imposing sanctions at a scale unwitnessed since the second world war, and that vulnerable people are losing their benefits and becoming increasingly disconnected from the state – to the point where they are in danger of becoming destitute.

The government is denying that there is any basis in these claims, but to coin a phrase: “They would, wouldn’t they?” Field’s concerns merit investigation, ideally in the form of the survey he is demanding.

The report includes other suggestions such as pursuing the idea of a “yellow card” for claimants facing sanctions and penalties, non-financial types of sanction, and the introduction of “grace periods” for claimants in times of transition or difficulty.

Certainly it seems to be a matter of great urgency to discover just how many people are being effectively “faded-out” of the welfare system. In a civilised society, it’s unacceptable for vast numbers of citizens to simply be “missing”, all but ghosted from the system. Is there really such a thing as the welfare disappeared? Time was, it was considered a great scandal when vulnerable people “fell through the net”. Are we entering an era where they’re effectively pushed through it?