Dogs, ducks and ethics

Politicians have long, long memories. At least we now know that Conservative MP for the Vale of Glamorgan, Alun Cairns doesn't forget a good line when he hears one.

The same, incidentally, goes for my colleague Tomos Livingstone, who spotted the nifty bit of recycling in the House of Commons this afternoon.

Thirteen years ago, Mr Cairns - then an AM - was compared to "a Victorian undertaker praying for a hard winter." It was Rhodri Morgan's line, a man known for his innovative use of the one liner.

Mr Cairns heard, noted, squirmed and squirreled it away - until today. During Prime Minister's Questions out it came, directed this time at Ed Miliband. I doubt he'd get away with a recycled one-legged duck but let's live in hope that he tries one day.

There were few laughs but plenty of nitty-gritty language in today's session of the Health and Social Care Committee. These are the people who must scrutinise the government's proposed Organ Donation Bill and let's face it, they can't afford to make many mistakes on that one. Victorian undertakers aside, this really is life and death stuff.

Into the Assembly committee room seeped real life, the sort of real life that makes scrutinising complex, controversial bills pretty tough. We heard about the reality of working in hospital wards where real doctors have regularly to juggle a real shortage of beds.

There were nitty-gritty, uncomfortable facts to go with the nitty-gritty language. For one there was a warning from critical care specialist Dr Peter Matthews that - to put it bluntly - there was a danger much needed beds in intensive care units would end up being used for the purposes of harvesting organs. He needed those beds for patients alive and fighting for life, not for patients who - as one committee member put it to me - are 'essentially dead' and are waiting for the system to allow their organs to be removed.

What of the Health Minister's evidence last week that the objection of any family member would be taken into account. Any family member? How high or how low up and down the family food chain does she intend doctors to go before an organ can be removed? Does she really mean 'any' family member? Her evidence has certainly left some in Cardiff Bay feeling "pretty jittery" a reliable source tells me.

There was a warning too that when it comes to organ donation, the key is our understanding of what is about to change, of what 'presumed consent' means.

Yes, the detail must be got right, unintended consequences must be spotted and guarded against, the difference between 'solid organs' and other forms of donation must be considered, but a simple, clear framework must be maintained.

It is key that we understand, key that we get the concept. For some, of course, the concept of presumed consent is all wrong. There were stories of two potential donors who'd turned against the idea precisely because what they had seen as an altruistic act - giving the chance of life to someone else when their own chance of life had gone - had become a demand from the state.

There was the counter argument from Sir Peter Simpson, chair of the UK Donor Ethics Committee , that 'deemed consent' doesn't mean you have no choice. You do have a choice. Deemed consent means you have the choice - to say no.


I'll end not with the nitty-gritty but with more laughs and with another duck.

Things got a bit raucous in the chamber as the day drew to a close. The Deputy Presiding Officer had had enough. "This may not be a library" he told members, "but neither is it The Dog and Duck."

The regulars rather enjoyed that one.