Dying patients should routinely be asked to donate their organs, according to an NHS watchdog.
The National Institute of Health and Clinical Excellence (NICE) says doctors shouldn't shy away from raising the sensitive subject with patients and their relatives, even in the bleakest of circumstances.
Around 10,000 people are currently on the waiting list for a transplant, but the shortage of organs results in 1,000 of them dying each year.
NICE says doctors need to be more positive about the opportunities of giving life after death and not apologise for raising the possibility of organ donation.
Karen Morgan, a transplant nurse who helped draw up the new guidelines, said: "I understand what a very difficult and emotional time the end of a person's life can be, and often the last thing loved ones want to think about at this time is organ donation.
"But sadly, there is a big shortage of donors, so it is imperative that more people seriously consider donating their organs."
Although 90% of people support organ donation, only 28% have joined the donor register.
"Although it is an important decision to make, many people are comforted knowing that some good will come out of their death," said Ms Morgan.
The NICE guidelines stress that doctors should assure patients that their care won't be affected by their decision.
Five-year-old William Simpson has been waiting three years for a new heart. His Mum Tracey said doctors must be upfront with potential donors.
She told Sky News: "Our best day will be somebody's worst day. That always plays on my mind. But what use are organs in the ground?
"That sounds so heartless coming from a mum, but it is from a mum whose child needs something."
The campaign group Patient Concern said every opportunity should be taken to increase organ donations.
Director Roger Goss said: "It is potentially compounding the distress that the relative may feel, but at the same time for some families the opportunity for some good to come out of their loss is a great relief.
"So if the subject has not come up previously, then death bed is the right place for that discussion."
“You Have the Power to Donate Life – to become an organ and tissue donor Sign-up today!
Tell Your Loved Ones of Your Decision”
Tell Your Loved Ones of Your Decision”
Australia, register at Australian Organ Donor Register
New Zealand, register at Organ Donation New Zealand
South Africa, http://www.odf.org.za/
United States, organdonor.gov
United Kingdom, register at NHS Organ Donor Register
Your generosity can save or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help by donating skin, corneas, bone, tendon, ligaments and heart valves
Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes and 18 people die each day waiting for an organ or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You.
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