ICU and You · Le coin français · Number 2
The French of this week's subject — and a register built the other way round
France keeps a national organ donation register. Nobody on it is a donor.
On 22 December 1976 the loi Caillavet made France one of the first countries in the world to adopt le consentement présumé — presumed consent. Everyone is a donor unless they said otherwise while living. The principle was reaffirmed by the health modernisation law of January 2016, which took effect at the beginning of 2017.
Which produces a register shaped like a photographic negative of ours. The registre national des refus, held by the Agence de la biomédecine, records only objections. Before any retrieval the team must consult it; if the name is not there, they then speak to the family. So in France the administrative act is refusing, and silence is a yes. In Australia the administrative act is agreeing, and silence is a conversation nobody wants to have at two in the morning.
The French system has its own gap, and it is the exact inverse of ours. Because the register records only refusals, a French citizen who wants to donate has no way to record it. France ADOT has argued for years that this is a real omission: the enthusiastic have nowhere to put their enthusiasm. And since 2017 the carte de donneur — the donor card — has had no legal standing at all.
Both countries, then, arrive at the same room by opposite routes, and in both the family is asked. The law changes what the question is. It does not remove the question.
Le prélèvement is the retrieval — le prélèvement d'organes. But in ordinary French it means a sample, or a deduction: un prélèvement sanguin is a blood sample, and le prélèvement automatique is a direct debit from your bank account.
The same root, doing both jobs: something taken from a larger whole. Which is either a slightly chilling etymology or a very precise one, depending on your mood.
La greffe. The everyday French word for a transplant is not transplantation but greffe — a graft, from horticulture, exactly as English once meant. The same word also names the registry office of a French court, le greffe du tribunal, because both descend from the Greek grapheion, a writing stylus, by way of the shape of a grafting shoot. A surgeon and a court clerk are doing etymologically the same thing.
Les proches. Where our law says next of kin, French law says les proches — literally the close ones. No hierarchy, no degrees of relation, no schedule of who outranks whom. Just whoever was near. It is a vaguer term and a kinder one, and it describes the people actually standing in the corridor rather better than a legal ranking does.
La mort encéphalique. Brain death, but naming the whole brain rather than the organ — and French keeps le donneur and le receveur, the giver and the receiver, where English reaches for donor and recipient and loses the transaction sitting inside both words.
Opt in, or opt out — which would you rather work under?
Not which produces more organs, though that argument is worth having too. Which would you rather be the one holding, at three in the morning, in a room with a family who have just been told? Send me a sentence either way, along with any French or Italian medical word that has caught you out.
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