NORMALLY, when a hospital is announcing an innovative new service, which could save the lives of dozens of patients, there is nothing but cause for unbridled celebration.

But yesterday's confirmation that surgeons at Edinburgh Royal Infirmary are to provide the UK's first liver transplant service using living donors was a slightly more muted affair.

Living donation is always controversial, simply because it involves carrying out major surgery on healthy people. In recent years, many relatives and partners of kidney patients have decided to help their loved ones by donating their "spare" part.

But the donation of part of your liver carries a great deal more risk than operations using donor kidneys. Around one in 200 patients will die - which is hardly an insignificant risk - and one in five donors will experience complications after surgery.

The dilemma that has faced the Edinburgh unit is that patients are dying on the transplant waiting list before a liver can be found - 13 people a year.

So shouldn't their families at least have the option of taking the risk of helping them? When surgeons have been forced to watch helplessly as their patients die, frustrated by the knowledge that they could be saving people, living donation is undoubtedly the least worst option.

The crazy situation is that most of us are willing to help someone else live after we die - surveys suggest up to 90 per cent support for it, but only 21 per cent of Scots are actually on the donor register. This is a human tragedy that has been allowed to persist for far too long, because there is another way.

Instead of asking us to sign up for the organ donor register, the law could be changed to presume that we will donate, unless we choose to opt out.

There are ethical issues at stake here and such a system is not something to be adopted lightly. But several other European countries, with healthier populations than ours, have already introduced it, including Belgium, Austria and Sweden. In Spain, the number of donors has been increasing year on year for a decade, and thanks to presumed consent, lives are being saved.

The Human Tissue (Scotland) Bill, which the Scottish Executive recently consulted the public on, proposes making it more difficult for relatives to veto the wishes of their loved ones. But all the evidence suggests this just does not go far enough.

Ministers do deserve credit for their decision to allow surgeons to take the difficult step of carrying out living donation liver transplants - there is no doubt that it will save lives.

But the fact the Edinburgh transplant unit felt compelled to make this application is the surest sign yet that a system of presumed consent is long overdue.

Funnily enough, I'd be willing to bet that after he's gone, memorials to Big Tam will spring up all over the city . . . not that I am suggesting he's likely to shuffle off this mortal coil any time soon. But I suppose when you're one of the world's biggest movie stars, you're not too worried that people will forget you after you're dead.

LIKE most Edinburgh people, I've always thought it was a very nice thing that the people of Norway sent us a lovely Christmas tree every year. I never imagined for a second that they might not be happy about it.

But this year, the people of a council housing estate in Hordaland have protested that they're losing their much-loved 66ft tree, which they've had for 32 years, to send to Edinburgh. So I'm not entirely sure we should be as willing to accept the Norwegians' Christmas pressie under these circumstances. It just doesn't seem right to take the tree when we know that it's going to be so sorely missed.

But it always seems a shame to me that so many trees are chopped down in the name of Christmas anyway. So maybe it's time that we started a new, 21st century tradition?

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