IT IS hard to imagine a more frightening or lonely feeling. Waiting for an organ donor to be found while you watch what might prove to be your last days ticking past is one of the most gruelling ordeals anyone could face.

Knowing your name is slowly moving up a list of those in need of a new heart, or lung or liver, must add immeasurably to the distress of being ill. What makes it worse is that, in most cases, an organ will become available only through someone else’s death.

Thus to the instinct to cling onto life at any cost is added the inescapable truth that the arithmetic of mortality on the transplant ward is stark indeed.

We all pray that no-one we love is ever in that situation. Yet even if we should be fortunate enough never to endure such a nightmare, only those made of granite could remain unmoved by the plight of patients holding on for that longed-for phone call.

Not knowing if it will ring in time, they must feel as if an egg-timer is draining grain by grain, and with it their chance of life. The Scottish Government’s 14-week public consultation on the introduction of presumed consent for organ donation is therefore a most heartening and enlightened step.

Were it to be implemented, it would mean individuals must either register that they do not want their organs to be used in the event of death or inform their relatives. The idea has been circulating for a long time but, with Holyrood’s intervention, its day seems to be drawing closer.

Perhaps because surgery has advanced so swiftly, and with it our understanding of a once almost taboo subject, it seems that we could be on the cusp of a medical breakthrough.

A sea-change in the public’s outlook can be discerned in the fact that Lesley Logan, the person who manages organ donation in Scotland, says she has received no objections from anyone about the subject being raised with them. She does, however, get complaints from relatives that they were never asked about organ donation.

Only ostriches can be unaware of the rising demand for organs across the UK.

At the time of writing, the waiting list in Scotland is around 530. Reasons for not wishing to become a donor, or for objecting to a family member doing so, will vary greatly, some of them valid, others less so. As the subject is brought to public attention, one hopes those who react initially with revulsion can be encouraged to overcome reservations that, with hindsight, they might regret.

If – one hopes when – presumed consent comes into practice, it will be long overdue. For years many of us had told our nearest and dearest of our wishes and carried plastic donor cards in our wallets.

When our names went onto the Organ Donor Registers database, the anxiety that the card might be lost or relatives forget their promise was one fewer thing to worry about as we braved the M8 in sleet and snow, or clipped on our crampons at the foot of Ben Nevis.

And yet, while I do not know for sure, it seems quite likely that those who first opted in to organ donation were predominantly young and in good health. At this age, the thought of dying is unimaginable, even though we know in theory that, whether by natural causes or accident or terrorist attack, it could befall any of us at any moment.

Ironically, however, as we grow older and our bodies start to break down like clapped-out bangers, we gradually accept we are not immortal. If there is any consolation in that bleak awareness it is that, on our death, someone else might be enabled to live.

And the same goes for those we care for. We might have been brought up to believe our bodies are temples but this does not mean they should be treated as sacrosanct. If they can be put to posthumous good use, how wonderful that would be. Thus youthful idealists and older pragmatists eventually come to the same conclusion.

Oddly, though, as we wizen it can become harder to discuss such things with a partner or, in particular, with younger family. Naturally enough most prefer to remain in deepest denial. But just because something is natural does not mean it is the best or right way to handle matters of conscience or of body and soul.

Sometimes we have to unzip our childish cocoon and face the harsh reality that our loved ones’ time is finite. In my experience such conversations, while upsetting, help prepare you a little for the dread of what lies ahead.

Nothing, of course, can ease the pain of bereavement, especially the loss of those who have not enjoyed a full and long life.

The tragedy of an early death is still something few of us have the courage to talk about or contemplate unless we absolutely must.

Yet I was struck by the spirit of the family of Alison Kerr, 42, from Wishaw, who died suddenly earlier this month.

A registered organ donor, her foresight and altruism allowed five others to live. As one of her daughters said: “She wanted to save lives and now she has. We are so proud of her.”

It will not bring Alison or those like her back but there must be a glimmer of comfort in knowing their selflessness has helped others.

The cruelty of their premature end was not entirely meaningless, since out of it came a gift that, for recipients, must feel like a miracle. Those who are religious often bemoan the fact that, these days, death is pushed out of sight, that we are quite happy to discuss sex in graphic detail but talk about dying in whispers.

You do not need to believe in an afterlife, though, to see that our terror of finality is excessive, ignorant, and even cowardly. Facing the truth is almost always better.

One of the challenges of presumed consent is to make those who wish to opt out explain why. It will force a discussion about this painful subject upon those probably least willing to have it.

And yet, unless they do, their refusal to grant permission will not be recorded, and their families remain in the dark. More positively, it ought also to encourage medics to talk openly to patients and their relatives before it is too late.

My experience of hospitals is a staggering reluctance among staff to address the fact of dying, even when it is happening in front of them. If doctors and nurses cannot do this, what hope is there for the rest of us?

It would be an unexpected and welcome outcome if this proposed new policy inspired more of us to contemplate and discuss the purpose of life and the inevitability of death, without being morbid or miserable or over-emotional.

It is often said that in the midst of life is death but it’s rarely added that some deaths could easily be avoided. Presumed consent offers the chance for one family’s heartbreak to be turned into another’s happy ending.