Apart from the fact that you likely wouldn’t be around to make the decision in the first place, the idea that the process of donations leading to life-saving transplants is simple and seamless is far from the reality.

Holly Northam has clocked up more than 40 years as a nurse, and has spent a good portion of that time campaigning for more awareness of organ donation.

And that goes for the medical profession, as well as the wider community.

"Most of our health professionals have a very poor understanding of organ and tissue donation themselves," she says.

"There are a few, but the problem is it's seen as a specialty area of practice."

From the point of view of families who would otherwise be on the receiving end of such medical expertise, the question should be made relatively simple.

Northam agrees that medical dramas on television have a lot to answer for this misperception, but she’s made it her life’s work to bring real life as close as possible to the fictionalised ideal.

These days, she’s committed to educating the next generation of nurses through her senior role at the University of Canberra Hospital. She has also worked as the ACT’s organ donor coordinator at the Canberra Hospital, and this year received the medal of the Order of Australia for her work.

Canberrans, she says, are extraordinarily generous when it comes to organ donation - on par with Spain, which has the world’s highest rate at 85 per cent.

But it was an experience long ago, as a junior nurse, that has stayed with her in her quest to normalise organ donation.

She was caring for a young woman with cystic fibrosis, who needed a lung transplant.

"I was caring for her when she went off to her year 12 graduation. She died soon after," she says.

The young woman may still have been alive today had she had an organ transplant.

"That was back in the very early 80s, and it was at a time when in the ACT, they only had just started to get the legislation in place for organ donation.

"Back then it was seen as a very, very novel thing, and of course this young woman, who could have benefited from a lung transplant, never got it, and we would never have even thought about it in those spaces.

"It really touched me, because she was young, she was healthy, she was beautiful, she was a very similar age to myself."

Born in Papua New Guinea, where her father was a senior government official, Northam spent most of her childhood there. After the country won self-government in 1973, the family moved to Australia, and settled in Darwin.

Just one year later, they lost their home and possessions in Cyclone Tracy, and moved again - this time to Canberra. She finished her final years of school here - she was a member of the "last sixth form" of Canberra High - and went on to study nursing.

Although she had many other career opportunities, it’s a decision she has never regretted; she maintains that the work is never, ever boring.

"We are the eyes, ears, nose and touch of the healthcare system, we're right at the interface, we get to see and hear everything," she says.

But it’s at the interface between life and death that she feels the most privileged. A trained midwife, she has worked in pediatrics and palliative care, and sees many spaces ripe for improvement.

"I ended up in the critical care environment, and I guess good quality care was very much a passion of mine," she says.

After stints in NSW, Perth and even Washington DC, where her husband was posted, the family, by now with three children, returned to Canberra. Northam was just in time to do the last intensive care shift at the old Canberra Hospital before it closed.

It was later, at what is now the Canberra Hospital, that she was put in charge of the organ donor program, which led her to further study in the area. Her work led her to various countries - England, America and Spain - to examine how they dealt with the issue of organ donation and end of life care.

Spain's high level of organ donation is largely due to their opt-out legislative framework, which means in essence that the system is geared towards a default assumption that a family will choose to have a loved one’s organs donated.

The option is put to the family as a matter of course, and while a coroner’s approval is generally required, the coroner is given only a very small timeframe to respond to a request. The donation will go ahead regardless. But in Australia, families and doctors can go for days waiting for approval.

"It takes a lot of negotiating to get a framework of positive support from the coronial system," she says.

"It's a bit better now than it used to be, but there is still no onus of responsibility upon those staff to actually support the donation going ahead."

Slow wheels of bureaucracy aside, Northam says what’s really needed is the right level of communication when it comes to helping grieving families in desperately sad situations.

"I have worked really hard to try and normalise the idea of organ and tissue donation after death, but really it’s about good quality end of life care, because if a person and their family receive really good communication and care, they're much more likely to feel comfortable, or may even offer to donate organs and tissue," she says.

"I think that's a lot of the issue that we're faced with in Australia. We currently have a 65 per cent consent rate, but if a family are asked at the time that their loved one is dying or has died, we should be getting around 85 per cent consent.

"As an educator, I see it as absolutely critical that we teach our health professionals how to have empathy and compassion for a family going through the experience of the dying of a relative, and support them in making a decision."

The trouble, she says, is that the process is not a given. Families are not automatically given the option, and even if a family instigates a conversation around donation, the doctors involved are not always in a position to respond.

"It's usually because people assume when they're asked, they've got a relative who's lying deceased, and looks like they're dead, whereas that's never really the case for organ donation. Usually they're on a ventilator, they will be pink and warm and look as though they're alive," she says.

"If that family doesn't trust the system, or the doctor, or can't understand what's gone before because there's been poor communication, this is where I say it's actually the health professionals' responsibility."

And while Canberra’s community is overwhelmingly generous when it comes to making decisions, the system needs to better enable and celebrate this trait.

"It's about how to give really beautiful, wraparound care for our families, and for the people that we are faced with caring," she says.

"And it’s about how we educate our health professionals to make sure that they've got the empathy and the compassion to manage those conversations even if they don't know the answers."