NEW POLL: is presumed consent the right way to boost organ donations?

The figures are stark. Here’s The Guardian:

An estimated 8,000 people in the UK need an organ transplant but only 3,000 operations are carried out each year. About 1,000 people in the UK die every year while waiting for a transplant.

The question is more difficult: should we move away from the current organ donor opt-in system towards a system of ‘presumed consent’, which would mean that unless people opted out of the register or family members objected, hospitals would be allowed to use their organs for transplants.

Lib Dem MP Dr Evan Harris, chair of All-Party Kidney Group and member of the British Medical Association’s Medical Ethics Committee, has previously lent his support to the idea of presumed consent:

Under an opt-out scheme donor’s real wishes will be more often respected, more lives would be saved and grieving relatives will be spared the experience of making the wrong decision at the worst time.”

Such calls have been echoed by the BMA, the Royal College of Surgeons and the Royal College of Pathologists, as well as the Prime Minister, Gordon Brown.

But today the independent Organ Donation Taskforce came out against presumed consent. You can read their full report here (PDF), but the principal concerns they noted were:

>> “the potentially negative implications for clinical practice, especially the potential to damage the vital relationship of trust between clinicians caring for people at the end of life, their patients and their families. Some intensive care staff in particular fear that a move to an opt out system would make critical care more difficult and could lead to some intensive care practitioners themselves opting out of participation in donation programmes.”

>> “powerful evidence from recipients of organs who stressed their need to know that organs had been freely given by donors and their families, and from donor families who often find great comfort in being an active part of the decision to donate.”

>> “that it would be both complex in practical terms and also costly to put in place an opt out system that could command the trust of professionals and members of the public.”

The report also notes that there was “support from members of the public and patients’ groups for the principle of informed consent, and a perception that assuming consent from silence belongs to a more paternalistic era. Some felt that an opt out system could be ‘dehumanising’. Given that current trends in healthcare place great emphasis on choice and responsiveness, this is an important consideration.”

So, here’s the question for LDV readers to consider (the poll itself is in the right-hand column): would it be right to introduce presumed consent for organ donations? Your possible answers are ‘Yes’, ‘No’ and ‘Don’t know’. Please feel free to use the comment thread for lengthier answers…

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18 Comments

  • Hywel Morgan 17th Nov '08 - 3:50pm

    The census point is a good illustration of what I’ve said on this issue for a while.

    Every year the “governemnt” sends people a number of mailings (Council tax bills, electoral registration, car tax, TV licence). In none of those can I recall having material about Organ donation.

    The opt-in system doesn’t have a good record of take up because it isn’t well promoted. When it is it tends to be in Doctor’s surgeries and Chemists which aren’t places frequented by young people who are the best prospects for donation but often don’t get round to registering.

  • Thomas Hemsley 17th Nov '08 - 5:26pm

    I’m worried that those who are less articulate – illiterate people, for example – may have trouble opting out. For that reason, I don’t think I can support it.

  • Richard Huzzey 17th Nov '08 - 6:26pm

    Joe’s suggestion is an excellent one — I have signed up today, having never got around to it before, to my shame.

    Including it in tax returns or censuses is what should be done.

    Presumed consent is a fundamental shift in the relationship between the individual in the state, and one we should not make lightly.

  • I’m in favour of assumed consent, but I’d always felt this was at odds with the myriad things that made me feel a liberal. I don’t want to cede control over my body to the Government, even after my death. The stark numbers quoted above make me feel I should make an exception on this crucial issue – but it is an exception.

  • Why not let people opt out of donating their organs at death, but with the price tag that they simultaneously surrender irreversibly and for life the chance to receive donated organs should they need one?

  • Steven Ronald 18th Nov '08 - 1:05pm

    “cede control over my body to the Government”

    This, to me, is a very strange way of looking at it. Rather it’s a more simple case of possibly being able to give one of my fellow humans the gift of life with my, now unneeded, body.

  • Voting is almost even.

    Guess which way I swung 😉

  • I’d prefer a half way implied consent, if someone carries a donor card there should be no need to ask the next of kin the donor has already consented.

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