The Debate: Should human organs be donated automatically?

Jan 15 2008 by Caroline Innes, Liverpool Daily Post

PRIME Minister Gordon Brown has given his backing to hospitals wanting to adopt a system of presumed consent for the removal of organs from dead patients.

A policy of presumed consent allows doctors to remove organs after people die, unless they or their families have previously stated they did not wish to be donors.

"A system of this kind seems to have the potential to close the aching gap between the potential benefits of transplant surgery in the UK and the limits imposed by our current system of consent," said Mr Brown, writing in a Sunday newspaper.

But, three years ago, the ruling Labour Party ruled out changing the law to allow presumed consent for organ donation - a system the British Medical Association (BMA) has backed to overcome the shortage of organs available for transplant.

With its "opt-out system", Spain has the highest recorded donor rate in the world at 35.1 donors per million population, while Britain's has 14.9 donors per million population, with 1,000 patients a year dying as they wait for an organ in the UK.

Today, the Government's taskforce on organ donation will release a report calling for every hospital to have a senior doctor acting as a "champion" of donation.

Meanwhile, managing director of UK Transplant Chris Rudge gave a cautious response to the adoption of a presumed consent system, claiming people who have received transplants like to know the organ has been donated by someone who wanted to take that step.

He said: "It is an active gift of life and a lot of people think the policy should stay as it is."

Today, the Daily Post asks: Should a system of presumed consent be introduced in England for organ donation?

carolineinnes@dailypost.co.uk

NO: The Case Aginst - Many present donors will tear up their cards

by Joyce Robins, co-director of Patient Concern

WE HAVE been inundated by emails and letters from members of the public who are horrified by Gordon Brown’s proposals.

They think this is a terrible idea as presumed consent turns volunteers into conscripts.

Presumed consent is not consent.

It is no consent at all, and I am fearful this new system would not tackle the problem of donor shortages anyway.

In this country, we have worked for years to get a system of proper, informed consent in the health service and Gordon Brown is now willing to throw it all out of the window.

Doctors previously did what they liked to patients and we sat there agreeing with what they suggested without really understanding what was going on or what was going to happen to our bodies.

If implemented, this will throw away the patient choice we have fought for, for so long, overnight.

We already have presumed consent for electronic records for patients - which Patient Concern disagrees with - and now there is this.

This sets a dangerous precedent and it won’t be long before we see presumed consent for research on our bodies unless we have opted out. This is frightening.

This turns the term "donor" into a joke. It seems ridiculous as it is something that is not taken by default. It is a gift of someone’s organs.

Of course, it is a scandal so many people are waiting for organs and lives are lost when suitable donors are not found.

But we have not put enough effort into getting more people signed up to the donor register.

I personally, in all my years, have never been asked about becoming a donor by any doctor or in any surgery or hospital or even while giving blood.

That should happen automatically and every healthcare professional should be using every opportunity to explain about the donor register to patients they come into contact with.

The Lords Committee are sitting on the subject of organ donation at the moment, and are saying they don’t know how to register to become a donor.

If informed people like that do not know how to go about it, then what chance do ordinary people have?

I do not understand why Gordon Brown is supporting this system now, when he rejected it three or four years ago when the Human Tissue Act came into force.

It would seem the new Prime Minister is grasping at whatever he can to make new policies and show he is in charge, but I have grave doubts about his motives.

Ultimately, the state does not own a person’s body and none of us have an obligation to donate our organs after death.

I have already spoken to some current donor card holders who say if this system of presumed consent is introduced then, on principle, they will tear up their donor cards and choose to opt out.

YES: The Case For - Not to have an opt-in system is such a waste of life

by President and founder of British Kidney Patient Association Elizabeth Despard Ward, OBE, Hon LLD

I FOUNDED the British Kidney Patient Association in 1975 after my son, Timbo, was diagnosed with kidney failure at the age of just 13 years.

And, 34 years on, I am still campaigning for a system of presumed consent for organ donation so hospitals can take organs - unless a person had explicitly opted out before death - to save thousands of lives.

When Timbo was diagnosed, there was no national association concerned with the plight of Britain’s kidney patients, many of whom were struggling to survive bitter blows to their health, pride and finances by the need for three-times-a-week dialysis - and the loss of their jobs.

I had understood naively that because of his age my son would be put forward for a transplant and would soon receive a kidney - but that never happened. And that is when I began to realise there was a big problem with the "opt-in" system.

I have been supporting a Private Members Bill for a system of presumed consent. The system seems to have the potential to close the aching gap between the potential benefits of transplant surgery in the UK and the limits imposed by our system of consent.

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

Too many people are needlessly dying while waiting for organs. And I think about those thous-ands of people who have already died unnecessarily. A system of presumed consent is so obviously the right thing to do. How could saving lives not be right?

Under such a system people still have the opportunity to dissent. They still have that choice. If they can’t be bothered to dissent or don’t feel strongly enough only good can come of it if they die.

Under the present system, if people can’t be bothered to regis-ter as a donor and die, nothing good will come of it, only death.

If people are concerned about becoming a donor I tell them not to see themselves as a donor but as a recipient of an organ.

If they had organ failure and were facing losing their life if a transplant wasn’t available would they want someone to donate to them? Of course they would. And people cannot take unless they are also prepared to give.

I have encountered so many instances where people have wanted to donate but their families have refused.

That is not respecting the wish-es of the dead. What sort of rela-tive are you if you do not honour that person’s wishes?

When we die, all that is left is a body of flesh, bone and organs. In four or five days, it will either be buried or cremated. Why should-n’t it be used to help someone else live? To not have such a system in place is such a waste of life.