Organ Donation: Opt In Still The Only Option

This month the Organ Donation Taskforce published another report

into the system of organ donation. It rejects the idea of

'presumed consent' - where organs could routinely be

removed from adults who die unless they have registered to opt out

of the system.

Background

This is, of course, not the first time that organ donation has

been considered in recent years. It was only in September 2006 that

the Human Tissue Act 2004 established a new legal framework for the

removal and/or retention of human tissue following the Alder Hey

scandal, which specifically emphasised the importance of prior

explicit consent. The Organ Donation Taskforce itself last reported

on the issue only in January this year, making 14 recommendations

aimed at increasing the number of donors by 50% in five years.

The problem

There are currently over 8 000 people on the transplant waiting

list (rising at 8% per year), but only 3000 transplants were

possible last year and 1000 people died waiting for a suitable

organ to become available. The urgent need to do something to

improve these statistics led the Government to ask the Organ

Donation Taskforce to look again at donation and specifically the

impact of an opt out system. Such a system has vastly improved

donation rates in other countries and has the apparent support of

the majority of the British public, the British Medical Association

and much of the Government itself.

The justification for an opt out system is obvious to its

supporters: more organs available for transplant mean more lives

saved. In addition, since repeated surveys have found up to 90% of

people in favour of donating their organs, but less than 25% on the

Organ Donation Register, it is argued that presuming consent rather

than objection is actually more likely to achieve the wishes of a

deceased person.

The report's findings

The taskforce considered both a 'soft' opt out system,

where bereaved families may object to organs being removed, as well

as a 'hard' opt out system, where only the deceased's

registered objection can avoid donation. It found that there was

little evidence to suggest that either opt out system would

automatically lead to a rise in actual transplantations taking

place without corresponding increases in donor coordinators to work

with families, trained clinicians and intensive care beds.

Moreover, setting up an opt out system was considered to be

fraught with practical difficulties including: the cost, ensuring

the register...