Sunday, 23 November 2008

A change in the lay on organ donations?

First published at

A proposed change in the law on organ donations, supported by Prime Minister Gordon Brown, would mean that everyone in the country would automatically be considered a donor unless they opt-out. Or relatives object.

The change was called for by the Chief Medical Officer- Liam Donaldson, and has gained support from The British Medical Association, the Royal College of Surgeons and the Royal College of Pathologists.

It would be a welcome change for scientists who are currently appealing for people to leave their brains to medical science in an attempt to find a cure for the debilitating and degenerative brain disease- Alzheimer’s.

But a focus group have deemed the move too soon. Is it too quick and radical a change to the current system of opting in, or were the focus groups swayed by religious groups speaking on the issue?

The argument for what is termed “presumed consent” is that experts believe there are apathetic people amongst us who don’t think to opt-in, or don’t consider the possibility that they could die suddenly with healthy and potentially life-saving organs (who wants to?), but would donate their organs, and that they believe more people would opt-in, given the opportunity, if it was made easy and clear. Or automatic. This in theory means more people considered as donors.

If more people are considered, more organs will be donated and more lives saved through transplants and research. Nearly 10,000 people are currently on the organ transplant waiting list, more then three times the number of transplants that were performed last year- 3,100. This means some terminally ill patients are not even put through what will ultimately be a fruit-less wait.

So the proposal looks promising. Bingo?

Like arguments on abortion and euthanasia, there is a divisive battle between the religious arguments of sanctity of life against a liberal, progressive viewpoint. We must remember that the United Kingdom is all but a secular country, and Parliament should arguably be a place free from the constraints of often conflicting religious viewpoints.

Under the new system if there is a religious objection, the person can opt out, and people’s relatives could object to donation after their death. Which still leaves room for a final say on the part of the bereaved. Unless the apparent apathy is really an objection, even without a religious element, as death is still a personal and uncomfortable reality.

But could the change reveal, or hide a more sinister outcome? Could doctors begin to put less effort into saving someone if the costs of their treatment and rehabilitation would be more than using the organs for donation? Body snatchers ring any bells?

Presumably, the changes would be met with adequate legislation to prevent doctors from doing this? And to make sure they stick to only those who are opted-in. Although, looking at the most famous case in the UK of a doctor abusing his position- the prolific serial killer Harold Shipman- and the organ removal scandal at Alder Hey (now going by the name Royal Liverpool Children’s) Hospital, families of the victims and the public alike might be cynical.

The more conservative alternative is to drive for more people to become donors under the current system. Which for now, looks like the official line. There is conflicting evidence from different countries with either of the two systems as to whether opt-in or opt-out produces more donors. Only time will tell whether greater promotion of the cause will bridge the gap between those who need organs, and those who donate.

Ultimately some people believe that organ donation is a gift, and making it almost compulsory takes away that element. But surely most people would want to give the gift of life should they suffer an untimely death?

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