Should consent for organ donation be presumed?
Gordon Brown, the British prime minister, set off a bit of row this past weekend with an op-ed calling for hospitals in the UK to adopt an "opt-out" policy for organ donation. That is, hospitals would presume that a person was willing to be an organ donor unless that person had explicitly declared otherwise. Here's a clip from Brown's piece in the Sunday Telegraph:
We know that transplant surgery is one of the great advances of medical science, and has saved the lives of thousands. Yet the organ donation on which it depends remains a difficult and sensitive issue on which feelings can be strong. Many of us will have friends and family members who have benefited from transplant surgery, or - tragically - who have endured the agonising wait for a life-saving organ that did not become available in time.
That is an avoidable human tragedy we can and must address. There are currently more than 8,000 people in the UK awaiting organ donation but only 3,000 transplants are carried out each year. Sadly, that means that more than 1,000 people die each year waiting for transplants. So we need to do more to ensure that organs are available to those who need them. This week, the Organ Donation Taskforce will report on how we can improve the management of transplant services and organ donations, and will set out a series of recommendations.
However, we may need to do more to encourage more of us to donate. In Britain we have 14.9 million people on the organ donor register - which is around 24 per cent of the population. In terms of actual donors (not just people willing to give, but those whose organs are actually used) we have a rate of about 13 donors per million in our population. This compares with about 22 per million in France, 25 per million in America and around 35 per million in Spain - the best in the world.
That is why I want to start a debate in this country about whether we should take steps to move towards a new system designed to enable far more of us to benefit from transplant surgery - one that better reflects survey findings that around 90 per cent of us are in favour of organ donation.
Brown appears to have been successful in starting a debate, though it might not end the way he had hoped. Officials from the Church of England have raised doubts, a rep from a patient group declared that "presumed consent is no consent at all," and others question whether Brown even has a handle on the problem.
But Brown isn't out by himself on this issue. The UK's chief medical officer supports the plan and The Observer (a sister publication of the Guardian) has started a campaign to change the system.
-Greg Dahlmann
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Wow!
This is a huge leap.
As one rep mentioned, "presumed consent is no consent at all"
The most vulnerable of society would be victimized.
Consent should always be informed, not omitted.
- by Virignia Brown on Jan 16, 2008 at 9:59 PM | link
I favor presumed consent. People can still opt out.
I believe we should assume one wants what the majority would want unless he/she has said otherwise.
I especially oppose the right of relatives to override their family member's wishes. It should be the decision of the potential donor and no one else.
- by Mike on Mar 22, 2008 at 8:07 PM | link
I don't think we need to jump to presumed consent. We could start by insisting that consent of the donating person as resorded on licenses etc trumps family wishes. That alone would solve much of the problem with many organs where consent is given and not honored. That pool could be expanded by having a better and more complete record of all persons wishes relating to donation.
- by emily on Mar 24, 2008 at 11:44 AM | link