For presumed consent: Dr Tony Calland

If the National Organ Taskforce rejects the idea of a move towards a system of presumed consent now, we hope it will not rule out future consideration of this option.

The British Medical Association (BMA) supports a “soft” system of presumed consent, where individuals who do not want to donate organs can register that objection and families are consulted to identify any unregistered objections. We believe this is more likely than the current system to ensure that the individual’s wishes are respected. Every year people die because a donor cannot be found to allow their transplant to go ahead. Evidence from other countries has shown that a system of presumed consent can save lives.

Of course, a system of presumed consent is not in itself a magical cure and the BMA has already stated that it strongly supports the series of measures proposed by the taskforce. We very much hope that these proposals will greatly enhance donation rates and will do whatever we can to help promote that goal.

Dr Tony Calland is the chairman of the Medical Ethics Committee of the BMA

Against: Rafael Matesanz and John Fabre

Last year, the Government embarked on a campaign to convince the nation that an “opt out” or “presumed consent” system for organ donation would improve the rate of donation. This decision, supported by the British Medical Association, is very curious given the weakness of the evidence supporting presumed consent as a factor in organ donation.

Our view is that it contributes little or nothing to the improvement of organ donation rates and diverts resources to imaginary solutions. An effective transplant coordination network, as recommended by the Department of Health’s Organ Donation Taskforce, is the measure that would really make a difference. The idea that the absence of an objection represents informed consent is plainly nonsense, and consent that is not informed is valueless.

Rafael Matesanz is the National Transplant Co-ordinator for the National Transplant Organisation in Spain. John Fabre is a Professor in the Department of Hepatology and Transplantation at King’s College London School of Medicine

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