Sarah-Kate Templeton, Health Editor
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THE chief medical officer wants everyone to be treated as organ donors after death unless they explicitly opt out of the scheme.
Sir Liam Donaldson believes the shortage of kidneys, livers and hearts is so acute that the country needs a donation system that will presume patients have given consent for their body parts to be transplanted.
Those who wanted to opt out would have to register in a similar way to those who now carry organ donor cards. This could be done through a central NHS database or through other documentation, such as driving licences.
Such a fundamental change is likely to prove controversial as critics claim it gives the state new powers over people’s bodies. However, supporters of the change point out that hundreds of people die each year because of shortages of organs. More than 7,300 Britons are on the waiting list for a life-saving organ, a rise of about 30% over the past decade.
Donaldson is expected to call for a change in the law when he publishes his annual report on the nation’s health on Tuesday. He has the backing of the medical profession. The British Medical Association (BMA) is already campaigning for presumed consent to be the default position.
A recent BMA report entitled Presumed consent for organ donation, states: “Each year, many people die waiting for organ transplant. At the same time, bodies are buried or cremated complete with organs that could have been used to save lives, not because the deceased objected to organ donation but simply because they never got round to signing up to the NHS Organ Donor Register or informing their relatives of their wishes.”
Surveys have shown that about 90% of Britons are willing to donate organs after their death, but only 14.5m, 23% of the population, are on the Organ Donor Register.
Donaldson, like the BMA, is expected to favour a “soft” opt-out that takes family members’ views into account. The BMA proposes that family members should be informed if a relative has not stated an objection to donation and be asked if they have any strong opposition.
The donation would go ahead unless families were aware of an unregistered objection, or if they would suffer extreme distress from the removal of a relative’s organs.
Other countries in the European Union have introduced presumed consent, leading to a large increase in the number of organs available for transplant. Belgium passed a “soft” presumed consent law in 1986 and has almost doubled the number of organs available. Belgians can register their objection at their town hall but only about 2% have done so.
Spain, widely credited with the most successful system, has operated a “soft” scheme since 1989. Its success in raising donation rates has been partly attributed, however, to its national network of transplant co-ordinators, who monitor intensive care units for organs, which was set up at the same time.
Dr Vivian Nathanson, the BMA’s head of science and ethics, believes British public opinion is coming round to an opt-out system. “We are now getting closer to a system of presumed consent,” she said. “We have exhausted all other ways of increasing the number of organs available but people are still dying on the waiting list, and that is making us more courageous.”
In 2005, a BBC survey of more than 2,000 people found that 60% supported a shift to presumed consent. However, opponents say presumed consent should not be introduced because the public do not fully understand what is involved in organ donation.
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This disgusting phrase 'presumed consent' semantically rapes the word 'consent' in every way. I will burn in a furnace without ever having some sickening scalpel cut my eyes out thankyou very much. Desecrate bodies and use them for eugenic neuroscience? No way. Half your stuff goes to universities!
Bill, Melbourne,
Thanks to my donor, my young son still has a mummy, my husband is not a widower, and my brother still has his beloved little sister in his life. You may not want to leave your organs to 'strangers' that's up to you, but please take a few moments to contemplate planning your own funeral at 33 years old, writing goodbye letters to those you love, sobbing as you hold your baby, knowing that without the amazing people who choose to let organs be used after their death, you will not live to see their next birthday. You might need a life saving transplant one day. Worse still, your son or daughter/husband or wife might. It's all very well to say that if people are ill then let them die. I am 37 now, and although I have an illness, I work and pay my taxes. I'm a mum and a wife. Please don't let me die if I need another transplant, I have too much to live for.
A, Suffolk.,
At last, a sensible proposal to save thousands of lives. It will be too late for my relative, who has been waiting for a transplant for 5 years and is now too ill to have one as he has become too weak to stand an operation. It's a scandal that organs that could save lives are being buried or burnt. If this had been proposed five years ago my relative might have a long healthy life ahead of him, instead he's had five years of suffering.
brokenhearted, Liverpool,
So have all of you who want to be asked - have you signed up yet? I am asking you now. I spent 3 years on dialysis waiting for a call and didnt get one. 3 months ago my half brother gave me one of his kidneys. It has transformed my life. He had the courage to be a living donor. Do you have the courage to leave a lasting and precious legacy by signing onto www.uktransplant.org.uk. There were only 780 deceased donors last year. Yet so many more patients could be helped if organs were donated. We have been begging for our lives which are in the hands of people who dont get around to declaring their wishes and signing up. So many of us have died waiting. A "soft" presumed consent as described by the CMO is one route forward.
Helen R, London, UK
How can it be a bad idea? Any person who does not agree with the proposal can take their name of the list.
People who disagree why not ask yourself, if I or a member of my family a child etc became sick and needed a transplant would I put myself on the donor list? If you would the way things are now you would only have a 50% chance of receiving the transplant, and you would die waiting.
And how can people say their organs fail because of their own health choices? I was born with cystic fibrosis and will die of cystic fibrosis unless I get a lung transplant, the only thing whcih can save my life. I didnt ask for this condition, and I wish their were another way but I am only 21 and I would like to live a longer life, one without being in hospital or on constant medication. I guess I share a different view to others who take their lives for granted but I would want my organs (the ones that still work) to save another life like mine when i die.
Anonomous, Northamptonshire,
i welcome Sir Liam Donaldsons comments today and may i say its been a long time coming. I have been a renal patient for some thirty years and unless people have gone through what i have they really wont understand why its so important that we in the UK opt for what Sir Liam's saying. I dialyse twice a week on a kidney machine with nurse suppo again unless people have experienced the pain, anguish and family problems that goes with it they wont understand. I believe the shortage of organs has to include an educational aspect let people see what dialysis is all about and other medical problems this presents us with then they will have a better awareness of the many side effects, such as oesteroporosis, heart problems, hair loss, headaches, haemoraging, sickness, cancers that we suffer. Yes i am selfish because i need a kidney and if anyone's spent 30yrs of their life with this terrible decease so would they be. I have also managed to work over those thirty years so have paid my dues.
Lyn Winter, Manchester, Lancs
I am the mother of an 11 year old girl who unfortunately died in 2005 after a tragic accident. She had expressed a wish to her twin brother that she agreed with the idea of organ donation. As a result, her kidneys and heart valves were used after her death. I am so proud of this selfless, kind hearted girl that was my daughter. Three people so far are living happy healthy lives thanks to my daughter's decision. Any discussion re organ donation is a good one and I support it 100%. The problem though I can see with opt out is that even if you wish to donate, you will still have to state which organs can be used. Therefore everybody will have to make time to state their wishes, whether they opt in or out. this I envisage may cause problems as this is a very emotive and personal subject
JK, Plymouth, UK
"" hundreds of people die each year because of shortages of organs. " "No, they die because their own organs fail, probably due to lack of regard for their own health. If people want to smoke, eat bad food, drink or indulge in dangerous activities then don't expect me to bail them out!" - Ben Summers
Wow talk about IGNORANCE! Are you telling me as a person with Cystic Fibrosis that I brought my END STAGE lung failure upon myself Ben???
"lets face it people are born, live, sometimes are sick and inevitively die, so be it." - Pam Austrailia
I guess then, Pam, that you are never going to take a tablet or recieve ANY sort of medical treatment in your life then, since we're all going to die anyway???
Rebee, Dublin,
3 years on list waiting for a kidney to come up and no call. Lucky I wasnt a cystic fibrosis patient because half of them die within 12 months of being put on the waiting list. My half brother gave me a kidney 3 mths ago. It has transformed my life. I feel well now. Instead of feeling ill all the time. There were only approx 780 deceased donors last year. Numbers are falling due to better road safety and prevention of strokes in young people. So you are more likely to need an organ than die being able to donate. If you feel strongly against this proposal then opt out. Even if more people opt out than have opted in we will have been able to increase the number of potential donors. Until a new law is passed please look at www.uktransplant.org.uk to find out how the process works and sign on the organ donor register. A transplant recipient and family will always have you in their thoughts should you sadly become a deceased organ donor.
Helen R, London, UK
My daughter, through no fault of her own or ours, was born with such severe heart abnormalities that the only option available to her after two open heart surgeries was a heart transplant. She is now 7 years old and is enjoying a relatively good quality of life and it is all down to the ultimate gift that a selfless family somewhere in the UK made. For that we will always be eternally grateful. If the situation had been reversed, we would donate - I have been on the register for 20+ years and my family all know my wishes.
I don't know if the opt out system is the way forward and will sit on the fence here. Perhaps more education in schools and changes in the way families are approached when there is no hope for their loved ones? More harm than good could be done by telling people what to do.
All I can say, is that organ donation has given my little girl a quality of life that she has never, ever known.
Bev, Hampshire, UK
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