Nicola Sturgeon, Cabinet Secretary for Health and Wellbeing, shied away from endorsing presumed consent for organ donation yesterday, emphasising that more could yet be done to persuade relatives to give their permission.

Although sympathetic previously to the idea that organs could be used unless a person had requested an “opt-out”, Ms Sturgeon appears unconvinced that the public are ready to accept such a change.

Relatives refuse permission in nearly half of all cases of potential organ donation. Last summer Harry Burns, Scotland's chief medical officer, made clear the public did not back changing to an “opt-out” system.

Ms Sturgeon, speaking at a conference in Edinburgh, urged people who were happy to donate organs after their death to tell their relatives about their wishes.

“The evidence shows that where relatives know their loved one wanted to donate, they will usually consider it their duty to make sure those wishes are fulfilled,” Ms Sturgeon said. She told the conference: “Relative refusal rates at the moment are over 40 per cent. Whichever system we adopt in future, reducing that refusal rate is going to be one of the key factors.”

She was addressing doctors at a gathering at the Royal College of Physicians of Edinburgh on the issue of “presumed consent” for organ donation. The medical community, who show widespread support for presumed consent, are also looking into other, less controversial, ways of tackling the organ shortage.

About 1,000 people die every year in the UK while waiting for suitable donor organs, and the country has one of the lowest organ donor rates in Europe, according to the college.While 90 per cent of the population supports organ donation in principle, only 25 per cent of the population has joined the NHS organ donor register.

Both the health watchdog Patient Concern and the Patients Association are against the policy, alleging that it turns people from volunteers into conscripts.

Under “presumed consent”, suitable organs would be collected from recently deceased patients unless a patient had chosen to “opt out”.

The issue is being considered by a UK organ donation taskforce, which is due to produce a report this summer. Gordon Brown, the Prime Minister, has given his backing in principle to a change in the law allowing presumed consent.

But Ms Sturgeon said: “I have made clear to the chair of the taskforce that I would understand if she felt that by taking a bit longer, a better piece of work would result.”

At yesterday's conference, experts from the main transplant specialties - heart, liver and kidney - debated for and against the introduction while considering other possible solutions.

They include increasing the number of organ donor transplant co-ordinators and strengthening the network of organ retrieval teams to allow 24-hour access to acute medical units.

Stuart Rodger, of the royal college, said: “Scotland is facing a major crisis in terms of a shortfall of suitable organ donors. We are reaching a point where Scotland will have to take a political decision as to how it wishes to address this shortfall.”

In her opening speech to the conference, Ms Sturgeon said: “Whatever stance people take on opting in or opting out, there is no doubt that the process has to be made as easy as possible for the relatives.”

Sir Liam Donaldson, England's Chief Medical Officer, has said that presumed consent is the only way to combat Britain's transplant crisis, where many die while on the waiting list for an organ. He said the NHS needed three times the number of organ donors on its register.

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