Organ Donation And Presumed Consent - BMA Position, UK

Main Category: Transplants / Organ Donations
Article Date: 15 Jan 2008 - 1:00 PDT

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The following briefing paper contains factual information about organ donation in the UK and an outline of the BMA's position on presumed consent, which it has long been calling for and which 64% of the public support1.

What are the problems facing organ transplantation and donation in the UK?

Surveys show that the majority of the public support organ donation. In 2003, a survey for UK Transplant showed that 90% of people supported organ donation. However, only 24% of the UK's population is registered with the NHS Organ Donor Register. Furthermore, when the family do not know their relative's wishes, 40% opt for the default position, which is not to donate.

This has created a situation where the supply of available organs does not match the demand from desperately ill patients. The current average waiting time for an adult kidney transplant, for example, stands at 841 days, while children wait on average 164 days. More than 400 people die every year in the UK while waiting for a transplant and many more die before they even get on to the transplant list.

Current research suggests that the gap between the supply of organs and the number of ill people requiring transplantation is actually widening.

What is the BMA's position on presumed consent?

The BMA supports the introduction of a carefully planned system of presumed consent.

Moving to a system that presumes consent, rather than presumes objection (as currently occurs), would not only increase organ donation rates, but it would also be more likely that the wishes of the deceased person would be respected.

What role should patients and relatives have in organ donation?

Presumed consent does not mean that the views of patients or relatives are ignored.

Under the "soft" form of presumed consent advocated by the BMA, patients would have the right to opt out of organ donation by joining an NHS Register that clinicians would be required to consult before performing any organ removal procedures.

This system would also respect the views of the deceased's relatives who, while not being asked to consent to donation (as under current arrangements), would be able to object, either because they are aware of an unregistered objection by the individual or because it would cause major distress to close relatives. There would be a clear requirement that all relatives should be consulted before any organs were removed from a deceased person.

The BMA believes that a full and open debate must occur before any changes are made in this complex and sensitive area. In addition, if presumed consent is adopted, it is vital that a high profile publicity campaign is carried out before presumed consent comes into force so that patients are fully informed about their rights under the new system.

Would a change of the definition of consent solve the UK's organ donor problems?

Although the introduction of presumed consent would lead to increased donation rates, a number of other measures will need to be introduced concurrently so that patients will be able to benefit from an increased supply of organs.

These include extra investment for transplantation services and an increase in the number of intensive care beds.

The BMA's report, Organ donation in the 21st century: time for a consolidated approach, outlines a number of recommendations that would help to improve the UK's overall transplant services:
click here.

Notes:

1. View details of a BMA survey of the public's attitudes to presumed consent.

2. View a detailed outline of the BMA's policy on presumed consent .

http://www.bma.org.uk