BMA Scotland Calls For Public Debate On How Best To Increase Organ Donation Rates

Main Category: Transplants / Organ Donations
Article Date: 07 Jul 2007 - 1:00 PDT

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BMA Scotland has renewed its calls for a public debate on the need for a system of presumed consent for organ donation. The call comes ahead of the launch of National Transplant Week (7-14 July 2007).

With waiting lists for organs at an all time high, and with the gap between the number of organs available and the number of people needing a transplant showing no sign of narrowing, doctors believe that the time is right to consider a review of the current organ donation system and look at new ways to improve donation rates.

Dr George Fernie, a member of the BMA's Scottish Council, said:

"The BMA has actively supported efforts to improve transplantation rates in the UK. But despite an increase in the number of donors, there is still a desperate shortage of organs. There are currently more than 800 people waiting for organs in Scotland - an increase of almost 20% since 2005. This doesn't include those who die before even making it on to the waiting list.

"Surveys have shown that 90% of the population supports organ donation, yet only 23% have signed up to the organ donor register. And so the decision falls to the family when they have just been told their relative has died or is dying. Not surprisingly, when they do not know their relative's wishes a large number (40%) opt for the default position, which is not to donate.

"The BMA believes that a change to a system of presumed consent for organ donation addresses this problem, by making donation the default position from which people may opt out during their lifetime if they so wish.

"The BMA is calling on the Scottish Executive to assess the level of support for such a policy. It is not acceptable to reject presumed consent without at least making a clear effort to determine what the public's opinion is on this matter.

"International experience shows that presumed consent improves donation rates and we would like to see a public debate on this issue to ascertain the best way forward."

1. National Transplant Week 2007 is taking place on 7 - 14 July. 2. The number of people on the active and temporarily suspended transplant waiting list in Scotland rose from 695 in September 2005 to 818 in July 2007.

3. A 'soft' system of presumed consent

The BMA supports the introduction of a 'soft' system of presumed consent in which relatives' views are also taken into account. Instead of being asked to consent to donation, they would be informed that their relative had not opted out of donation and unless they object - either because they are aware of an unregistered objection by the individual or because it would cause major distress to close relatives - th donation would proceed. Donation would therefore become the default position.

The introduction of a 'soft' system of presumed consent would represent a shift of emphasis in favour of donation without major changes to practice. It would respect both the wishes of the potential donors and the sensitivities of their families.

4. International Experience

- Analysis of 28 countries found that those countries that consistently implemented a policy presumed consent had higher donation rates than those that did not.

- In 2004, Belgium and the Czech Republic - both of which operate the type of opt out system we are proposing - had donation rates of 20.8 and 20.5 respectively (per million of population).

- In Belgium, after the introduction of legislation in 1986, Leuwen adopted presumed consent whereas Antwerp and Brussels did not. Donation rates rose sharply in Leuwen, but remained static in the other two centres.

- By comparison, the rate for the UK in 2004 was only 12.3 per million of population.

http://www.bma.org.uk

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