Presumed-consent organ donation plan backed by health leaders and charities

Proposals for England receive warm welcome.
Donor card

 A shift towards a system of presumed consent for organ donation in England has been welcomed by health organisations and charities.

Picture: PA Wire

Prime minister Theresa May told the Conservative Party conference on Wednesday that 500 people died in England last year because a suitable donor organ was not available, as she signalled the move to an opt-out system.

The British Medical Association (BMA) said the announcement had the potential to save many lives, while Kidney Care UK said it was a 'momentous day'.

Transplant list

Ms May told the conference in Manchester: 'Our ability to help people who need transplants is limited by the number of organ donors that come forward. And there are 6,500 people on the transplant list today.

'So to address this challenge that affects all communities in our country, we will change that system, shifting the balance of presumption in favour of organ donation.'

Ms May highlighted the fact that members of black and minority ethnic (BME) communities had an increased risk of conditions, including high blood pressure, that may lead to the need for an organ transplant.

'Excellent news'

BMA council chair Chaand Nagpaul said: 'The decision to introduce an opt-out system for organ donation in England is excellent news.

'The BMA has lobbied and campaigned tirelessly on this for many years and has the potential to save many lives.

'It is important that the new process is well publicised to ensure the public are fully aware of, and understand, this important change.

'The health service must also have the resources, as well as facilities, to ensure transplant procedures can be performed when they are needed.

Kidney Care UK policy director Fiona Loud said: 'This is a truly momentous day for the 25,000 people in England on dialysis with kidney failure.

'One person dies every day while waiting for a kidney transplant, and this change has the potential to be life-saving and life-changing.'


Key questions about the presumed-consent proposal

What has been announced?

The government will hold a consultation on its proposal to automatically enter everyone in England on the donor register – unless they decide to opt-out – under a system known as 'presumed consent'.

What is the current system?

Anyone currently wishing to donate their organs in England has to opt in, which requires registration on a scheme run by NHS Blood and Transplant. Should a person die without making their wishes known, a family member can consent to the donation of the deceased's organs.

Why should it change?

The government says there is a 'severe' shortage of suitable organs for donation – up to three people die waiting for an organ every day – and ministers have backed campaigners calling for new measures to increase donation rates.

The number of people on transplant waiting lists is greater than the number of organs available, with around 6,500 patients currently listed in England.

There are particularly long waiting times for those in BME communities, with people waiting on average six months longer for a kidney than people from other groups.

Consent rates are also low in BME communities, at about 35% compared with 66% in the non-BME population. In 2016 just over 6% of deceased donors were from black and Asian communities.

What are the options?

Presumed consent can be implemented in two ways, referred to as 'hard' and 'soft' opt-outs.

Under a soft opt-out system, consent is deemed to have been given unless the person objected to donation in their lifetime. However, the deceased's family is also involved in the decision process. If the family says the deceased relative objected to organ donation then no harvesting will go ahead.

But the family cannot veto donation because they object. If a person's family cannot be reached, donation will not go ahead.

Under a hard opt-out system, doctors can remove organs even if the deceased person objected to donation during their lifetime but had failed to register their decision.

Do any countries already do this?

A soft opt-out system was introduced in Wales in 2015 and the Scottish Government has said it intends to introduce similar legislation.

Austria, Belgium, the Czech Republic, Finland, France, Greece, Hungary, Israel, Italy, Luxembourg, Norway, Poland, Slovenia, Spain, Sweden and Turkey are also listed by the World Health Organization as countries with opt-out organ donation systems.

Why should it not change?

Some people may oppose presumed consent for ethnic, religious and cultural reasons. The government has said it will listen to, and take account of, the views of people from a range of communities when considering changing the law.

When will the system change?

The 12-week consultation will be launched by the end of 2017. The timescale for introducing new legislation will depend on the outcome of the consultation.

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