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Why England’s 2020 opt-out organ donation law is so important for emergency services

Early engagement with specialist organ donation colleagues is vital as soon as decisions are made around end of life care in the resus room

Early engagement with specialist organ donation colleagues is vital as soon as decisions are made around end of life care in the resus room

Picture shows medical person carrying human organ for transplant in box. Early engagement with specialist organ donation colleagues is vital as soon as decisions are made around end of life care in the resus room
Picture: iStock

As emergency nurses we are frequently faced with caring for the relatives of patients whose lives have been dramatically cut short.

Difficult conversations about organ donation are undertaken with distressed families during this tragic and confusing time.

In spring 2020, the law around organ donation in England is changing to an opt-out system. This means that adults will be considered to be an organ donor unless they opt out of the register.

As the law currently stands, adults wanting to become organ donors need to sign up to the register.

‘Even with the opt-out system of organ donation, family consent is vital and support for loved ones at this time is crucial for best interest decisions to be made’

Wales has highest consent rates for deceased organ donors in UK

In Wales, an opt-out system has been in place since 2015 and the country now has the highest consent rates in the whole of the UK. In 2018, there was a 21% increase in deceased organ donors.

A large media campaign alongside the legislation change improved public awareness and encouraged the Welsh public to discuss their wishes with their loved ones.

Even with the opt-out system of organ donation, family consent is vital and support for loved ones at this time is crucial for best interest decisions to be made.

The new law in England will affect the way nurses working in emergency departments approach organ donation.

‘Hopefully this change in the law will lead to a further increase in the number of organ donors across the UK’

There will be a greater need to engage with specialist organ donation colleagues. National Institute of Health and Care Excellence guidelines advocate partnership working with the multidisciplinary team and the early involvement of specialist nurse organ donation (SN-OD) in this process.

Sensitive decision-making discussions with families

Early engagement is vital as soon as decisions are made around end of life care in the resus room.

Research has shown that consent rates are improved when SN-ODs are involved in discussions with families of potential organ donors.

SN-ODs undergo extensive training on how to approach sensitive decision-making conversations with relatives. This also allows SN-ODs to offer one-to-one support and guidance to families in the ED and this care continues beyond the point of donation.

Hopefully this change in the law will lead to a further increase in the number of organ donors across the UK, changing the lives for the better of the thousands of people awaiting organ transplants.

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About the author

Sara Morgan is senior lecturer nursing at the Faculty of Life Science and Education, University of South Wales

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