'Opt-out' organ donor system presents conflict for nurses, says RCN

RCN Scotland raises concerns about proposed change in the law

A change in the law governing organ and tissue donation in Scotland could undermine legal protection for nurses, says the RCN.

The Scottish parliament is debating a bill tabled by MSP Anne McTaggart that would allow clinicians to presume consent for organ donation unless otherwise stated. This would bring Scotland into line with Wales, where such an 'opt-out' system will become law next month.

The bill would allow consent to be granted after death by the individual's relative or appointed proxy, providing the deceased had made no written objections.

Holyrood's health committee is hearing evidence from organisations including BMA Scotland. RCN Scotland made a written submission setting out its position. The college's governing council voted in 2009 to support the current opt-in system and RCN Scotland said it does not want to depart from that stance.

The college stated in its submission: ‘Should the bill proceed, there would be questions around providing adequate protection for staff and sufficient resources for staff education and training.’

RCN Scotland fears that switching to an opt-out system could lead to a conflict of interest in which the nurse’s role in caring for a dying patient might be perceived as secondary to their role in the retrieval of organs for transplantation.

Instead, it championed the role nurses currently play, saying they are often the first healthcare professionals to broach the subject with patients or relatives when a terminal diagnosis is made.

The submission continues: ‘When patients become critically ill, nurses play a central role in the assessment to establish their suitability (for organ donation).

‘Nurses also play a central role in ensuring end of life care conforms to what are known to be, or what can reasonably be assumed to be, the expectations of the patient.’

The bill was introduced after it was revealed there are more than 500 people waiting for organs in Scotland, some of whom will die before a match can be found.

Despite studies showing around 90% of the Scottish population supports organ donation, fewer than half have signed up to the register.

You can follow the bill’s progress here

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