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Expert comment: Opt-out system for organ donation in England is welcome, but timing is unfortunate

England switches to an opt-out system for organ donation today, as the world battles COVID-19. Dr Greg Moorlock, who researches the ethics of organ donation at Warwick Medical School, has commented on the impact that the timing is likely to have.

Dr Moorlock says: “Moving to an opt-out system provides a welcome opportunity to increase the number of organ donors. By changing the default position to an assumption that people are in favour of their organs being donated, opt-out systems make it as easy as possible for people to become organ donors if they wish.

"Unfortunately, the timing of England’s move to opt-out is likely to significantly compromise both its impact and its ethical underpinnings. A fundamental ethical aspect for any opt-out donation system is that people are informed about the change, so that they are aware that they will potentially become an organ donor unless they register a wish to the contrary. Everybody needs to be informed of the change, so that they can ensure that their organ donor status accurately reflects their wishes.

"Unfortunately, the COVID-19 crisis has completely, and understandably, swamped recent news, and massively overshadowed the move to opt-out. We should have been seeing a public awareness campaign over the last few weeks and months, alerting everybody to the changes and promoting discussions about organ donation. Due to COVID-19, however, we have seen very little of this. There is a very real risk that lots of people will not be aware that we have moved to an opt-out system, and may therefore find themselves presumed to be willing organ donors despite this not being the case. This could be extremely detrimental in terms of public trust in the organ donation system, which relies extensively on public goodwill. These issues, coupled with public concerns about ICU rationing, Do No Attempt Resuscitation paperwork, and the fact that transplantation has mostly been suspended during Covid, mean that the timing of the change could not be much worse. Frustratingly, we only get one chance to make this change and yield a positive impact from it, and it appears that this chance is being blown.”

20 May 2020


Peter Thorley
Media Relations Manager (Warwick Medical School and Department of Physics)


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