Ministers begin a consultation today on a proposed 'opt-out' system for organ donation in England, with the aim of making more organs available for transplant.

Dr Gregory Moorlock, an expert in the ethics of organ donation and transplantation from Warwick Medical School, comments:

"Transplantation is a remarkable area of medicine, which can significantly extend or improve the lives of patients with organ failure. It relies, however, on the generosity of the public. Organs will only be donated after death if appropriate permission has been given, either by the patient earlier in their life, or by their relatives at the time of death.

"Under opt-in systems, people record their wishes regarding organ donation by joining the Organ Donor Register. Although around a third of the population has registered as donors, there are many more people who are willing to donate but never take the step of joining the Organ Donor Register. Moving to an opt-out system makes it easier for these people to become donors, by presuming that everyone would be willing to become a donor unless they have stated otherwise.

"The significant change is the default position. In opt-in systems, people are not on the register unless they take action. In opt-out systems, they are. Importantly, under opt-out systems, people remain free to not donate by removing themselves from the Organ Donor Register (and it should be made easy for them to do this). Opt-out should not be confused with compulsory donation. It is also likely that an opt-out system will be a ‘soft’ one, where family members would be allowed to refuse donation even if their relative had not removed him/herself from the Organ Donor Register. If an opt-out system is implemented carefully and with appropriate publicity, it should result in more people’s wishes about organ donation being followed.

"Actions to increase the number of organ donors should generally be encouraged, but opt-out by itself will not solve the organ shortage. The Government’s own impact assessment suggests that the evidence is inconclusive as to whether it will increase consent rates. A further benefit of this consultation, however, is that it will prompt a national conversation about organ donation and the good that it can achieve. Raising further awareness of organ donation, educating the public and promoting discussion of people’s wises is perhaps more likely to bring about cultural and practical shifts needed to tackle the shortage of organs head-on."

12 December 2017

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Luke Walton, International Press Manager

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