Law on Consent May Not Make Organs Available

Jan 16, 12:35 PM

It is true that organ donation rates in Spain are considerably higher than in Scotland, but this is not entirely the result of a law of presumed consent there. There is a much higher rate of acute brain injury in Spain, mainly owing to the higher number of road accidents, and there is a much more developed transplant infrastructure in place, including transplant co-ordinators in every hospital.

These factors alone are responsible for much of the increased availability of organs for transplant. Other countries in Europe also have a policy of presumed consent, but some actually have lower rates of organ donation than Scotland. When examined in detail, the evidence that a simple change in the law to presumed consent would improve donation rates is not convincing.

Furthermore, given this country's strong instinct for upholding individuals' rights and freedoms, there must be a strong worry that implementation of a presumed consent law may alienate some of the population, with an adverse effect on the donation rate. In particular, to be a legally and ethically valid conduit for people wishing to opt out from donation, the opt-out register would have to be accessible and well-publicised.

It is also unthinkable that a dead patient's organs would be taken without family agreement, and hence discussion with the deceased's family after brain-stem death will need to continue as before. It is vital that this discussion is informed by accurate knowledge of the patient's wishes expressed before death. This can only be guaranteed by a compulsory registation of patients' wishes, whether for or against donation.

Anything less than this form of balanced registration would be invalid as an indicator of the deceased's wishes, and could not reasonably be used to inform the discussion with the deceased's family which will still need to take place, even with a change in the law to presumed consent.

I write as a senior intensive care clinician with almost 30 years experience of dealing with brain-stem death and organ donation, and who strongly supports organ donation and transplantation.

I urge extreme caution before proceeding with a change in the law to presumed consent.

Ian Grant, 2 Ashburnham Gardens, South Queensferry.

Originally published by Newsquest Media Group.

(c) 2008 Herald, The; Glasgow (UK). Provided by ProQuest Information and Learning. All rights Reserved. Law on Consent May Not Make Organs Available
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