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BMJ. 2007 September 29; 335(7621): 634–635.
PMCID: PMC1995470

UK considers moving to system of presumed consent to transplantation

Clare Dyer, legal correspondent

The UK government is considering moving to a system where people will be presumed to have consented to the use of their organs for transplantation unless they have opted out.

The health secretary, Alan Johnson, has asked the organ donation task force to look at the ramifications of moving from the present “opt-in” system, in which organs can be used only if people have given their prior consent, to the sort of opt-out regime currently operating in some other countries, including Sweden and Austria.

The task force, set up in 2006 to look at barriers to organ donation, will examine the legal, ethical, practical, and medical issues, including whether the family of somebody who has died should be given the final say on organ donation. At present the family's consent is required unless the potential donor has signed up to the organ donor register or otherwise expressed a wish to donate organs.

Mr Johnson said, “We know that around 8000 people in the United Kingdom need an organ transplant, but only 3000 transplantations are carried out each year. With more than 400 people dying every year waiting for a new kidney, heart, lung, or liver, we need to do everything possible to increase organ donation.

“I want to see organ donation and transplant rates start to rise and match the rates seen in some other European countries, enabling us to save many more lives. This is a sensitive issue, but it is vital that all possible options for increasing the number of organs available for transplant are explored.”

A recent survey by Ipsos MORI for the Human Tissue Authority found that although 68% of respondents said they were likely or certain to donate their body, organs, or tissue, only 5% had taken the necessary steps to do so (BMJ 2007;335:533, 15 Sep doi: 10.1136/bmj.39335.479583.DB).

The organ donation task force has a remit covering the whole of the UK. Last year, when legislation on organ donation was going through the Scottish parliament, members rejected a move to require people to opt out of becoming donors.

Vivienne Nathanson, the BMA's head of ethics and science, said the association favoured a system of presumed consent, but with safeguards. “Before any changes go ahead, however, it is essential that a public information campaign is launched so that people are completely aware of the choices they can make about organ donation.”

The Liberal Democrats' science spokesman, Evan Harris, a former hospital doctor, said he would re-table an amendment introducing an opt-out scheme when the Human Tissue and Embryo Bill comes before parliament next year.

“When I last put this to parliament, during the passage of the 2004 Human Tissue Act, the government whipped against it, claiming that it would not work and that their own plans to improve the current system should be tried first.”


Articles from The BMJ are provided here courtesy of BMJ Publishing Group