Intended for healthcare professionals


BMA wants presumed consent for organ donors

BMJ 1999; 319 doi: (Published 17 July 1999) Cite this as: BMJ 1999;319:141
  1. Linda Beecham
  1. BMJ

    The BMA will lobby the government to introduce a system of “presumed consent” for organ donation under which doctors will be allowed to assume that all patients are willing to have their organs removed after death unless they have registered their objection beforehand.

    Representatives at last week's meeting of the BMA's annual meeting in Belfast voted overwhelmingly in favour of an opt- out system, a change in the policy that it has held for nearly 30 years. They also called for a public education campaign about the merits of organ donation.

    About 2800 organs are transplanted each year, but more than 5000 people are awaiting transplants, and the number of transplant operations fell last year.

    Dr Evan Harris, who practised in a renal dialysis and transplant unit before he became a Liberal Democrat MP, told the meeting that an opt out system had been in existence in Belgium for 10 years The number of organs available had doubled after it was introduced, and there had been little objection from the public.

    He believed that many people were prepared to have their organs used but few people carried donor cards. “Organs that could be used to save lives are buried with the patient while someone else is buried later for want of that organ,” Dr Harris said. People who did not want to give their organs could be registered through driving licences, the electoral register, passports, or tax returns.

    But Dr Judith Langfield, a GP in Bristol, who opposed the change in policy, said, “Some people have religious and cultural objections to transplantation.” She did not think that any system would be foolproof or could guarantee that organs would not be taken against a patient's wishes. Dr Chris Tiarks, a GP from Eigg, also opposed the change. He did not think that informed consent should change after death. “If you die intestate the state does not immediately seize your assets. Why should it seize your body?”

    The meeting also agreed to campaign for a change or clarification in the law so that relatives would not be able to overrule the wishes of donors after death.

    In the week that the government ordered an inquiry into a transplant operation in Sheffield for which organs were donated with conditions attached as to the race of the recipient, the BMA said that organs donated must be accepted unconditionally by hospitals for any suitable recipient.

    A recent Department of Health survey showed that half of the public supports the existing opt-in donor card system and only 28% support a system of presumed consent. (see p193)