Scotland is missing an opportunity to increase organ donation rates, claims BMA

Category: Transplants/Organ Donations News

November 26, 2005

Commenting on the publication of the stage 1 report on the Human Tissue (Scotland) Bill by the Scottish Parliament Health Committee today (Tuesday 22 November 2005), the BMA expressed disappointment that the committee had failed to recommend a change in the current system for organ donation.

The BMA did, however, welcome the Committee's support for the general principles of the Bill, particularly the introduction of the concept of authorisation and of measures to improve procedures for post mortem.

The BMA echoed concerns raised by the Committee that action must be taken to improve donation rates. Dr Peter Terry, chairman of the BMA in Scotland said:

"The BMA has actively supported all of the recent efforts to improve transplantation rates in the UK. But despite many high profile campaigns to generate an increase in the number of donors, there has been limited success.

"Between April 2004 and March 2005, 52 Scots died while they were waiting for an organ transplant, others have died without even reaching the waiting list. Meanwhile, repeated studies show that 90% of the population supports organ donation, yet only 21% have signed up to the organ donor register.

"There is clearly a need to increase the number of organ donors and with this Bill, Scotland has an opportunity to take the bold step of changing the current system of organ donation. It is disappointing that the Health Committee does not accept this point.

"A recent UK-wide survey of opinion conducted by the BBC demonstrated 60% support for a change to presumed consent for organ donation and this is before there has been any concerted effort to educate and inform the public about making a change. It is not acceptable to reject presumed consent without at least making a clear effort to determine what the public's opinion is on this matter.

"The BMA believes that a change to a system of presumed consent for organ donation addresses this problem, by making donation the default position from which people may opt out during their lifetime if they so wish. Given the exceptionally high level of support for donation, this is simply making it easier for people to achieve their wish to donate and so is entirely consistent with the underlying principle of the Bill."

A 'Soft' system of presumed consent

The BMA supports the introduction of a 'soft' system of presumed consent in which relatives' views are also taken into account. Instead of being asked to consent to donation, they would be informed that their relative had not opted out of donation and unless they object - either because they are aware of an unregistered objection by the individual or because it would cause major distress to close relatives - the donation would proceed. Donation would therefore become the default position.

The introduction of a 'soft' system of presumed consent would represent a shift of emphasis in favour of donation without major changes to practice. It would respect both the wishes of the potential donors and the sensitivities of their families.

international Experience

-- In 2004, Belgium and the Czech republic - both of which operate the type of opt out system we are proposing - had donation rates of 20.8 and 20.5 respectively (per million of population).

-- In Belgium, after the introduction of legislation in 1986, Leuwen adopted presumed consent whereas Antwerp and Brussels did not. Donation rates rose sharply in Leuwen, but remained static in the other two centres.

-- By comparison, the rate for the UK in 2004 was only 12.3 per million of population.

http://www.bma.org.uk

Copyright © 2003-2005 Medical News Today.

This article posted December 24, 2005.