After nine months of deliberation, the Organ Donation Taskforce recommended to the government this week not to change the law to presume all organs are a donation upon death unless instructed otherwise. Ostensibly, this would seem like an admirable solution to the clear problem concerning organ donation. The lack of donors in the UK is a major issue; we currently have the lowest donor rates per capita within Europe. More than 1,000 people have died in the past year while waiting for a new organ, despite more than one million new donors registering.
The issue of trust has emerged to be at the crux of the debate surrounding presumed consent. Fears abound that the Prime Minister is attempting to nationalise our bodies.
There are also concerns surrounding government’s habit of losing data, particularly given the sensitive nature of donor records. But the primary concern regarding trust lies with doctors and medical officials. The image of doctors wheeling patients off to die in an operating theatre, scalpels at the ready, pertains. This is underlined by the belief that doctors will place a higher value on the life of those patients requiring life-saving organs, rather than fairly distributing their efforts to all of those in need. Although unlikely, the fear that a doctor could defend the life of a potential donor with less passion is a potent argument against any organ donation, but particularly against presumed consent.
The idea that a lack of opposition equals ‘informed consent’ is a key problem with ‘presumed consent’. While organ donation is widely publicised, the socially disadvantaged are less likely to be aware of their rights, and less confident in defending them if their organs are assumed to be a donation. Of greater concern are those who choose to opt out. Would they be a lower priority to receive organs should they need them? While we think of organ donation as morally upstanding, many prefer not to, and should not be judged on this matter of conscience.
The real issue is that we don’t talk about this problem enough. Our families rarely know our wishes and so could not enact them, should they need to. The head of the British Medical Association, a supporter of presumed consent, has highlighted the need to discuss organ donation with friends and family, as education alone has not raised the issue prominently enough. Undoubtedly further publicity, education and openness regarding organ donation will help; presumed consent is not the answer we’re searching for.