Confusion over law halts Scots organ transplants

Published on Saturday 5 July 2008 19:55

SCORES of desperately ill Scots have been denied organ transplants because of mistakes by medical staff and confusion over the law, Scotland on Sunday can reveal.

An investigation by the authorities has established that on seven occasions in one year, relatives stepped in to stop organs being taken even though the donor had signed up to the Organ Donor Register. To do so breaches current donation laws.

And a separate investigation at a Scottish hospital unit discovered several occasions where staff missed clear opportunities to provide organs for donation.

In all, it is estimated that as many as 100 potential transplants were lost because of the problems.

Campaigners said last night the revelations strengthened the case for better procedures and training within hospitals, and for reform of donation law to a system of presumed consent. Scotland on Sunday is campaigning for ministers to make this change.

Papers obtained under Freedom of Information laws show that between November 2006 and December 2007 there were seven occasions on which families intervened to stop organs being taken from relatives on the register. In some cases families refused donation altogether and in other cases they refused donation of certain organs, corneas or tissue.

Two years ago the law was changed, enshrining people's rights to "authorise" donation of their own organs by signing the Organ Donor Register.

The Human Tissue Act (Scotland) 2006 states that relatives should only be asked if there are any medical reasons

preventing donation. However, the report reveals that in practice doctors are unwilling to overrule relatives' wishes even if that means ignoring the wishes of the deceased.

The loss of seven potential donors is particularly serious because only around 50 Scots a year become organ donors.

The investigation, carried out by government body The Scottish Transplant Group, was prompted by revelations in Scotland on Sunday last year that doctors were reluctant on ethical grounds to overrule next of kin.

Last night John Forsythe, chairman of the Scottish Transplant Group, said the issue was "very sensitive" but insisted doctors would not take organs if it was going to cause relatives further distress.

He said: "If relatives are saying no because it's a step too far in this tragic incident then what do you do? There has to be a pragmatic approach. Can you imagine relatives holding on to a bed, saying we mustn't take loved ones? It would be awful."

Another investigation, of the neurological intensive care unit at the Southern General Hospital, Glasgow found "occasional missed opportunities" to refer accident victims for assessment for their potential as organ donors.

An audit from 2005-2007 found a total of eight cases where a donor might have been found but was not.

In six cases a donor transplant coordinator was not involved, which is seen by experts as the best way to reassure families. On one occasion, organ retrieval could not go ahead because of a lack of theatre space and on the other occasion a suitable patient was missed.

However, despite this, donation rates were still found to be higher at the Southern General than at other UK hospitals.

Campaigners point out that every donor is desperately needed. There are currently 7,551 patients waiting for transplants across the UK and one donor can save the lives of several people.

Gillian MacCormick, who has been waiting for a liver transplant for two years, said the wishes of the deceased should be prioritised.

"If someone has requested that their organs be used I definitely don't think their family has the right to overrule that."