Why we shouldn't assume anything on organ donation

Published on Monday 26 January 2009 19:20

SHOULD it be assumed that we want to donate our salvageable organs after our death unless we sign a designated form opting out of this arrangement?

This question was the subject of one of the last Scottish Parliamentary debates of 2008 and all MSPs had a free vote on the matter.

To my surprise, my views on the issue changed radically as I researched my speech. For many years I have agreed with the British Medical Association, and others, that assumed consent to donate is the way forward.

Lots of people die every year, or suffer enormously, for want of an available organ, and what use are your organs to you after death? Better that they be salvaged and used to help someone else.

What changed my mind was a report from the UK Organ Donation Taskforce. This group of people, most of them with direct experience of arranging organ transplants, were broadly split down the middle regarding opt-out or opt-in schemes when they began their work.

Yet, after they had studied the topic for many months, taking evidence from all over Britain, they came out unanimously against an opt-out system.

They found an opt-out system could erode trust between a doctor and patient and that doctors might be tempted to "jump in too quickly", before a person was actually dead.

Some faith groups even threatened to start an anti-donation movement, while others felt that it was a little paternalistic to assume consent in this modern era.

If a group of people dedicated to increasing the number of transplants unanimously give the thumbs-down to assumed consent, then that is something you must take seriously. The rest of the parliament saw things the same way, and we have agreed to advance other methods to encourage organ donation and to review the outcome in five years.

Meanwhile, in the health and sport committee, we are back on the trail of seeing how we can encourage people to take up sport and exercise in general. The first thing you notice as an outsider is the plethora of sporting bodies that exist. Join a club, with a committee of course, and you will find you are governed by one of 70 sporting bodies. They, in turn, relate to one of about 12 national bodies; Scottish Sports Association, Scottish Association of Local Sports Councils, or Scottish University Sports for example. That is before you involve SportScotland, the Scottish Institute of Sport, National Sports Centres, Winning Scotland, Coaching Scotland, or Disability Scotland. (I apologise to the many organisations I have left out.)

While I am sure most of these bodies do valuable work, I wonder if a successful business would operate in this way. There must be more guys in blazers than athletes at sporting occasions these days. And, judging by the number of sports people we have encountered who suffer from permanent injury due to taking part in elite sport, one still wonders whether the link with health is a little tenuous.

Distinction awards for NHS consultants came under the spotlight at the end of last session. The justification for adding amounts of up to 74,768 yearly to a person's salary, with consequential pension enhancements, varies from rewarding service over and above the call of duty to preventing stars from emigrating or going into private practice. Yet 40 per cent of all consultants aged between 60 and 65 receive distinction awards. Can they all deserve them? Somehow I doubt it. And why does no other group of health workers receive such benefits?

The Scottish Distinction Award scheme will, next year, cost the taxpayer 28 million. Many are beginning to think that this money could be better spent elsewhere.

&#149 Ian McKee is a Lothians MSP and a member of the Scottish Parliament's health and sport committee.