Donating organs should be voluntary, doctor warns

GREATER effort should be focused on increasing voluntary organ donation until there is evidence that an “opt-out” system would be more successful, a conference will hear.
Organ donation rates have increased in Scotland in recent years. Picture: GettyOrgan donation rates have increased in Scotland in recent years. Picture: Getty
Organ donation rates have increased in Scotland in recent years. Picture: Getty

Since 1999, the British Medical Association (BMA) has called for a system of “presumed consent” to be introduced in the UK to boost donor numbers, with everyone presumed to be a donor unless they opt out in advance.

But this stance will be challenged at the organisation’s own conference in Harrogate later this month when a Scottish doctor will say that many health staff are opposed to presumed consent.

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Dr Christine Robison, an anaesthetist in Edinburgh, will say that energy and resources should concentrate on promoting voluntary donation until there was “robust evidence” that opt-out would make a significant improvement.

Speaking ahead of the meeting, Dr Robison said she did not back presumed consent on ethical grounds, and doubts it would increase donations.

“I have lots of colleagues who work in the transplant unit,” she said.

“Everyone I have spoken to about this disagrees with opt-out. I have spoken to nurses, doctors, surgeons, anaesthetists, people who work in organ retrieval teams, and they have serious misgivings about this.”

Dr Robison said organ donation rates had increased in Scotland in recent years so changing the law would not be necessary, though others argued that presumed consent would increase numbers of donors even more.

Recent figures show that the number of people in Scotland who donated their organs after death almost doubled in the past six years, but 600 people are still awaiting a transplant.

Dr Robison pointed out that the Scottish Government had said it would examine the situation in Wales, where politicians have backed an opt-out system to be introduced next year, before doing the same here.

In the meantime, she said experts needed to focus on why some organs were being lost to transplant, such as making sure retrieval teams were able to get to potential donors in time.

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Dr Robison said her own ethical concerns about an opt-out system were around the issue of consent.

“Most doctors are brought up to believe that you are not supposed to carry out any treatment without consent,” she said.

A BMA Scotland spokeswoman said: “We believe that introducing an opt-out system as part of a wider strategy of measures to increase organ donation could help to save lives.”

A Scottish Government spokesman said: “The government has said it wishes to wait to see an evaluation of the impact of opt-out on organ donation in Wales before deciding whether or not to make a similar change in Scotland.”