Medics ‘shouldn’t force organ donation’ if family are opposed, say experts

A change will see Scotland move to an 'opt-out' system. Picture: Rob McDougall.
A change will see Scotland move to an 'opt-out' system. Picture: Rob McDougall.
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Healthcare professionals must not be made to force through an organ donation against the wishes of a distressed family, experts have told MSPs.

The Scottish Parliament’s Heath Committee heard claims medics would be put in a “very difficult” position if there were any rules that compelled them to override the wishes of relatives.

The committee has been taking evidence on plans to introduce an opt-out system for organ donations in Scotland.

The change proposed under the Human Tissue (Authorisation) (Scotland) Bill would mean people would be assumed to have consented to their organs being used to help others unless they had signed an opt-out, potentially increasing the number of organ transplants that can take place each year.

READ MORE: Half of Scots registered for organ donation

In an evidence session on Tuesday, SNP MSP Keith Brown sought clarity on where the rights of the person whose organs may be donated should sit in relation to the rights of the state and the rights of their own relatives.

He also later sought views on whether a so-called family veto should be written into the Bill.

Rachel Cackett, policy adviser for the Royal College of Nursing (RCN) Scotland said: “Professionals who are doing this at a very difficult time for families are highly trained, sensitive to the conversations that they are having and have an ongoing relationship with the family.

“But we’re also very clear that no practitioner should be put in the place of having to force a donation ...

“Certainly, our position is that if a family does not want a donation to go ahead it should not be forced.”

Two other experts giving evidence appeared to share a similar view.

READ MORE: 10% of people could opt out of organ donation system

Mary Agnew, assistant director for standards and ethics at the General Medical Council (GMC) said: “In situations of extreme distress to the family, I don’t think you would want to put professionals in a position where it was felt they had to somehow override a very distressed family.”

Dr Sue Robertson, deputy chairwoman of British Medical Association (BMA) Scotland, told MSPs: “I think that to have the soft opt-out part of this legislation means that if the healthcare professionals involved feel that this is just going to cause undue distress to this family then I do think we have a duty of care to them as well ...

“If you feel it’s going to cause undue distress then I think there should be a situation whereby authorisation (for the donation) will not go ahead.”

MSPs later heard it is relatively rare for families to override the donation wishes of their deceased loved one.

Lesley Logan, regional manager for organ donation at NHS Blood and Transplant, suggested such disagreement happens only around three times a year in Scotland.

Dr Stephen Cole, consultant in intensive care medicine at Ninewells Hospital in Dundee, representing the Scottish Intensive Care Society, told MSPs: “Having dealt with this on a daily and weekly basis, I would find it difficult in my profession to over-ride the wishes expressed by the relatives of those patients.

“Or if a patient’s family said ‘Yes, he signed up to the organ donor register, it was the expression of a wish at a point in time, I now have more information which says this is actually not what he or she wanted’, then as the intensive care consultant speaking to that family, I would listen to that.

“I don’t think that we can push families into a situation where donation is forced through against their wishes. I would find that a very difficult situation to be in.”