The Welsh government has announced plans to introduce presumed consent for organ donation. They are calling it "deemed consent", in which people living in Wales for a period of six months or more will be opted-in automatically as organ donors. This will include prisoners, tourists, and students.
A consultation on the draft bill "Human Transplantation (Wales) Bill" opened on 18 June 2012, and closes on 10 September 2012. The consultation is open to everyone. SPUC has produced a briefing and summary assisting pro-lifers to fill in the consultation.
I blogged about the dangers of presumed consent for organ donation in January 2008 when Gordon Brown, the former British prime minister, wanted the law on organ donation to allow presumed consent, and July 2008 when the Welsh Assembly rejected presumed consent for organ donation.These measures could impact negatively on the seriously-ill and dying and their families, who may not be aware of medical controversies surrounding the determination of death which,
if known to them, might make some reluctant to donate their organs. The evidence seems mixed about whether such a change would increase the number of organs available. Some countries with presumed consent systems do worse than the UK but some do better, suggesting that other factors may be more important.
There are many serious objections to the proposals that are not addressed at all (or only inadequately) in setting out these proposals; most importantly the question of whether so-called ‘brain-death’ or ‘brain stem death’ is actual death. As David W Evans MD, FRCP has noted:
“the basis upon which a mortally sick patient is declared “deceased” – for the purpose of acquiring his or her organs for transplantation without legal difficulties – is very different from the basis upon which death is ordinarily diagnosed and certified and that highly relevant fact is not fully and generally understood.”
The proposals ignore the facts concerning this area of scientific dispute, yet this is a question with enormous ethical implications. Most organ donors are unaware that their hearts may be beating when their organs are taken, and that they may be pink, warm, able to heal wounds, fight infections,
respond to stimuli, etc.
They are also unaware of common practices of paralysing and (sometimes) anaesthetising supposedly brain-dead donors before their organs are taken.
Simply signing a donor card does not in any way indicate that the prospective consenting donor understands what will be involved, and those who are merely ‘presumed to consent’ are likely to know even less.
In other medical contexts, informed consent is the gold standard. So it really must be asked why in this particular setting informed consent is being set aside. Presumed consent effectively abolishes organ donation understood as a free gift (providing all ethical considerations are fulfilled).
The key documents are:
- the draft Bill http://wales.gov.uk/docs/dhss/consultation/120618billen.pdf
- the bill's explanatory memorandum http://wales.gov.uk/docs/dhss/consultation/120618memoen.pdf
- the consultation document http://wales.gov.uk/docs/dhss/consultation/120618documenten.pdf
- the response form (scroll down to bottom of page. The response form is the Word document) http://wales.gov.uk/consultations/healthsocialcare/organbill/?lang=en
How to respond:
- online: http://goo.gl/kvovB
- email: fill in the consultation response form (above) and email it to organdonation@wales.gsi.gov.uk Please mark the subject of your email: Consultation on the Draft Human Transplantation (Wales) Bill
- post: print out the consultation response form (above), fill it in, and post it to: Organ Donation Legislation Team, Medical Directorate, 4th Floor, Welsh Government, Cathays Park, Cardiff, CF10 3NQ
- telephone: call the following number and ask for a response form to be posted to you. Large print, Braille, and alternative language versions are available. 029 2037 0011
