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Time to Opt Out

Why organ donation systems that assume consent save lives

The current system for organ donation in England requires an individual to actively sign up to the organ donor register. While 80% of people, when asked, say they would happily donate their organs after their death, only 36% have gone through the formal process to ensure this can happen.

There are currently 6,400 people in the UK on the transplant waiting list, and three people die every day while on it. As many as 30 donation opportunities are missed a day.

I believe that an ‘opt-out’ system, where consent is deemed to have been given unless an individual has specifically expressed otherwise, could make a huge difference to the number of organ donations offered in this country. I know some people feel anxious that such a system may mean medical teams might work less hard to save, for example, an older person’s life if they know a matching child could receive those organs. I would like to dispel that myth.

Before joining general practice, I worked for several years in hospital medicine, including in intensive care. My colleagues and I worked tirelessly and pulled out all the stops to look after the sickest of patients. Admitting a critically ill person and watching them improve to the point that they could be discharged to a general ward to continue their recuperation has been one of the most fulfilling parts of my career. Sadly, there have also been occasions when despite our best efforts an individual didn’t make it. Telling relatives that news was a hideous part of the job.

The way the system stands at the moment, a doctor is required to ask the nearest and dearest – at that traumatic time – whether their next of kin had considered donation. Agreeing to donation can be an exceptionally difficult decision to make if the patient had not previously expressed an opinion or joined the register. If their relative is on the register, 91% of families agree to donation. If not, that figure falls to 47%.

Importantly, it is only when next of kin give permission for organs to be used that the donation can go ahead. The intensive care team do all they can to save a patient. It is only when that becomes impossible and consent is given that the transplant team are brought in and they will retrieve the organs and find matches as quickly as possible. There is absolutely no horse-trading.

Wales has already adopted an opt-out policy, and the number of donations has risen by more than a third since 2015. The move for England to follow suit is under way – the bill is now at the committee stage in the House of Commons.

I sincerely hope that England (and the rest of the UK) adopts this policy. In the meantime, if you haven’t already, I urge you to register and have those difficult conversations with your family. You could save lives. 

Opinions are writer’s own and do not necessarily reflect those of Benenden Health