Ten years on: Welsh ‘opt-out’ model for organ donations had ‘little impact’

NHS Wales statistics show the controversial soft ‘opt-out’ model for organ donations has had “little impact”.

It has been ten years since new rules came into place presuming consent to organ donation unless the individual or their family indicates otherwise—yet despite an initial increase, donation consent rates have now dropped to lower than they were a decade ago.

Critics of the model warned that evidence from other countries showed it did not improve consent rates, and that it would undermine public trust in the NHS.

Ethical tensions

Healthcare scientist Dr Leah McLaughlin, from Bangor University, said: “The anticipated increase in organ donation consent rates has not materialised. Although the pandemic may have played a role in this, our research suggests that legislative changes alone are insufficient without addressing the underlying ethical tensions and the need for clear, compassionate communication with families during such difficult times.”

Her colleague, Professor Jane Noyes said: “Clearer public education is essential, as many people still don’t realise they are presumed to have given consent unless they opt out.”

She recommended that the donation process “be simplified” and that giving “greater legal weight to decisions made in life, such as joining the Organ Donor Register, could help prevent families from overriding their loved one’s decision”.

An altruistic gift

In 2015, when the new rules were about to come into effect, Dr Gordon Macdonald, the CARE for Scotland’s Parliamentary Officer, said that while the soft ‘opt-in’ system ‘looks and sounds good’, it is “not proven to work”.

He instead called for more work in schools, colleges and universities to raise awareness of the need for organ donations.

Dr Macdonald explained then that he opposed the ‘opt-out’ model, as: “The State does not have a right to anyone’s organs and even a so called soft opt-out system ruins the nature of organ donation as an altruistic gift.”