Organ donation rates stagnate under controversial opt-out model

Campaigners have urged people to have conversations about organ donation, in light of the failure of the controversial opt-out model.

Matthew Smith was diagnosed with a terminal lung condition in 2023, but had to wait almost a year to be informed that an organ was available. There are more than 8,000 people in the UK waiting for an organ donation – the highest on record. However, consent rates have not risen.

Across the UK, there is now presumed consent for a person’s organs unless they explicitly opt-out or their family refuse on their behalf.  Despite this, analysis of NHS Wales data has shown that the new model has had “little impact” over the last decade.

Ethical tensions

Nurse and organ donor specialist Harpreet Matharu explained: “What we’ve always said is talk to your loved one, make a decision and sign on the register, because we know when a patient has opted in and had those conversations, consent is much higher in those circumstances”.

Matthew Smith’s wife, Nicola, said that on the day of the surgery: “I think I cried from when he went in until he came out. It’s the start of a new beginning. It’s a new life”.

This year, the couple hope to mark their 30th wedding anniversary with a celebration on the beach. Nicola urged people to think about organ donation, saying: “You’re giving somebody the chance of a new future”.

Dr Gordon Macdonald explained in 2015 that he opposed the ‘opt-out’ model because 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.”

Wales

Speaking last year, 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”.