Presumed organ donation ‘ethically unacceptable’

Plans in Scotland to allow doctors to harvest organs without prior consent are “ethically unacceptable”, the Scottish Council on Human Bioethics has said.

Writing in The Scotsman on behalf of the Council, Will Mata explained that it is “crucial” for organs or tissues only to be taken if the patient has given their permission while they were alive.

Labour MSP Anne McTaggart has drawn up a Bill to introduce presumed consent, as patients in Scotland can currently choose to donate their organs. Where there is no knowledge, the patient’s closest relative is allowed to give authorisation.

Pivotal flaw

Mata pointed out that the “pivotal flaw” with McTaggart’s opt-out system is it “does not draw the line between presumed and explicit consent”.

He highlighted the Government’s UK Organ Donation Taskforce’s statement in 2008 that presumed consent is a “misnomer” in medical care, because consent is an “active process”.

“The ethical importance is highlighted in incidents such as those at Alder Hey Children’s Hospital in Liverpool in the late 1990s – where body parts were retained without consultation and with the presumed consent of parents”, he added.

Explicit consent

Mata commented that Scotland should return to an opt-in system “where a deceased person’s organs and tissue would not be used for transplantation without his or her informed explicit consent”.

“Any other system”, he explained, “has the potential to undermine the concept of organ donation as a gift, to erode trust in the NHS and to negatively impact on donation numbers.”

Mata concluded, “any opt-out system that relies upon presumed consent is impractical, ambiguous and may be unethical.

Promote

“Everything should be done, instead, to promote organ donation through explicit and informed consent.”

Wales is introducing a new system of presumed consent for organ donation next year.