Friday, 19 October 2007

Opting in, opting out and 'presumed consent'

Let me say from the outset that I am fully in favour of organ donation.  The ability of medicine to reuse organs and as a result either save people's lives or give them a heightened quality of life is one of the major successes of medical science in the last fifty years.  Let me also say that I am fully aware of the heartbreak caused by te death of a young person simply because there are no organs available having lost two close relatives in this way.  We should all be prepared to donate our organs on death unless we have good reasons not to.  It is our way of giving something to others who often deperately need what we no longer have a use for.

The critical dimension of this is that it is our donation, our gift to others.  However, the increasing view of public opinion is that there should be an opt-out system of organ donation.  It appears that there will be the assumption of 'presumed consent' unless you specify otherwise.  This concerns me greatly.  Although the BMA says that 'there will never be a compulsion to donate' and I have no personal objections to donation, it is this notion of presumed consent that concerns me because it could well be the thin edge of the wedge.  At present organs can only be taken from people who have actively chosen to be donors, and carry donor cards. Results from a British Medical Association survey showed that 64% of those taking part thought Britain should adopt the new system.  Just over a quarter of the more than 2,000 people surveyed in England, Scotland and Wales, said they were on the NHS Organ Donor Register. However, 62% told investigators they would be willing to donate their organs for transplantation after death, in which case why aren't they actually on the Organ Donor Register?  If they were, there would be no need for an opt out system.

Perhaps I'm being cynical but I strongly believe that the state has too much power and interfers in what should be our lifestyle decisions and that, whatever those in favour of this proposed system say, presumed consent will be a decision made by the state and if it can apply the concept to organ donation then there is no logical reason why it could not be applied say to euthansia or other less platable or popular issues.  Yes you can demand that your organs are not used but what if you can no longer make that choice?   Will it be presumed that you are willing to have your organs used?  Or will your relatives have the right to make that choice for you?  I am certain there will be the usual legislative safeguards but whether they will be sufficient is a debatable point.  An individual's body is their own and, whether in life or death, we should have control over our bodies and the state should not presume to tell us what we should or should not do with them.

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