Friday, August 01, 2008

Presumed Consent.

Been catching up on Welsh politics, now that my gaze has returned from family matters. And I see from the BBC that there was a major issue on the agenda at the National Assembly this week. An Assembly Committee rejected the idea of 'presumed consent' in respect of the donation of human organs. This must have been a really tough call. Must admit that I would have gone with the majority opinion.

There can be no doubt that introducing 'presumed consent' would greatly increase the donor rate, and that more lives would be saved. Such an argument cannot be lightly ignored. But the reality is that if organs were taken from dead people, unless they had specified otherwise, many body parts would be removed from dead bodies whose owners did not want this to happen. So many people just do not get around to preparations for death, until the Grim Reaper has actually come into view.

I sense that the change will come in the end though. The force of science seems to be irresistible. And I can imagine that it would be a traumatic experience talking to the family of someone, recently deceased, whose life could have been saved if only there had been a donor organ available. But there you are. Politics is about tough decisions - and they don't come much tougher than this one.


Anonymous said...

Some people are already fearful of their doctor - and now if they are severely injured they might, if presumed consent had passed, be under the hands of a doctor who might play God and decide their organs should be removed to benefit others even if their life could have been saved.

Respect for human life is moving into the commodities market. The use of embryonic stem cells, doctors who engage in killing babies and assisted suicide (some of which is done with the help of medical doctors) is undermining respect in the medical profession.

Look at how old people are routinely treated by many NHS doctors – treated as second class citizens who should be routinely denied NHS care. More than one published study has exposed this appalling ageism issue in the NHS and while it has shocked many it has been going on for years c/o medical gatekeepers - often the family doctor who fobs off his older patients with crippling pain from arthritis with "it's part of growing old, get used to it" commentary.

Frankly, we are moving into a time when people are less trustful of medical practitioners. Why should they get the opportunity to make decisions about organ transplants from someone who might otherwise be saved, but if raided of their organs could help five other people?

Hen Ferchetan said...

As a topic I've posted on a couple of times recently I'm dismayed at the majority decision.

At the moment there are three types of people - those who are opposed to giving and would therefore opt out, those that desperatly want to giv and who have already opted in and those who don't really care and who wouldn't opt in or out.

If a person opposes to having hi organs used to save others then they could optout - as simple as that. The fact that a 150 people in Wales die each year beause normal people without objection to donating are toolazy to opt in, and our AM's are too scared to bring in an opt-out is disgraceful.

I do hope that you're right in thinking that an opt-in will come sooner rather than later.

Anonymous said...

If stem cell based organs are supposed to be around the corner, why do we need presumed consent?

Glyn Davies said...

anon - I don't think this is a significant danger, but I do think the consequences of 'presumed consent' will be a 'spare part' culture in the way dead bodies are treated, in a way that would appear shocking to us at present.

hen ferchetan - while I disagree with you, I do accept that your case is hard to argue against from the standpoint of logic. I just feel that it is wrong, and that the proper way is for a proper innovative campaign to persuade people to carry donor cards.

anon - because they are not around the corner. That's just scientists making the case for greater disregard for the sanctity of life.

Dafydd Emlyn Harris said...

You know Glyn,
One can't ignore this
Under the microscope as it is.

Forget politics. This is about conscience
Universal donor cards are best
Card carriers can then decide.
Knowing your organs will be used.
I would settle for that.
Never really thought about it.
Glyn you are to be praised.

I don't have the answers
Does anyone?
I only know it is difficult.
Only the individual can choose.
This is a tricky subject.

Anonymous said...

'Soylent Green' here we come!

Doctors will end up mimicing the Army and airforce, cannibalizing parts from near-dead people to put into living people. Doctors will calculate along the lines of "well, if I harvest this person's organs I can treat five others - so let's harvest".

Soya Green here we come c/o 'caring' doctors.

'Soylent Green' here we come!

Anonymous said...

Not with you on this one Glyn - a trip around the Hospitals of our fair Wales may well give you second thoughts - or perhaps the many on waiting lists - children in particular.
Your 100% right on ID Cards etc but the choice element is maintained here - may need to be a stronger safeguards though.

Anonymous said...

What if ur a tourist visiting the UK?

As an American I would never visit a country where if I happened to be seriously injured my organs might be taken out of me without because of "presumed consent".

That is so much BS - watch earnings from tourism go down the pan.

Anonymous said...

A thoughtfully provoking blog but it misses out on the large numbers in need of transplants who are waiting in fear. I know from my own experience. The current system is too slow and many of our people need a new system that will help them. The Assembly AMs need to look at other models of work across the EU!

Glyn Davies said...

Dafydd - Its the difficulty of deciding that makes it interesting. It is a moral issue. Science has no morality, or mechanism for predicting long term consequences.

anons - your comments reflect the competing arguments. I do think there is a need for an innovative campaign to persuade people to choos eto carry donor cards. What about a weekly lottery prize, launched on the National Lottery programme, or something simililar.

Anonymous said...

If women can own their own bodies, then men should be allowed to too. The state should never presume they own my body - what next for heaven's sake. We have medical doctors playing God as it is.

Anonymous said...



A missed chance

SIR – I am disappointed by the WAG Health Committees’ decision not to pursue creating a “soft” opt-out system for organ donation.

Patients continue to die on waiting lists as the demand for organs increases; a natural consequence of patients living longer with co morbidities and chronic illnesses. An opt out system would have stimulated debate amongst the public, raised awareness regarding organ donation as well as the current dire shortage, as well as forcing people to face up to discussing death with their families.

One only has to look to recent media headlines to see the fantastic second chance that organ donor problems provides, with the tragic loss of life of a three-year-old girl crushed to death turning to happiness as her parents decided to help others by donating her heart and parts of her eyes.

I only hope that the Welsh Assembly Government now commit themselves to running a vast public awareness campaign encouraging people to become voluntary donors under the current system.

I only hope that in years to come a review may decide that opt out is the route to take for Wales. This decision is a missed opportunity to once again lead the way in healthcare. My only fear is that as a doctor, I may have to face many patients and their families, desperate to receive an organ and break the tragic news to them that they may die as there is no organ available.

Pant, Merthyr Tydfil

Glyn Davies said...

Chair KWF - Dr Samuel's letter articulates the case for presumed consent very well indeed. But there is another side to the debate. No-one would advocate taking the organs of someone who was opposed to it happening to their bodies, and under a system of presumed consent, this is what will be happening to people who did not get around to opting out.