Thursday, November 06, 2008

Presumed Consent

My opinion is no more settled than it was this morning. This is despite spending an hour and more at what I can only describe as an Assembly Government sponsored 'discussion' in Newtown. The subject was 'Presumed Consent'. The basic question is whether following death, human body organ donation should be carried out unless the deceased has a way of expressing an opinion that he or she did not want it to happen.

The Assembly Health Minister has already expressed a 'personal view' that this should be the position. Today's discussion was constitutionally odd - the Minister checking with the people before translating her 'personal view' into law. Gordon Brown and Rhodri Morgan have expressed the same personal view as Edwina Hart. I pointed out that a cross party Assembly Committee takes an opposing opinion. The problem as I see it is that if 'presumed consent' were to be adopted, there would be many organs removed from dead people who would not have wanted their bodies mutilated. I'm not at all sure that this is morally acceptable. The response that its the recently deceased responsibility to carry an opt-out card seems highly questionable to me.

I learnt some interesting facts today. In no particular order.

People waiting on a transplant list are more likely to die as waiting than to receive the transplant that they need.

Spain, (which has a 'presumed consent' policy), has a higher level of organ donation than any other country. However, it was administrative changes which raised the level rather than the 'presumed consent' policy itself.

The discussion is about organ donation policy, and is not about where the organ distribution policy, or about where organ receivers live in the UK.

In the US, more organs are taken from the bodies of the living than the dead.

I still believe that Government should take more seriously the job of persuading people to carry donation cards, and that the focus of Government policy should remain on promoting agreed organ donation. But I can see that its not easy. One final point. If we are going to go down the 'presumed consent' route, I would much prefer it to be done on a UK basis.

11 comments:

Chris Wood (PhD not MD) said...

So what happens under 'presumed consent' if you are, for example, a tourist visiting Wales unaware of the 'presumed consent' policy (if enacted in Wales) and you die unexpectedly. Does 'presumed consent' apply to visitors to Wales? I can imagine a family of a deceased tourist getting pretty upset to (a) learn that their loved one has died, and (b) parts of the body are missing.

Glyn Davies said...

chris - I would not expect that to happen. There are many similar questions as yet unanswered. There remains much work to do by the Asembly Government if the Minister decides to proceed with 'presumed consent'. I would also imagine that theseissues have been addressed in any country that has 'presumed consent'.

Anonymous said...

glyn, do you know how many countries use the assumed consent method?

Glyn Davies said...

Anon - I don't know, but the information leaflet accompanying the discussion gives us some examples.

There are two types of 'presumed consent' systems - usually referred to as 'hard' and 'soft'.

The 'soft' versions are to be found in Belgium and Spain, and allow for a relative's veto of the potential donor's wishes. The 'hard' version is to be found in Austria, and this does not allow relatives to veto.

Any consideration of the effectiveness of these systems would have to take into account many other factors as well. For example, the number of organ transplants in Spain did not increase when 'presumed consent' was introduced - but did increase greatly when other changes to the organ donation system were introduced some time later - at least this is what we were told yesterday.

Che Grav-ara said...

Glyn I haven't attended one of these meetings yet so maybe you can clarify what you are suggesting by saying "I can only describe as an Assembly Government sponsored 'discussion' in Newtown." I personally think it’s an excellent idea that these meetings are taking place but you are suggesting that it is something sinister?

I am all for organ donation. At the end of the day too many people are dying where not enough people are registered to give their organs. Even though I am sure many would be willing.

One point I don't get is,

"One final point. If we are going to go down the 'presumed consent' route, I would much prefer it to be done on a UK basis."

Why?

Chris Wood (PhD not MD) said...

This sounds like state ownership come nationalization of peoples' bodies. If someone wants to donate their organs upon their death, then fine. They can carry a donor card.

Not so long ago we thought it was awful that Chinese prisoners had to donate their organs upon death. Pretty soon there were stories of prisoners being put to death to harvest their organs.

Once our bodies' become property of the state - we become less human, more commodity in nature and one step closer to the state deciding who is more worthy of your body's organs, you or someone the state believes should have them.

Glyn Davies said...

Che - you seem to misread me - quite often as it happens. I was trying to describe what the meeting was. We were told it was not a 'consultation meeting' on a Assembly Government proposal. It was not even a discussion based on the Minister's intention. It was a discussion about organ donation, against the background of the Minister having expressed her personal support for 'presumed consent'. I'm quite happy to use whatever description you want me to.

chris - You are concerned about developments which are not on the agenda. But where you are correct is that the adoption of' presumed consent' will be but one step alond a dangerous path - which is why so many doctors are against the change.

Anonymous said...

It is like the people are sleep walking into a dead-end where the ownership of their body will be in the hands of the state.

Che Grav-ara said...

"One final point. If we are going to go down the 'presumed consent' route, I would much prefer it to be done on a UK basis."

Why?

you never responded to this Glyn?

Valleys Mam said...

why are we presuming anything, surely the state can not presume for me - or are we in a Gulag.
Having looked at other countries and the problems ,especially in France
I would like the right to make my own presumptions about my body.
I think that more should be done to encourage people in donation, not any other options

Glyn Davies said...

che - Because organ transplantation is arranged and will continue to be arranged on a UK basis. Most people in Montgomeryshire who become donors (after death) are unlikely to be in a Welsh hospital when life is ended, and the transplants themselves will be carried out in England. A very good friend of mine received her new heart at Papworth Hospital. Its only the donation aspect that is being considered on a Welsh basis. It just seems better to me that all of the organ transplant system should be arranged on a UK basis.