Presumed Consent. Triumph of Idealogy over Evidence.

As long as I can remember, I have been enthusiastic about organ donation. Carried a donor card, but much more importantly have told next of kin of my wishes. Been involved in campaigns, and met up with Specialist Nurses (SNODS) to discuss how we can increase donation levels. But I have always been an implacable opponent of presumed consent. I simply do not consider it right that the state should take the organs of the dead, without the expressed approval of the dead or a family member taking the decision on behalf of the dead. And it doesn’t deliver more organs for donation.

Unfortunately, whenever this issue is under discussion, I have to repeat that I support Organ Donation. I also have to repeat that my opposition is not based of faith or religion, but on efficacy. It does not work. I now refuse to do media interviews. What happens is that someone needing a transplant informs the listener that an organ is needed to save his or her life - and then I’m asked why I disagree. I politely make clear that I don’t disagree. The follow up question (totally ignoring what I’ve just said) is usually asking how I can support religion blocking the saving of a life. I politely point out that my views have nothing to do with religion, but are based on there being no evidence that presumed consent will improve donation levels, and may well lead to the opposite. My experience confirms that there are none so deaf as those who will not listen.

There are three ways in which we can increase organ donation. Firstly promote ‘opting in’. Donor cards are useful but most effective way by a country mile is to tell next of kin. Secondly, increase number of Specialist Nurses (SNODS) who are trained to talk with next of kin when they are coping with the pain of a loved one’s death. Evidence tells us the rate of donation increases dramatically when SNODS are involved. And thirdly, increase number of Intensive Care beds, which are needed to allow a transplant to take place.

Of course, we will all be able to ‘opt out’. But we know that most people will not ever think of this issue. The state will be taking organs from people who would have opted out if they had thought about it. This is anathema to those of us who remember the horror of Alder Hey. My view is that ‘opting out’ will in effect be reserved to the more educated, informed part of society.

But the main reason I’m opposed to presumed consent is that it transforms the principle of donated ‘gift’ into a statutory ‘duty’. The State decides and then ‘the state’ acts. We as individuals no longer need to. ‘The State’ will have no interest in asking us. Over recent years we’ve see huge increases in live donors, often donating altruistically. This will fall, (they already are) in the same way care of elderly family members has fallen over time as the state took over the responsibility.

I was very disappointed to learn that my government intends to proceed with presumed consent. There is no evidence to support such a policy. I will not oppose it if it’s a whipped vote, but it should be a ‘free vote’. I will continue to publically oppose it, as I’m doing now, and challenge it on the floor of the House of Commons. It’s putting ideology before evidence. And worst of all, It will not increase number of donors - may even decrease them.