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Friday, 22 August 2008

Wales has lost a golden opportunity to take the lead on organ donation

The Assembly’s Health Committee has rejected the idea of introducing presumed consent for organ donation in the near future. They voted against a proposal to apply for a Legislative Competence Order (LCO), which would give the Assembly the power to bring in such a system in Wales, by six votes to three. And the reason they gave for doing so? They do not believe that it is currently the most urgent priority and would act as a “distraction”. So does that mean missing out on the chance to potentially save more lives is not a priority?

The committee also recommended that if any presumed consent system were to be introduced in the UK, it should be the "soft" version, where loved ones are consulted and their views taken into account. This is something BMA Cymru Wales wholeheartedly supports and I cannot see why this should not have been an option for consideration.

There is little doubt that a system of presumed consent would produce a far higher potential donor rate than at present, which is far too low at 22%. Experience of other European countries that have introduced presumed consent have demonstrated this. Some 400 people in Wales are still waiting for transplants and one person dies each day in the UK, waiting. The committee has missed an opportunity to shorten the delay for those people waiting desperately for a transplant. It is difficult to see how the decision will be explained to these patients and relatives as it does not stack up on the basis of the evidence.

We appreciate some people may feel that presumed consent means interference by the state and they will have no control over what happens to their organs after death. With a “soft” presumed consent system that certainly is NOT the case. A person’s organs would only be used to benefit others, IF the deceased’s family agreed to it and only if that individual had not removed themselves from the register and that option would be open at any time.

It would seem the committee did not even properly listen to and take into account the views of the general public they surveyed as part of this report. As many as 73% of those polled said when they die, they would like their organs to be taken automatically to save or improve someone’s life. And yet six of the health committee members voted AGAINST presumed consent. So what was the purpose here of consulting with the general public? The committee even reached the conclusion that, “presumed consent appears to have a positive effect on donation and transplantation rates.”

BMA Cymru Wales acknowledges that introducing a “soft” system of presumed consent would not necessarily, on its own, solve the shortage of donors, but it would go along way to doing so. And by making improvements to the transplant infrastructure as well, such as more training, increasing the availability of transplant co-ordinators, reviewing the health service’s capacity to cope and ensuring sufficient availability of intensive and critical care beds, then Wales would really be able to say it had made a significant contribution to saving the lives of those on transplant lists.