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Monday, December 28, 1998 Published at 17:22 GMT


Doctors reconsider transplant stance

More transplants could take place as a result of the move

Doctors are rethinking the rules covering the removal of organs for transplant from patients who die in hospital.

The British Medical Association's ethics committee is to consider dropping its historical opposition to the idea of "presumed consent", whereby organs are removed and used unless there is a specific objection from relatives.

The decision could lead to a reduction in the number of people who die while waiting for a transplant.

It would mark a major shift from the current situation, where people have to choose to donate their organs by putting their names on the national donor register or signing a donor card.

'Welcome legislation'

Dr Michael Wilks, chairman of the BMA ethics committee, said: "The committee has considered the matter and taken the view that we would welcome a move towards legislation for presumed consent.

"The current situation is that you opt in, we are looking at changing that around so people instead opt out."

[ image: Dr Michael Wilks:
Dr Michael Wilks: "We would like to see a change"
The issue is likely to be one of the main items on the agenda at the BMA's annual representative meeting in July.

If doctors voted to make "presumed consent" a part of BMA policy it would put pressure on the Government to consider a change in the law.

A spokeswoman for the Department of Health said: "Clearly we would take serious note of the BMA's opinions.

"At the moment what we want is to encourage more people to opt in, but we will be looking very carefully at what the BMA is saying."

Dr Wilks said evidence from other European countries, notably Belgium, suggested there would be a "significant increase" in the number of organs available for transplant if the UK moved to a system of presumed consent.

"The other main reason is the interests of people on dialysis waiting for a kidney transplants," he said.

"Being on dialysis greatly reduces their quality of life, and their interests would be served by increasing the number of organs available."

Cost concern

Keeping someone on kidney dialysis is also far more expensive than giving them a kidney transplant, he added.

At the moment, it is common practice for doctors to approach relatives even if the dead patient carried a donor card, and in around a third of cases relatives refuse permission for organs to be removed.

The initiative was welcomed by Oxford West and Abingdon MP Evan Harris, who introduced a private member's bill during the last session of Parliament aiming to increase the number of organs available for donation.

The Liberal Democrat MP said: "I am delighted that, after initially opposing my proposals, the BMA ethics committee is now supporting a system of presumed consent.

"There is a silent tragedy of hundreds, if not thousands of people dying each year while waiting for a transplant, while healthy organs are discarded because of our inefficient donation-retrieval system."

Government figures show that in 1997 more than 200 people died while on a waiting list for a heart, lung, heart-lung or liver transplant.

During the same year there were 1,635 kidney transplant operations and a waiting list of more than 5,000 people.

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