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Thursday, 8 July, 1999, 22:28 GMT 23:28 UK
Doctors back organ donation reform
Organ box
There is a serious shortage of donor organs
Doctors have backed a call to be allowed to use dead people's organs for transplants without having to seek permission first.

The move is likely to increase pressure on the government to scrap the current system under which doctors must ask permission from bereaved relatives unless the donor was carrying a donor card or was on a register of people wishing to donate their organs.

The British Medical Association annual conference in Belfast also passed a motion on Thursday barring hospitals from accepting donor organs from patients who place conditions on their use.

This follows revelations that a hospital accepted organs for transplant on the condition that they were only used to save the life of a white patient.

In a separate incident, Manchester Royal Infirmary refused organs from a dead Asian because "racist conditions" were attached by relatives.

Dr John Sterland, who proposed the emergency motion, said: "Doctors in this country will never, ever, not here or there or anywhere have anything whatsoever to do with accepting organs given with reservations and will always strive to match the best recipient with the best organ."

'Presumed consent'

Dr Michael Wilks
Dr Michael Wilks wants reform
Only those patients who specifically state before death that their organs should not be removed would be exempt from the proposed new system of "presumed consent" - otherwise known as 'opt-out' rather than 'opt-in'.

The doctors' decision to back the opt-out system comes as the UK's National Health Service struggles with a shortage of organs.

But the Department of Health said it had "no plans" to change the existing "opt-in" donor card scheme.

Officials pointed to a survey last week which showed only 28% of the public were in favour of an opt-out scheme, compared to 50% who backed the current system.

Dr Michael Wilks, chairman of the BMA's ethics committee, said patients were dying while waiting for organs.

"Presumed consent is currently the only real solution to going some way towards improving the organ donation rate," he said.

The motion calling for a system of presumed consent was proposed by Dr Evan Harris, also a Liberal Democrat MP.

Dr Harris said: "The situation is that relatives can oppose donation even when there is express consent.

"At the time of bereavement it is a very difficult time to ask relatives about donation and the views of their loved one.

"The Presumed Consent scheme solves most of these problems. It forces people to make a decision."

But Dr Judith Langfield from Berkshire said that no "opt-out" scheme could provide adequate safeguards for people who did not want to donate their organs.

She told the conference: "Not everyone is happy with the idea of transplant.

"There are people who find it repulsive and there are those who have religious and cultural objections.

"Rights are further eroded if relatives are not allowed to override the wishes of the doctors.

"I defy anyone to guarantee 100% safeguards against organs being harvested where the deceased has recorded pre-mortal dissent.

"Getting it wrong could lead to prolonged distress for relatives and could lead to a backlash against doctors and against organ donation itself."


Organ transplantation is a controversial issue
Presumed consent is already used in several other European countries, including France, Spain and Belgium.

In opt-out schemes already running, only 2% of people decide they do not want to donate their organs.

The British Kidney Patient Association, which has been campaigning for presumed consent for years, says a recent survey showed 70% of British adults questioned are willing to donate their organs.

However, Elizabeth Ward, the association's president, says many fail to register their wishes before their death.

She says 6,000 people are currently on dialysis, awaiting transplants, while only 2,000 operations a year are performed.

Adopting a policy of supporting presumed consent puts the BMA at odds with the British Transplant Service and the Royal College of Surgeons, which have opposed the presumed consent scheme.

The University of Surrey is to carry out the first-ever detailed research into families asked about organ donation.

The three-year study, which starts in September, will investigate the bereavement process of donor and non-donor families.

BBC Health Correspondent Richard Hannaford: "Many countries already operate presumed consent schemes"
The BBC's James Westhead: "Public confidence may be damaged"
The BBC's Fergus Walsh: "Three transplant patients wait for every organ that becomes available"
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