by Peter Griffiths
Last Updated: 2007-07-17 16:00:35 -0400 (Reuters Health)
LONDON (Reuters) – Everyone should be treated as a potential organ donor unless they explicitly ask to opt out of the system, the chief medical officer said on Tuesday.
Sir Liam Donaldson said reversing the current system would help tackle a chronic organ shortage that leads to the deaths of hundreds of patients on waiting lists each year.
"There are simply not enough organs donated to meet the need for transplants, with one person dying every day while waiting," he said. The number of people on the NHS donor register needed to treble to meet the growing demand.
"I believe we can only do this through changing the legislation to an opt-out system with proper regulation and safeguards," he added.
Under current laws, donors must explicitly opt-in. The proposed changes would mean patients were presumed to have given their consent.
The government rejected similar proposals when it reformed the system in 2004. The Department of Health said Donaldson’s report would be given "careful consideration".
"Ministers have established an Organ Donation Taskforce to look at the barriers to donation and we are awaiting their report," a spokesman said. "Recommendations will be made to ministers later this year on how donation rates could be improved."
Opponents of "presumed consent" say it would be unethical for doctors to be given such powers.
They say apathy should not be interpreted as a desire to donate organs. Some patients oppose donation for religious and moral reasons.
Critics point to the public outrage sparked by the organ retention investigations at Bristol Royal Infirmary and Alder Hey children’s hospital in Liverpool.
However, surveys suggest up to seven out of 10 people support the idea of donating their organs. But only a fifth of the population, 13 million people, have actually added their names to the NHS register.
Doctors say more patients are going abroad for transplants and coming home with serious complications.
"These `transplant tourists’ often face low standards of safety and quality of care," Donaldson wrote in his annual report, at www.dh.gov.uk . "The risks of damaged organs, infections and death are markedly increased."
One in 10 heart patients dies while waiting for a transplant, while the average wait for a kidney is two years.
The British Medical Association, which represents doctors, said the proposal would help save lives.
"We must increase the number of donors available and the BMA believes that a system of presumed consent with safeguards will help to achieve this," said Dr Tony Calland, chairman of the BMA medical ethics committee.
The National Kidney Federation said the changes would not automatically lead to a rise in transplants.
"To make a difference we need more surgeons, we need more intensive care unit beds, we need the government to put more money behind transplantation and we need more willing donors," said Chief Executive Timothy Statham.
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