The National Assembly for Wales has voted to approve a soft opt-out system for consent to deceased organ and tissue donation for Wales starting from 2015. The stated aim of the Bill is to increase the number of organs and tissues available for transplant.
Yesterday’s vote follows a consultation process to which the Council contributed written responses, and Council member Dr Tim Lewens gave evidence to expand on recommendations from the Council’s 2011 report Human bodies: donation for medicine and research. The report concluded that an opt-out system is not unethical in principle, providing families continue to have the opportunity, without pressure, to express their views on what the deceased person would have wanted and whether donation would cause the family significant distress.
However, more evidence is needed to determine whether opt-out systems do lead to more organs being donated: at present it is unclear whether increases achieved in other countries have resulted from changes in the law or from the practical improvement in organ donation systems that are often made around the same time. Our report recommended that the introduction of such a system in Wales must be accompanied by robust research into the impact both on the role of relatives in determining whether organs may be donated, and on the effect that the change in the law has had on levels of donation.
In our evidence to the Committee, we also highlighted the need for clear communication about changes to the system for consent to ensure that people are well informed and understand what their options are, and also to prevent any loss of trust in health professionals and the health care system. It will be important to avoid the perception that the state is ‘taking’ organs, for example by making sure that those seeking relatives’ views are not themselves subject to targets which might be seen as leading them to put pressure on relatives.