Thursday 6 October 2011

Can we have your liver please?

The Welsh Government is currently putting on the finishing touches for its legislation of presumed consent for organ donation. If the new law is passed, Wales will become the first part of the UK where the state has the right to remove organs from deceased people regardless of whether or not they have consented to this.

There has been an unusual consensus amongst the politicians in Cardiff Bay that 'presumed consent' is the way forward for organ donation. Why they are so certain that this is a good way to increase organ supply is not quite clear however. More recently, the critical voices have become more prominent.

First, while there is widespread acknowledgement that more organs are needed, presumed consent is a highly controversial way of going about it. Advocates of presumed consent often point to the success of Spain in increasing donations substantially after introducing similar legislation. However, a more detailed look at Spain's success story reveals a variety of factors that contributed to the increase of years (BBC presumed consent controversial).

The expert behind the Spanish success in fact pointed out a while ago that the critical factor for better organ supplies was not legislation for presumed consent, but the sensitive and helpful advice and guidance nurses gave in hospital environments to the family of the deceased (BBC The Spanish model of organ donation). It is up to the nurses and doctors in moments of grief to respond to the emotional need of family members yet also to explain the benefits of helping others through organ donation. This is not an easy task and requires specialist training, something that lies at the heart of the Spanish success story.

The Welsh Government has failed to listen to other concerns as well. The most important one is that presumed consent may lead to a backlash that could eradicate the significant progress in organ donations Wales has seen over the last decade. People may not like that the state can simply take your organs without asking for approval, and many people may rush to record their opting out of presumed consent as the law is passed. This would be counterproductive, not least because Wales is in fact the home nation with the highest number of organ donations already. Complicating the matter is that Wales goes this alone, so there may be issues around whether the law would stand if organ donors happen to be across the borders in England at the time of death.

So, without serious consultation on how best to achieve a clearly desirable increase in organ donations, the Welsh government is heading for a PR disaster. The best that can be said about this legislation is that, if Monty Python is right, it only takes a good song. You can see their approach through the link below but, careful, this is not for the faint hearted!


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