Following a public consultation, on 5 August the government announced plans for a new system of consent for organ and tissue donation in England. The RCP has issued a statement outlining its position.
Currently, people have to ‘opt-in’ to organ donation by registering. Under the proposals, they will have to ‘opt-out’. That means that if someone dies without recording that they do not want to donate, they will be deemed to have given consent. Children under 18, individuals who lack the mental capacity to understand the changes and people who have not lived in England for at least 12 months before their death will be excluded from the plans.
The proposed new system is expected to come into effect in England in spring 2020. The legislation, which was introduced in parliament last July, is expected to return to the House of Commons in the autumn.
On 17 July 2018, RCP Council agreed the following statement:
The RCP welcomes any changes to the system of organ donation in England that will help more people to improve the health and lives of others through transplantation. We recognise that there are legitimate differences of opinion as to whether the system of organ donation should be based on the principle of opt-in or opt-out, and believe both can be justified.
If a change is to be made to the current opt-in system in England, the following important conditions must be met:
- Trends in donation must be monitored to assess whether any reform has its intended effect. Experience to date shows that moving from an opt-in to an opt-out system does not necessarily increase donation rates.
- The administrative support for information management must be of a high quality. We must learn from other countries that have an opt-out system. An opt-out system poses more administrative challenges than an opt-in system, particularly if there is a variety of ways of signalling a decision to opt-out.
- At least as much respect must be paid to the views of families and relatives as in the current system.
- There should be an ongoing, effective information campaign to ensure that everyone who is likely to be regarded as a donor is aware of it. The campaign should aim to convey the criteria of death that are used for donation and explain who is excluded from the opt-out system.
- There must be a guarantee that a decision to opt-out will be respected whatever the reasons for that decision, be they religious, conscientious, personal or something else.
- Appropriate resources should be made available to make sure that any new system meets the above conditions.
- An impact assessment should be conducted to assess whether the same resources would be better employed in improving the current opt-in system.