WESTMINSTER, United Kingdom, February 14, 2019 (LifeSiteNews) – The House of Lords has passed a bill that will allow the English branch of the National Health Service to take the organs of anyone who dies without “opting out” of organ donation.
On February 1, the Organ Donation (Deemed Consent) Bill 2017-19 was passed by the House of Lords at the committee stage without alteration and will soon be signed into law. The new law will assume that residents of England have consented to the removal of their organs after death for transplant if they have not registered their objection to it. Matters pertaining to health are a devolved issue in the United Kingdom, and Wales has already passed similar legislation.
Currently in England and Scotland, doctors may remove organs for transplant only if the donor has given prior consent and his or family does not object.
In an intervention in the House of Lords, Lord McColl of Dulwich, a former transplant surgeon, argued that the government’s presumption of silent consent would erode the trust of patients in their doctors and reduce the “total pool” of donors. He called for an amendment to assure patients that the will of their families in the matter outweighs the state’s opinion.
“For anyone who is unfamiliar with the world of organ donations and assumes that only those who have signed the organ donor register can be donors, it is easy to see the huge appeal of deemed consent,” he said.
“If 37% of people have signed the donor register, then introducing deemed consent is clearly attractive; even if this provoked 10% of people to opt out, one would still be increasing the total pool of donors from 37% to 90%—a huge boost,” he continued.
“But this is not how organ donation works.”
Lord McColl explained that most organs donated in England in the past few years come from donors who had not signed the register. The decision had been made by their families.
“Rather than increasing the total pool of donors, the introduction of presumed consent actually threatens to reduce the total pool of potential donors from 99.3% to something more like 90%—a small but not insignificant minority opt-out,” he pointed out.
The former surgeon observed that six percent of potential donors in Wales, over 180,000, had actively opted out, and therefore their families could not donate their organs.
However, Lord O’Shaughnessy disagreed with the idea that families should have the final say in organ donation and believes that the opt-out system is more respectful to the autonomy of donors.
“Under a deemed consent system, people are actually able to express a preference not to have their organs donated, which they are unable to express now. That is good because it is about control and agency,” he said.
“Under the system we have now, it must be the case that some people’s organs are being donated because their families have agreed even though they would not have agreed. That cannot be right,” he continued.
“I used to be skeptical about opt-out systems but the proposal in this legislation, which has been demonstrated to work in Wales, strikes the right balance, giving people power and control while making sure that they can make a positive choice if they are well informed.”
‘The state cannot presume ownership of its citizens’ bodies’
Fiorella Nash of England’s Society for the Protection of Unborn Children (SPUC) told LifeSiteNews that pro-lifers should be concerned about the new legislation.
“We should [be concerned] because of the ethical implications but also the issue of bodily integrity. The state cannot presume ownership of its citizens’ bodies, however well intentioned,” she said.
Caroline Farrow, the well-known English Catholic commentator, told LifeSiteNews that she found the new law “extremely concerning.”
“It treats our bodies as though they are properties of the state,” she said via social media.
Farrow stated that an opt-out system undermines trust in the medical profession and that the data demonstrates that it does not increase the level of donations.
“Organ donation should always be thought of as a gift, not a state-enforced responsibility,” Farrow asserted.
Farrow’s conclusion was repeated by James Mildred, spokesman for the UK’s Christian Action and Research (CARE).
“Organ donation should be an entirely voluntary gift where people choose to donate if they want to,” he told LifeSiteNews via email. “The problem with presumed consent is it involves an overreach of the State which is ethically very troubling.”
Mildred, too, said that there is evidence opt-out does not even work.
“In Wales, where an opt-out system has been in operation for a few years, the evidence is hardly overwhelming,” he told LifeSiteNews. “What has been proven to work is investment in providing more specialist organ donation nurses.”
The CARE spokesman said that the charity supports organ donation, but wants it to be done “ethically and effectively.”
“Sadly the British Government is intent of being seen to do something rather than following the evidence,” he said.
“Now [that] they are set on introducing presumed consent, they need to guarantee the family will retain a veto and ensure enough money is spent on a proper advertising campaign to make sure consent is truly informed,” Mildred continued.
“This will be a costly exercise but vital to ensure people know what the change to opt-out actually involves.”
‘Uncertainties’ around diagnoses of death of organ donors
Dr. Anthony McCarthy, SPUC’s Education and Communications Director, released a statement to LifeSiteNews saying that although “organ transplantation is potentially life-giving and a very important social contribution…it does raise fundamental issues surrounding respect for the human body, the meaning of gift-giving and indeed, diagnosis of death.”
“These are serious issues that need to be faced by anyone wishing to promote ethical forms of donation while protecting donors and the common good. In seeking to benefit patients whose need for organs may be urgent and compelling, the rights of potential donors and their families must always be respected,” he said.
One serious issue is whether or not a donor is actually dead when his or her organs are removed.
“Tests for diagnosing death vary from country to country and even within a single country, while a growing body of specialists regard standard tests used as potentially unreliable,” he continued.
“Some of the latter favour abandoning the ‘dead donor’ rule and simply taking vital organs from those admitted to be still alive though perhaps unconscious and close to death. If such specialists are correct, then we will in some cases be dealing with operations to remove vital organs from what may still be living human beings.”
As an example, McCarthy explained that donated hearts are still heating when they are taken from their donors.
“Donor hearts, for example, are in practice harvested from so-called ‘beating heart cadavers’: something unknown to many members of the public though of course known to transplant teams themselves,” he said.
“It is also well-known to transplant teams that heart-beating donors move when organs are taken, unless they are paralysed by drugs, and that their blood pressure goes up when the incision is made. It is worth noting that some anaesthetists recommend that the supposed ‘cadaver’ be anaesthetised when his [or] her organs are retrieved,” McCarthy stated.
He added that most organ donors, including those who give explicit consent before they die, are unaware that their hearts may be beating when their organs are taken, and that they may be pink, warm, able to heal wounds, fight infections, and respond to stimuli.
“It is also the case that supposedly brain dead people (such as pregnant women who are given high tech medical support) can appear to survive for months while demonstrating integrated bodily activity of a kind that arguably indicates that life still remains,” McCarthy said.
McCarthy said that because there are “uncertainties” surrounding the diagnosis of death, there must be extra safeguards for donors, particularly children and the mentally disabled.
“If ‘opt out’ legislation is set to go ahead, those who recognise these dangers should at least try to increase the opportunity for relatives to object, and for organ harvesting from children and mentally disabled people to be restricted to non heart-beating donation, after sufficient time from the last heartbeat has elapsed,” he wrote.
“If it is difficult for potential donors generally to learn of certain facts about organ harvesting from heart-beating donors, this will be still more difficult for children and mentally disabled people who will generally have less opportunity to become aware of these facts, and of controversies in this area.”
England’s Times reported in 2017 that Professor Chris Rudge, one of the country’s most preeminent experts in transplant surgery, was going to opt out of donating his organs if the new law went ahead.
“I think I would opt out because organ donation should be a present and not for the state to assume that they can take my organs without asking me,” he said.