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'Presume' to be different, organ donation, urges BMA Scotland

June 02, 2017

The BMA in Scotland has urged the Scottish Parliament Health Committee to consider introducing a system of presumed consent for organ donation. The call comes as the BMA prepares to give evidence on the Human Tissue (Scotland) Bill today (Monday 3 October 2005).

Commenting on the bill, Dr Bill O'Neill, Scottish Secretary of the BMA, said:

"There is a great deal that the BMA welcomes and supports in this bill. However we believe the Scottish Executive is wasting an opportunity here by not including provision for presumed consent for organ donation in the proposed legislation.

"There is an increasing gap between the supply of organs for donation and the numbers of people requiring a transplant. A system of presumed consent could go some way to bridging this gap.

"We believe there is growing public support for such a shift and we hope that public debate on this very important issue will continue during the passage of the Bill."

In written evidence to the Committee, the BMA said:

"While the BMA welcomes moves to encourage more people to discuss organ donation and to ensure that their wishes are known and respected, we are not convinced, based on past experience, that this will succeed in overcoming the very serious shortage of donors. Where, as in the majority of cases, the individual has not made his or her wishes known, relatives tend to opt for the default position - which is not to donate - and this may account for the very high number of relative refusals. Under a system of presumed consent, with safeguards, the default position would change. Based on the very strong support for donation expressed in all public surveys - up to 90% - it is reasonable to assume that a particular person wished to donate unless he or she had expressed an alternate view. Statistically, the default position is more likely to reflect the individual's wishes if that is based on a presumed consent system than on the 'presumed objection' scheme that currently operates."

The BMA supports a system of presumed consent, with safeguards, for those over the age of 16, where relatives' views are taken into account. The crucial difference from the current system would be in the approach to relatives. Where there is no record of the deceased patient's wishes, instead of being asked to consent to donation, they would be informed that their relative had not opted out of donation. Unless they object - either because they are aware of an unregistered objection by the individual or because it would cause major distress to the close relatives - the donation would proceed.

A full copy of the BMA's written evidence to the Scottish Parliament Health Committee is available at: bma/ap.nsf/Content/humantissuebill

The Human Tissue (Scotland) Bill proposes a new framework for organ donation and transplantation, hospital post-mortems, the removal, retention and use of body parts, anatomical examination and the public display of bodies. More information on the Bill is available at the Scottish Parliament website