THE chief medical officer wants everyone to be treated as organ donors after death unless they explicitly opt out of the scheme.

Sir Liam Donaldson believes the shortage of kidneys, livers and hearts is so acute that the country needs a donation system that will presume patients have given consent for their body parts to be transplanted.

Those who wanted to opt out would have to register in a similar way to those who now carry organ donor cards. This could be done through a central NHS database or through other documentation, such as driving licences.

Such a fundamental change is likely to prove controversial as critics claim it gives the state new powers over people’s bodies. However, supporters of the change point out that hundreds of people die each year because of shortages of organs. More than 7,300 Britons are on the waiting list for a life-saving organ, a rise of about 30% over the past decade.

Donaldson is expected to call for a change in the law when he publishes his annual report on the nation’s health on Tuesday. He has the backing of the medical profession. The British Medical Association (BMA) is already campaigning for presumed consent to be the default position.

A recent BMA report entitled Presumed consent for organ donation, states: “Each year, many people die waiting for organ transplant. At the same time, bodies are buried or cremated complete with organs that could have been used to save lives, not because the deceased objected to organ donation but simply because they never got round to signing up to the NHS Organ Donor Register or informing their relatives of their wishes.”

Surveys have shown that about 90% of Britons are willing to donate organs after their death, but only 14.5m, 23% of the population, are on the Organ Donor Register.

Donaldson, like the BMA, is expected to favour a “soft” opt-out that takes family members’ views into account. The BMA proposes that family members should be informed if a relative has not stated an objection to donation and be asked if they have any strong opposition.

The donation would go ahead unless families were aware of an unregistered objection, or if they would suffer extreme distress from the removal of a relative’s organs.

Other countries in the European Union have introduced presumed consent, leading to a large increase in the number of organs available for transplant. Belgium passed a “soft” presumed consent law in 1986 and has almost doubled the number of organs available. Belgians can register their objection at their town hall but only about 2% have done so.

Spain, widely credited with the most successful system, has operated a “soft” scheme since 1989. Its success in raising donation rates has been partly attributed, however, to its national network of transplant co-ordinators, who monitor intensive care units for organs, which was set up at the same time.

Dr Vivian Nathanson, the BMA’s head of science and ethics, believes British public opinion is coming round to an opt-out system. “We are now getting closer to a system of presumed consent,” she said. “We have exhausted all other ways of increasing the number of organs available but people are still dying on the waiting list, and that is making us more courageous.”

In 2005, a BBC survey of more than 2,000 people found that 60% supported a shift to presumed consent. However, opponents say presumed consent should not be introduced because the public do not fully understand what is involved in organ donation.

This article was originally published on The Sunday Times.

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