Monday, 10 January 2011

Organ donation and medical research – the ultimate patient choice

This weekend the UK Times newspaper published a thought-provoking article entitled ‘The NHS needs our bodies as well as our cash’ by Colin Blakemore, a Professor of Neuroscience.

Blakemore feels that as there is a ‘crisis in the development of medical treatments’ some ‘regulation is strangling medical research’ and goes on to say ‘surely, unless patients opt out, it should be assumed we all want to help’.

He presents a feasible argument that patients should ‘opt out’ rather than ‘opt in’ to allow their records, tissue and blood samples and scans to be used. He also suggests that as 90% of people when surveyed were willing to donate their organs to a stranger after their death, consent should be assumed. The current system dictates that patients must ‘opt in’ by joining the organ donor register prior to their death – or the next of kin can also be asked to consent to the removal of organs from their deceased loved one.

The NHS is, of course, a rich source of such organs and tissue samples and if those with similar views to Blakemore had their way, there would be a massive increased availability in organs for transplant and research.

Blakemore reminds us that the NHS is a social contract, providing care from the cradle to the grave. He suggests that in order to qualify for that care, we should, in return, offer assumed consent for organ donation and medical research

I am very uncomfortable with this point of view, even though I will admit that if someone close to me needed a transplant, I would be the first to beg for an organ on their behalf. I have opted in to the organ donation register and would be happy for my organs to be used following my death. But that’s the point – it is my choice.

All civilised societies not only care for the sick and explore ways of improving treatments and outcomes, we also treat the dead with the greatest of respect. We entrust their bodies to people who will undertake the appropriate duties with dignity and sensitivity. We ensure that their wishes for their funeral are followed, that their memory is honoured. Surely we should also respect their choice as to whether their organs are harvested? I believe that to assume consent is to deny an individual or their next of kin of the last but arguably one of their most significant, choices.

Yes, we do need more organs for transplant – it is a telling measure of the success of the seat belt laws that the resultant drop in fatal traffic accidents caused a transplant crisis.  But let’s increase education and prompts to encourage such philanthropy. A form to join the organ donor register is to be included with driving licence applications. This is an excellent idea and certainly works as my daughter joined the register following such a prompt. By all means, continue to allow doctors to have that difficult discussion with the next of kin if a deceased patient could provide a vital route to life for others. But we must accept that the answer could be ’No’

I am fully supportive of a national campaign to encourage us all to join the organ donor register. If you live in the UK and you wish to join – opt in:

But we should not have the choice taken away - this is too big a decision to be left to assumption. 

My thoughts and warm wishes are sent to all my American friends as you come to terms with the tragedy in Arizona


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