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Published on July 4th, 2014 | by Will Highfield
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Organ donation: when government policy kills

Around 1,000 people die waiting for an organ transplant every year, and over 10,500 people currently need one.  Meanwhile, 5,000 people die every year in circumstances where had they been on the donor register, their organs could have been transplanted.  These statistics highlight the ongoing, unacceptable and unnecessary suffering of patients and their families and friends.

The ability to transplant organs is an amazing scientific achievement, but we are yet to harness its true potential.  A single donor can give two people their sight back, save several lives, and improve the quality of life for others.  Whilst 90% of the UK public support organ donation, only 33% have actually signed up.  This gap needs to be closed, and adopting an opt-out system would go some way towards achieving this.

The donor-register in England and Scotland runs on an opt-in basis, meaning that a person must give explicit consent if their organs are to be considered for donation after death.  Switching to an opt-out system with safeguards, which assumes people have consented to organ donation unless they have registered an objection, is supported by former chief medical officer Liam Donaldson and the British Medical Association.  The evidence suggests that countries which have an opt-out system have 25-30% higher donation rates than those that do not.

The rationale behind switching to an opt-out system is simple.  Whilst some people have made a considered judgement that they don’t want their organs donated, many simply cannot be bothered to join the register or are unaware of its existence.  The problem is that we cannot currently distinguish between these groups.  It is wrong for any person to die simply because of the indifference, ignorance or laziness of others, and it therefore makes sense to introduce an opt-out system.

Some critics argue that the system would give the government “too much power over people’s bodies.”  In a poll of 830 Lib Dem members, the thought that “the state does not own my body” was a common complaint amongst those who oppose an opt-out system.  However, it is worth remembering that under an opt-out system the government does not “own” people’s bodies – individuals are free to register an objection to their organs being donated.

Suppose that we don’t know whether a deceased person wanted their organs to be donated or not. One option is to assume that they didn’t want their organs donated, and this could lead to several unnecessary deaths.  On the other hand, we can assume that they did want their organs to be donated, which could potentially save several lives.  In a society that values life, happiness and health, and cares more about the living than the dead, the second assumption is the one we should be making.

Another criticism of the opt-out system is that it would somehow take away the compassion and generosity of organ donation, and remove the “ethical decision-making process.”  This criticism completely ignores the possibility of a person making an informed choice, grounded in compassion and moral conviction, not to opt-out.  Choosing not to opt-out is no less ethically praiseworthy than choosing to opt-in.  Furthermore, it would be absurd to say that someone should not receive an organ because the potential donor chose not to opt-out because of indifference rather than out of moral conviction. 

Switching to an opt-out system makes not only moral sense but political sense too.  The Organ Donation Taskforce found that, in 2008, 72% of the UK public supported an opt-out system.  In Scotland, more than 70% support such a change, as do 82% in Northern Ireland and 63% in Wales.  This is a level of public support which very few prospective policies obtain.

As long as we idly stand by and fail to modernise the organ donor system, hundreds if not thousands of people will continue to die needlessly each year.  Parliament has the chance to bring into law a popular, life-saving, and ethical policy.  Failing to do so would be a regrettable moral failure of our time.


Please note that all blog posts do not represent the views of Catch21 but only of the individual writers. We also aim to be factually accurate and balanced across all content taken as a whole.

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About the Author

is a recent graduate from the University of Nottingham where he studied Philosophy.

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