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Doubts over opt-out donation scheme

Study claims families will not be sure loved ones intended to donate

Mark Gould

Thursday, 16 August 2018

An opt-out organ donation register in England may not increase the number of organs donated because grieving relatives could be less sure of what their loved ones had wanted, a study* suggests.

Under the opt-out system, planned to come in from 2020, consent is presumed unless family members decide otherwise.

But research by Queen Mary University London surveyed attitudes in several nations with varying donation policies. The researchers concluded that donors should actively choose to be on the register by opting-in to ensure they genuinely want to donate their organs and to limit families from refusing the donation of their deceased relatives’ organs.

The psychological experiment involved nearly 1,300 people from countries with different systems of organ donation, including the US, UK, Germany, Austria, Spain, France and Norway.

Participants were presented with a fictional scenario and asked to judge the likelihood that an individual's "true wish" was to actually donate their organs, given that they were registered to donate.

A donor's preference to donate was deemed to be stronger when they had chosen to opt in - therefore expressing an active choice - compared to when they were passively presumed to consent to donation, under the opt-out system.

Also, people rarely communicate their wishes to their families on this subject and that leaves them in a quandary, and therefore more likely to say no to donation.

Lead author Dr Magda Osman, said: "To help increase actual rates of organ donation, we need more transplant co-ordinators working with families to help them understand the issues before being faced with a monumental and distressing decision.

"We also need to offer people a way to indicate explicitly what they wish to do.

"This should involve an expressed statement of intention if their wish is to donate, or an expressed statement of intention if there is an objection to donate.

"This reduces the ambiguity in trying to infer what someone wanted to do when it comes to donating their organs."

NHS Blood and Transplant say the change would make families debate the subject. And it said this would support an increase in donation. An opt-out system has been in place in Wales since 2015, although two years into the scheme the number of donors had not increased in the country. Scotland plans to introduce a similar scheme and Northern Ireland has also expressed an interest.

A spokesman from NHS Blood and Transplant spokesman said: "Under the new legislation, you would still be able to express a decision to opt into donation, and you would still be able to opt out.

"People who do not register a decision will be deemed to have given consent for donation."

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