‘Opt-out donor system won’t work’

Fear of being sued by next-of-kin means surgeons will not remove organs from deceased donors against the family’s wishes even if Ireland introduces an “opt-out” system of donation, it has been claimed.

Philip Watt, chairman of the Irish Donor Network (IDN), said that replacing the existing “opt-in” or explicit consent approach with an opt-out or presumed consent system would create legal difficulties for doctors and was not the best approach to boosting organ donation rates.

“Imagine a surgeon turning around to the parents of a child killed in a road traffic accident and saying ‘we’re preparing to harvest your child’s organs’, and the parents say ‘no you’re not’ and the surgeon saying ‘well we have the power to do so’. There would be uproar. It would only have to happen once and the whole sense of donation being a ‘gift of life’ is gone.”

He said the opt-out approach would be “disastrous” in an Irish context.

Under the opt-out system, the person is presumed to have consented to donate his or her organs after death, unless he or she has specified otherwise. The current opt-in position in Ireland means the person can decide in advance to consent to donate his or her organs or to nominate someone to make the decision on their behalf after death. Where the deceased has not made a decision, the family may do so.

Under a public consultation process in 2009 as part of preparations for a Human Tissue Bill, people were asked to consider options including opt-out and opt-in. Out of 30 bodies who made submissions — including medical and patient representatives — just one was in favour of opt-out. While the Programme for Government is committed to legislating to change organ donation to an opt-out system and the Human Tissue Bill is expected to be progressed next year, Mr Watt said the focus should be on putting organ donation co-ordinators in hospitals to liaise with families and transplant teams.

He said co-ordinators have been recognised as a “key factor in the outstanding success of transplant rates” in other countries. However, they had been talking with the Department of Health for three years about the appointment of such co-ordinators and nothing had happened. This was despite a 2008 audit by the HSE showing that up to 21% of potential organ donors in Irish hospitals were being missed.

A panel discussion on the controversies of organ donation takes place at UCC this evening at 6pm.

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