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MSPs support the ‘opt-out’ system for organ donations in Scotland

NHS organ donation

The Scottish Parliament is considering an ‘opt-out’ system for organ donations which would presume consent.

MSPs have given their support to the proposed legislation that would set up a system of presumed consent for organ donations in Scotland.

The Health and Sport Committee has been examining the Human Tissue (Authorisation) (Scotland) Bill, introduced in June 2018, and has expressed its support for it.

The Bill would put in place a system of ‘deemed authorization’ to assume consent for organ donation, unless the individual has signed to deny permission.

Current legislation requires people to ‘opt-in’ and sign up for their organs to be donated.

Presumed consent means that when a person dies, and they have not opted-out of the donation system, then the NHS will be able to use their organs to help people on the transplant waiting lists.

The proposed legislation aims to increase the number of donors, as people wouldn’t need to take the time to give their names.

A committee report on the Bill reads:

“The Bill is mainly concerned with increasing deceased donation rates. However, only a small number of people die in circumstances which allow them to be donors.

“In Scotland, there are about 400 potential donors each year but only around 100 of these people will actually become donors.

“This would still allow those who do not wish to donate their organs to deny their consent by choosing to opt-out.” 

Organ Donation Scotland

“All the major organs including kidneys, heart, liver, lungs, pancreas and the small bowel can be transplanted.” – http://www.organdonationscotland.org

A similar system was set up in Wales in 2015, and England is also moving towards an ‘opt-out’ system that could be in place by 2020.

The committee considered the decision that was made in Wales before concluding it would support the Bill.

Scottish Labour MSP Lewis Macdonald, convener of the committee, said:

“It is the committee’s view that moving to a system of consent being presumed is the correct approach and this Bill can help to alleviate some existing uncertainties around donation.

“However, it is important to recognise this Bill alone will not increase donation rates and the committee have stated a continued awareness raising campaign is required so that people are familiar and comfortable with this change.”

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Issues with this change have surfaced since the legislation was proposed last June.

Concerns address the possibility of a hard ‘opt-out’ system, as opposed with a soft one.

A soft ‘opt-out’ system would mean that families still have a final say on whether the organs of the deceased should be donated.

A hard ‘opt-out’ system, instead, would mean families have no say and the donation could be imposed if consent had not been previously denied.

The Scottish Government is still to decide on what option it will choose, either the hard or soft ‘opt-out’ system.

Organ donation form

The current system requires you to opt-in to be an organ donor.

The Health Committee has heard concerns about medics possibly facing a difficult position if they were compelled to override the wishes of relatives, STV reported last year.

To this, further concerns have been added about families being uncomfortable with the procedure because of various religious beliefs and lifestyles.

A committee report from last November stated:

“There are many reasons why someone may not become a donor but one reason is family refusal. The family refusal rate in Scotland is around 40% each year and results in the loss of around 100 potential donors.

“Part of the logic of the Bill is that by presuming consent, there will be fewer occasions when family authorisation is required and this may reduce the family refusal rate and thereby increase donations.”

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The part of the Bill that has raised some concerns is in the bit about the family’s say in the case of an individual not stating express consent nor denying it. In this eventuality, the person’s consent would be assumed.

Regarding this, the report says there would be “no override for the family but they would be involved in ensuring the deceased person’s wishes were known.”

This leaves some doubt on how specific situations would be handled.

However, recent years have seen most countries in the UK moving towards some kind of ‘opt-out’ system. Only Northern Ireland is expected to maintain a ‘opt-in’ scheme.

The Health Committee believes that this new legislation would help the situation in Scotland, with over 500 people at any one time waiting for a transplant.

The Bill is still at Stage 1 in Parliament, and there is no clear indication of when the legislation might be put in place, although a fair speculation would set it around 2020, when England could also get a system of ‘deemed consent’.

Before it comes into force, the Bill can be amended, and more clarity could be set out for dealing with families of deceased whose consent is assumed.


Quotes from committee convener provided by Press Association.

About Sara Lovallo

Sara is an award-winning student journalist at Glasgow Clyde College. During her career in media she hopes to explore the fields of investigative reporting, production and magazine journalism. Pizza connoisseur.

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