“We are delighted that legislation has been passed by the UK Parliament, known as the Organ Donation (Deemed Consent) Act 2019, to introduce an opt-out system (also known as ‘deemed consent’) for organ donation in England. It is expected that England will have the new system in place from spring 2020.
The BMA supported this important piece of legislation throughout its stages of scrutiny in Parliament. As well as our parliamentary briefings, our members wrote to their local MPs about the importance to doctors of bringing about this life-saving change in law.
More donor organs are needed in the UK than are available, partly because people just don’t bother to fill in a donor card. There are sometimes reasons that they don’t: the image of a doctor, desperate to save another’s life, lurking behind a curtain with a big scalpel as you gasp out your last breath is difficult to eradicate.
‘If they know they can use my organs, will they be as keen to keep me alive?’ you wonder as your biro hovers over the consent form. More often than not we just don’t bother, squeamishly avoiding thinking about the subject, with perhaps a touch of ‘It won’t affect me so why should I care’, making indifference the easy option.
In some ways the case is simple – your heart is of no use to you when you’re dead and it might just as well be used by someone else in desperate need – but there are profound implications behind the idea that the State has the right to dictate what you can do with your own body.
While not a devout worshipper at the Church of Slippery Slopes, I cannot but feel uneasy at this usurpation of normal rules of ownership. What right has anyone, let alone the State, to say what happens to my body after death? One of the pillars of our civilisation is ownership, and usurpation of that right is – or should be – hedged about with law and precedent, only to be entered into with care and trepidation.
How then can we resolve the dilemma? It’s easy if you realise that the central premise behind the process is wrong. Your post-mortem heart/liver/lungs/kidneys (the surgeon’s haggis) are not without value when you are alive, they are an asset which you can trade on a futures market. While anyone can see the disadvantage of giving a monetary value to my future still-beating heart as it sits on the pillion seat of a medical motorbike, there are other values than money.
If my heart fails I’d like a replacement. Perhaps it’s the same for you. I’m reluctant to just give my heart away unless there’s some benefit to me, and as I’ll not be there when the surgeon-vultures get cracking with their implements it’s difficult to see how there can be a benefit. Perhaps it’s not the same for you because some people are altruistic, some people are good, but that’s not the way to bet. So give selfish me an incentive to sign that consent form.
Make it reciprocal.
“I consent to donate any and all useful organs for transplant in the event of my death. In exchange I will be put on the transplant recipient register. By registering to donate I understand that I will receive the reciprocal right to be given a donated organ, if available, should I ever need it.”
And while we’re tidying things up, let’s make it easy for surgeons to check if I’m on the register. A couple of discreet tattoos, maybe just dots, would be easy and quicker than searching a database.
It’s not difficult. To resolve the dilemma, all you have to do is think like a human.