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Sunday 16 November 2008

To save lives, we have to change attitudes to organ donation

The Organ Donation Taskforce will tomorrow present the findings of its year-long review into the system that finds organs for would-be transplant patients. It will reject the most radical option - switching from the current system by which people 'opt in' to the register of willing donors, to one of 'presumed consent', where anyone unhappy with the idea of their organs being used can freely 'opt out' of the register.

Some 1,000 people die every year in Britain for want of donors.

Waiting lists are growing. The Observer has campaigned for the law to be changed to introduce 'presumed consent' as the most effective way to save lives.

For the taskforce to reject this approach is deeply regrettable. It is a disappointment to patients awaiting surgery and to many doctors who are frustrated that the current system stops them carrying out life-saving operations. That frustration is shared by the government's own Chief Medical Officer, Sir Liam Donaldson, who has backed the Observer campaign.

Why has the taskforce concluded otherwise? Not all medics are comfortable with presumed consent. Some worry it would affect their relationship with critically ill patients, who might fear their treatment was compromised by a hospital's interest in their organs, should they die.

The taskforce also believes that the public is not ready for presumed consent. This is a strange argument since no concerted attempt has been made to explain the idea. A sensible debate has not properly begun. The taskforce recommends instead recruitment of more co-ordinators to work in hospitals, encouraging patients and bereaved families to donate, an approach modelled on the system in Spain, which has the world's highest rate of donation.

But Spain also has presumed consent. Transplant coordinators there work within a culture less inhibited by stigma around the subject. It is the assumption that donation is normal that gives doctors the confidence to discuss it with patients without fear of seeming insensitive or ghoulish. That is the sort of culture change we need in Britain, and that is why the case must still be made.

Presumed consent is not the state assuming ownership of our organs. It is a way for society to show collective compassion to people in desperate need. It is, as Sir Liam Donaldson says, a matter of 'solidarity, generosity and humanity'.

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