Urgent action is needed to increase the number of organ donors in England and Wales, but following Wales’ example and pursuing an opt-out system of ‘presumed consent’ is unlikely to yield much success.
The Welsh Government published its two-year evaluation of presumed consent on 30 November and the report reveals that presumed consent has not had the desired outcome.
Far from increasing donors by the projected 25 to 30%, the donation rate of resident Welsh donors has actually fallen. The report states that “among Welsh resident donors, the respective quarterly mean averages are 14.6 for the period before the change in the law and 13.4 for the time since then.”
Spain has been the world leader in organ donation for the last 25 years and does not have a system of presumed consent, instead it operates a system of informed consent. It invests in specialist nurses who liaise with the family of the deceased, who in lieu of specific direction, make the decision on whether to donate the organs in question.
178,000 people have also withdrawn from organ donation since the introduction of presumed consent in Wales. Under the old system of informed consent (the current system in England) their organs could have been donated by their families had they found themselves in a position to donate but under presumed consent these organs have been lost.
Wales accounts for less than 5% of the UK population yet it now represents 85% of the UK population that has opted out of becoming an organ donor.
Instead of spending millions of pounds on introducing presumed consent, in relation to which there is no evidence of success, the Government should increase the number of specialist nurses in organ donation, SN-ODs. This has been proven to increase organ donations.
CARE’s Chief Executive Nola Leach Speaks Out
“Presuming consent in Wales is not working. The Welsh Government Evaluation published at the end of November states that “among Welsh resident donors, the respective quarterly mean averages are 14.6 for the period before the change in the law and 13.4 for the time since then.’ This decrease clearly shows that despite all the expense of introducing presumed consent, so far the only evidence that we have of any effect on resident Welsh donors is negative.”
Leach continued, “where we do have evidence is in relation to specialist nurses in organ donation. The Nuffield Council has shown that investing in specialist organ donation nurses dramatically increases the number of organ donations. Their research found that the rates of family consent were 68.6% when a specialist nurse in organ donation approached the family, but just 27.5% when the approach was made by other staff without the specialised training. This shows that the Government should focus additional investment in the provision of more specialist nurses in organ donation for now rather than on the introduction of presumed consent.”
“It’s important that we take action to increase the number of organ donations across the UK, but let us put the money into something that has been proven to increase organ donations. Let’s recruit more specialist nurses so that we can start to see the numbers of people waiting on the transplant list finally start to decrease.”