LEICESTER, UK – The UK's leading Catholic bioethics centre says it would be “regrettable” to move to an “opt-out” system for organ donation in England.
From 20 May, most people in England will be considered organ donors unless they record their intention not to donate.
“This change to the law is unfortunate as it undermines the very concept of 'organ donation'. Without the explicit consent of each individual, the genuineness of the choice is left in doubt,” the Oxford-based Anscombe Centre for Bioethics said in a statement.
“This law may increase situations in which people who are deemed to have consented have not discussed organ donation with family or friends, making it difficult to ascertain their true wishes and increasing distress for their families. Furthermore, there is insufficient evidence to show that an opt-out system, in itself, leads to an increase in the supply of organs for transplant,” the statement continued.
The Catholic Bishops' Conference of England and Wales said in a statement that while the Catholic Church has “consistently encouraged its faithful to consider organ donation, a presumed consent system risks taking away an individual's right to decide to donate their organs and therefore potentially undermines the concept of organ donation as a gift.”
The bishops have issued guidelines for Catholics on organ donation, including a brief outline of Catholic teaching and instructions on how to record their decision online through the Organ Donor Register (ODR).
“Preparing for death is not something we need to fear,” said Bishop Paul Mason, head of health affairs for the bishops' conference.
“These guidelines are intended to provide information to help you make an informed decision about whether to donate your organs after death. It's important to discuss it with your family and loved ones so they can understand and respect your decision. And we hope this will start a conversation so that you, too, can make an informed choice about your loved one when the time comes,” Mason explained.
In a statement, the Anscombe Centre for Bioethics said Catholic teaching holds that “vital organs present alone in the body can only be removed after death”.
“The definition of death used by a hospital may be grounds for refusal for some people, even if they are not opposed to organ donation. Many organ transplants occur when a patient has been declared dead by neurological criteria (commonly known as 'brain death'), and there is ongoing debate as to whether this method of diagnosing death is accurate,” the statement continued.
In his speech, Mason expressed gratitude to the Human Tissue Authority for retaining and strengthening the section on faith in the final code of conduct on organ donation.
“The code also provides further clarity on cases in which a family member may object to organ donation where consent is deemed to have been given, and the role of Specialist Nurses (SNs) in this scenario. We thank the Human Tissue Authority for considering their response to our consultation and for providing these assurances,” the bishop said.
In a letter to faith groups, Professor John Forsyth, medical director for organ donation at NHS Blood and Transplant, which handles organ donation issues in the UK's national health system, said he and Dr Dale Gardiner, the department's national clinical lead, wanted to provide “greater clarity to people who wish to donate their organs but would like more reassurance about how their faith and beliefs will be respected if they are able to donate their organs or tissues after their death”.
“When discussing the possibility of organ donation, our specialist nurses will explore a person's faith and beliefs to ensure that, if organ donation occurs, it is only in line with their beliefs. Families can consult with their religious leader if they wish. If families have concerns, our specialist nurses will support them to address those concerns and agree the best approach,” Forsyth and Gardiner wrote.
“The fundamental principle we wish to emphasise is that when people have the opportunity to discuss organ donation with their families, their faith and beliefs will be respected, regardless of whether they have recorded their decision in a register or not,” the letter said.
There are exceptions to the new law, including people under 18, those who lack the mental capacity to understand the arrangements, visitors to England, people who are not voluntarily living in England, and people who had lived in England for less than a year before their death.
Additionally, people who have had COVID-19 or been exposed to the virus will not be considered as organ donors.
Asked by Dr Mason for clarification on organ donation in light of the coronavirus pandemic, NHS Blood and Transplant Centre said that healthcare workers are contacting the families of all potential organ donors to discuss whether their loved ones would have wanted to donate their organs.
“We continue to offer families the opportunity to receive advice about organ donation from a religious leader, in this case a priest. Our specialist nurses mediate the discussion and provide support in person or over the phone, depending on the hospital's circumstances. Whether this service can continue due to COVID-19 depends on local hospital policy,” the NHS told the bishops.
“We recognise this is an incredibly difficult time for families and the hospital is doing the best it can in extremely challenging circumstances. However, please be assured that our specialist nurses remain committed to supporting discussions about organ donation and the organ donation process with the same care, dignity and compassion as always.”
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