For 3 hours yesterday I sat in on a Private Members Bill, the aim of which is to give the state the power to utilise parts of our dead bodies, without our express permission or that of our next of kin. While I am not in support of this at all, it was a good enjoyable debate. I did not participate in this debate because I wanted to conclude it as quickly as possible, to allow enough time for my Overseas Electors Bill which followed it. And I don’t think its a change which will do much actual harm. It’s just that it will not do what the proponents of Presumed Consent claim it will. There is simply no evidence whatsoever to suggest that it will.
For 25 yrs I have been a champion of Organ Donation. No greater gift can we as human beings give. I have advocated changes that will increase the number of organs available, and there are several. And I have always said I would support presumed consent, despite concerns about the principle of the state greatly expanding its power, if there was evidence that it would work. It won’t.
Now let consider what we should do. Firstly we should increase the availability of IC beds (Intensive Care). The bodies from which organs are taken are usually ‘brain dead’ and being kept alive artificially while preparations are made for donation. Spain offers us the best international example. I’m told there are three times as many IC beds available in Spanish hospitals (pro rata) No-one mentioned that in yesterday’s three hour debate.
Secondly we should greatly increase the number of SNODS (Specialist Nurses in Organ Donation). We know the refusal rate of next of kin to consent to donation means a great many organs are ‘wasted’. And we know the refusal rates drop dramatically when SNODS are involved. Again, I’m told that Spain has vastly more SNODS than the UK has (pro rata). What should happen in that the next of kin of every potential donor should be asked by a Specialist Nurse, trained to work in what is always a very traumatic circumstance. In Spain, people do not carry donor cards. The Spanish Government has a policy where everyone is asked. Everyone is considered to be a potential donor, not just a card carrier.
In yesterday’s debate there were references to Spain being an ‘Opt out’ country. This was irritating. It’s not. It is true that Presumed Consent was legislated for in 1979, but it did not increase donation at all. Other changes which made the difference were made in 1989, ten years later. Presumed Consent mat remain on the statute book but it’s not acted on, and hasn’t been since 1989.
Another concern I have is the impact that the state taking over the right to decide on donation of our body parts will have on live donation. Until there was public debate, generated by the Welsh Government moving to a system of presumed consent, there was an exponential increase in number of live donors, particularly important to those in need of a new kidney. Over the last three years that number has started to fall significantly. Impossible to know if there is a connection, but it’s always been part of my opposition to presumed consent that “When the state takes over responsibility, the people tend to leave it to the state” – as has happened over recent decades in respect of social care.
The final step Govt should take is to finance campaigns promoting “Tell your next of kin your wishes”. This is the one area where the debate about presumed consent could be useful. The publicity surrounding it, despite being hugely misleading, generates discussion. It may be that it will lead to greater awareness amongst families. In the end, this is why I don’t think this Bill if it becomes an act will do harm. And why I may be very opposed to it, but will maybe abstain. No way could I ever vote for it.