I attended the launch of the PHA Organ Donation Awareness campaign ‘speak up and save a life’ at the MAC in Belfast. Whether you be placed in the terrible position of deciding what happens to a loved ones organs, or a transplant specialist nurse working in a trauma unit, the one thing that makes it more likely for consent to be given for organ donation is if the person making the decision knows the wishes of their loved one.
This is precisely why I believe legislation to introduce ‘presumed consent/ opt out’ is divisive, unnecessary and potentially counterproductive. Let us carefully consider what such legislation would mean. The proposed ‘opt out’ Bill as proposed by Jo Anne Dobson would consider every adult in Northern Ireland as a willing organ donor, without ever specifically asking them whether that is their wish or not.
Let’s be clear - the Assembly, not you, would decide through legislation that you are a willing organ donor. This would become the default position. Leaving aside whether it is right for government, rather than the individual, to take such a decision in the first place, the legislation would mean that people could continue to live their lives without ever having to think about or take a decision about whether or not to be an organ donor. That would be the worst outcome as families would not have to discuss the matter and would be under increased pressure when asked difficult and sensitive questions about organ donation by specialist nurses in trauma units. This is why I believe ‘opt out’ legislation to be counterproductive, and why I have consistently favoured the ‘opt in’ approach that allows individuals during their lives to give their consent for their organs to be used upon death, if it is their wish to do so. The opt in approach gives more certainly to families, nurses and clinicians when dealing with difficult decisions that families must make about allowing their loved ones organs to be donated.
We should also carefully examine the experience of ‘opt out / presumed consent’ from elsewhere in the world. It hasn’t worked in places like Sweden, Norway, Brazil or Chile, indeed it has had the opposite effect. Those in favour of presumed consent often cite Spain as an example of a successful country using ‘opt out’. The reality for those who care to actually study the Spanish model will quickly realise that the 1979 ‘opt out’ legislation has never been used, and the main driver for organ donation has been public awareness and structural changes within the health service, changes that we have also started to implement and that have led to an 82% increase in Northern Ireland over the past five years.
I believe the approach by the Health Minister to be the correct one. As legislators we should listen to the experts who are saying that legislation is unwise and counterproductive. We should help clinicians and specialist
nurses by ensuring certainty in the system rather than introduce mistrust and uncertainty. We should inform individuals so that they can take positive decisions rather than legislating to take that decision for them. All of us who wish to see more lives saved from successful transplants should work together to ensure the PHA campaign is a success.
Alastair Ross MLA