Taking the 'informed' out of consent

The Welsh Assembly has stood the word "donation" on its head. Last night it voted for an "opt out" system of organ donation.

To date in the UK there has been an "opt in" system. Organ donors volunteer to be placed on the organ donor register. But if you have lived in Wales for 12 months and you do not carry a donor "opt out" card, your body is no longer your own. From 2015 you will be presumed to have given consent, and your organs may be taken for transplantation.

The move is an attempt to increase the number of transplantation organs available. There is pressure for similar legislation in England and Scotland.

Said Joyce Robins, of Patient Concern, "Everyone knows the absence of refusal is not consent. Pretending that it can be is dishonest and disrespectful. Provision of a right to opt out is a smokescreen. 

"Assurance that every citizen would hear of the new law, understand it, realise its implications, grasp how to opt out and get around to doing so - if they wish - is pure fantasy. Silence should not amount to consent."

Hearts, livers and pancreases for transplantation are taken only from patients who have been diagnosed brain-stem dead. Such a patient is breathing and his or her heart is beating. She can digest food, urinate, and can develop bed sores. If she is a pregnant woman, she can bring the baby to term. I do not believe that brain-stem death is in fact death, but rather an excuse to take the organs.

Doctors would say they are ending a life - a strange term to use for someone they say is dead already - to save the lives of others.

The end does not justify the means.

Hearts, livers and pancreases for transplantation are taken only from patients who are breathing and whose hearts are beating. Organ donors and their next of kin are given to understand that life support - a ventilator - will be turned off and the organs then removed. In fact, the organs are removed and then life support is turned off.

Many doctors do not give an anaesthetic when the organs are removed. To do so would be to admit the patient is alive. There is a violent physical reaction, but doctors say the patient is unaware. Complete unawareness is difficult to prove.

The fact that potential organ donors and their next of kin are not told that donors will be breathing and their hearts beating when organs are removed is unethical and immoral.