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13.02.11

BMA outlines organ donation proposals

Patients could be kept artificially alive, hearts retrieved from newborn babies and eligibility criteria for donation expanded in an effort to ease the chronic organ shortage in the UK.

The BMA has released a report, ‘Building on Progress: Where next for organ donation policy in the UK?’ examining a range of options to improve donation rates and increase debate on the subject. Some of the options covered are already being used in other countries and some are being trialled in parts of the UK.

Elective ventilation, where patients are diagnosed as brain dead, involves keeping these patients alive purely for the purpose of organ donation. This could significantly increase organ retrieval rates, but there is concern about the ethics of giving patients treatment to benefit other people.

Slightly stretching the eligibility rules of donation, including revising the upper age limit, could also improve donation rates. The BMA also recommends encouraging A&E staff to identify more dying patients who may be donors, as relatives of up to 400 people who die in A&E each year are not asked about it.

Additionally, advertising campaigns could reduce the amount of families who refuse to give permission for organ donation, and the obligation to answer questions about donation should be extended when applying for or renewing documents.

The BMA supports an opt-out system with safeguards to improve organ donation rates.

Chairman of the BMA’s Medical Ethics Committee, Dr Tony Calland, said: “We are at a crossroads in terms of public policy. As a society we need to decide whether we should accept that we have done all we can or whether we should move forward, cautiously, and look at other options for increasing the number of donors.

“These are complex issues that throw up many ethical challenges. It is important that society discusses them openly in a reassuring way. The aim here is to save lives while at the same time protecting individual rights and autonomy.”

A Department of Health spokesman said: “Any action taken prior to death must be in the patient’s best interests. Anything that places the person at risk of serious harm or distress is unlikely to ever be in the person's best interests.”

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