Current Topics: Organ Donation, Opt In or Opt Out?

By Dr Emma Brierley

With Wales choosing an ‘opt-out’ policy for organ donation, Dr Emma Brierley deliberates whether this should be used universally.

Organ Donation

The NHS Organ Donor Register and National Transplant Register states that there are currently around 6,500 people on the UK transplant waiting list. These people are in desperate need of a transplant to save or dramatically improve their life. In 2016 the Register stated that nearly 500 people died while waiting for a transplant.

Organs are donated when a person has either brain stem death or circulatory death. Living donations can occur when the donor is alive and donates for example a part of their liver or a kidney.

There are currently discussions to change the current policy of organ donation to an ‘opt out’ rather than an ‘opt in’ policy.

So what is the difference?

‘Opt in’

This policy is were you have to choose to become an organ donor. The easiest way to become an organ donor is to sign up, this can be done in many ways such as directly through the website or even when gaining or renewing your driving licence. It is also important to express your wishes to your family and next of kin. If a person is not registered but has expressed to their family they would be an organ donor the family can give consent on their death for their organs to be donated.

On death although legally families cannot overturn your decision to be an organ donor, donations do not go ahead if the family refuse to accept the decision.

‘Opt out’

This policy is when it is assumed that everyone is an organ donor unless you specifically state that you do not want to be one.  You can register online if you do not want to donate or if you only want to donate certain organs. The UK is currently considering bringing this policy in. It was introduced in Wales in December 2015, however currently there is no evidence that introducing this policy has increased the number of organ donations.

Organ donation can be a highly emotive subject and it is always essential that as a doctor you approach the patient and their families with empathy and respect.

Organ donation points to consider in interview:

  • Do you think the UK should introduce the ‘opt out’ policy?

  • Do you think that family and next of kin should be allowed to overturn the decision?

  • What is the biggest problems facing organ donation?

  • How is organ donation advertised? How could this be improved?

  • If you were Secretary of State for Health what measures would you take to increase organ donation?

  • Should we encourage more living donors? What are the problems with this?