Organ donation and consent

Sir, – The majority of patient groups on the Irish Donor Network (IDN) welcome the recently launched public consultation process on an opt-out system for organ donation In Ireland.

The IDN believes that, as one part of a broader strategy, a shift to a “soft opt-out” system will have a positive effect on organ donation rates in Ireland.

A 2008 HSE audit showed that up to 21 per cent of potential organ donors in Irish hospitals were being missed. While Ireland is generally in the top half of countries in the Council of Europe when it comes to organ donation, Ireland also continues to lag far behind the deceased organ donor rates of Spain, Croatia, Austria and Sweden (for example). All these countries have both an opt-out system and a well-resourced transplant infrastructure.

The IDN supports the principle behind a soft opt-out system – that if people do not object to their organs being used after death, they should be used to save lives, with the proviso that next of kin must continue to be consulted. We welcome Minister for Health James Reilly’s commitment that organ donation would not occur where next of kin object. This is a significant change from 2009 when this issue was last debated.

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Under an opt-out system, individuals have exactly the same choice as in an opt-in system – to donate or not to donate. An opt-out system continues to give protection to those who do not wish to donate and makes it more likely that those who are willing to donate will be able to do so.

The most important change with an opt-out system is that organ donation becomes the default position which, with public support, changes expectations in society. This is not “presumed consent” because of the protections offered by the “soft’” approach and it represents a more sustainable approach to organ donation, which is to be encouraged.

Too many people continue to die in Ireland while waiting for a kidney, heart, lung, liver or pancreas transplant. An opt-out system, as an essential part of a broader strategy, is better for recipients (because more organs will be available), better for donors (because it is more likely their wishes will be respected) and better for relatives (because the donor’s own wishes will be known and they will continue to have a say). – Yours, etc,

PHILIP WATT,

Irish Donor Network ,

Chief Executive Officer,

Cystic Fibrosis Ireland,

24 Lower Rathmines Road,

Dublin 6.