Learning Objectives:-

A healthcare professional should try and find out if a patient has indicated if they wish to donate their organs. This can be done by checking the Organ Donor Register, looking for an organ donor card on the person, or checking the patient's medical records. If this is the case, organ donation can then go ahead, legally.

The Human Tissue Act 2004 details the guidelines for which organ donation can occur.

If the patient has indicated their wish for organ donation, but their family objects to it, then legally under the Human Tissue Act 2004, the family cannot veto this consent. In practice though, few surgeons would consider carrying out organ retrieval over the family's wishes.

If the patient has not indicated their wish for organ donation before their death, consent can be given posthumously, by a person in a 'qualifying relationship' (Human Tissue Act 2004). The Human Tissue Act actually ranks people who could be in a 'qualifying relationship' with the patient, as to who can give consent first.

• In posthumous donation, a dead person lacks capacity to consent. So by giving 'treatment'- ventilating them, are you acting in the patient's best interests? But does a dead person have any interests anyway?
• Consent to 'treatment' by another adult is not allowed in all other branches of medicine, unless the patient has created a lasting power of attorney. Why should it be different here?
• Which organs are being donated? Should all the organs be used for donation to maximise the benefit from one donor?

Organs and tissues suitable for transplantation:

• Organs: kidney, heart, lung, liver, pancreas, small bowel
• Tissues: cornea, bone, tendon, skin, heart valve.

Families must never feel under any pressure to agree to donation, and must be assured that their decision will be respected.

The NHSBT (NHS Blood & Transplant) service has strict rules for the subsequent organ allocation. This system aims to treat patients equally, to ensure that organs are allocated fairly according to patients' needs, and to achieve the best possible match between donors and recipients.

• Human Tissue Act 2004
  http://www.hta.gov.uk/legislationpoliciesandcodesofpractice/legislation/humantissueact.cfm
• Organ Donor Register
  http://www.uktransplant.org.uk/ukt/how_to_become_a_donor/how_to_become_a_donor.jsp

Les Ann says...

I think the government should really introduce opt-out donation

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almostadoctor replied...

Apparently 24 EU countries have an opt-out system (Spain, Austria, and Belgium) http://news.bbc.co.uk/1/hi/health/7051235.stm Looks like most people (66%) support opt-out system in the UK!

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GuadalupeYork says...

The very poor would happily participate in organ donation if paid, right? Well, New Zealand is considering this, but many people are arguing that saving lives is somehow unethical. Read more here

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