NKF Campaigns Zone:
New Legislation for Organ Donation

On 25th February 2002, Jacqui Smith, a Minister of State in the Health Department, said in a written reply to a question tabled in the House of Commons:-

Jacqui Smith:
“We have no plans to introduce an opt-out scheme for organ donation. We are in the process of undertaking a comprehensive review of the law governing the taking, removal and use of human tissue, and will be issuing a consultation paper shortly.”

The National Kidney Federation welcomes the forthcoming review, and has long argued for one comprehensive piece of legislation to cover all aspects of organ donation and transplantation. Together with other members of the Transplant Partnership (hosted by the BMA), the NKF has agreed to press Government for the following 8 points :-

1. A single, comprehensive piece of legislation covering all aspects of organ donation - from both live and cadaveric donors.
2. Clarification or removal of ambiguous terms and phrases such as “person lawfully in possession of the body” and “such reasonable enquiry as may be practicable”.
3. Restricting the range of people it is necessary to make efforts to contact from ”any surviving relative”. One suggestion is that this should be restricted to any surviving spouse or partner or if there is no partner, any parent or child. (There would be nothing to prevent others being contacted but this would simply limit the legal minimum.)
4. The Act should make specific reference to the NHS Organ Donor Register (but should allow scope for the abolition of the register if, at some stage in the future, it is found to be unhelpful).
5. In order to allay the concerns of some members of the public, a requirement should be added into the legislation that, for heart-beating donors, the most up to date guidelines must be followed in determining death by brain stem tests before organs are removed.
6. Any reference to “brain stem death” should be replaced with “death confirmed by brain stem tests”.
7. Specific authorisation should be given to the use of invasive procedures after death in order to clarify the existing legal uncertainty about the use of non-heart beating donors.
8. Removal of the distinction between related and unrelated live altruistic donors. There should be a streamlined system of review applied to all living donations, either by ULTRA or through some other mechanism, to ensure that the potential donor – who is known to the recipient but may or may not be related – is acting voluntarily and free from pressure.

In addition, there are other areas where further debate needs to be encouraged providing an opportunity for all views to be considered. Whilst not all members of the Transplant Partnership necessarily support the introduction of all of these options, all member organisations gree on the need for serious debate about each of these options in order that all arguments can be heard.

These are:

• Living kidney exchange schemes.
• “Good Samaritan” living donors.
• Elective ventilation.
• Introduction of a “soft” form of presumed consent (opt-out).

The NKF is keen to encourage all Individuals and other interested parties, in particular UK Kidney Patient Associations, to submit supporting evidence and views as soon as the consultation paper is published. It would be helpful to the NKF if any such submissions could be copied to the National Kidney Federation for their records and consideration.

Submissions should be made to:-

Consultation Paper - Review of the Taking of Human Tissue
Submissions
The Department Of Health
Richmond House
79 Whitehall
London SW1A 2NS