The National Kidney Federation has voted overwhelmingly in favour of the opting out system of organ donation, where organs can be freely used unless the donor has registered his or her objection.
The vote, taken at the NKF's Annual Council meeting in Blackpool, reversed the long-standing policy of the NKF to support the existing system of registering donors (the opt in system). It comes at a time of crisis in transplantation, when the waiting list is rising and the number of transplants dropping.
The change had been foreshadowed by a poll in the summer issue of Kidney Life and follows a vote by the British Medical Association to support the opting out system, a major shift in policy for the doctors.
Representatives of KPAs voted for the change by 21 to 3. The NKF will now join with the BMA and other kidney organisations in calling on the Government to review the present system.
Chairman Austin Donohoe said it was with great personal sadness that he supported the change. In an ideal world it would not be necessary, since consent to use organs would be automatic, he said. But around 30 per cent of relatives refuse permission, most of them because they do not know what the persons wishes were.
Several people argued that, instead of taking the risk of a major change of policy with the spectre of adverse media publicity and a possible backlash, the present system of donor registers should be strengthened by education and more publicity.
Lilian Rutherford, a renal nurse and kidney patient, said she was concerned about transplant co-ordinators who were mostly against opt-out and were perhaps frightened of their jobs.
One delegate spoke as a transplant recipient and also the relative of a donor, since her mother's organs had been used after her death. Relatives wishes should not be discounted, she said. But many of the delegates were prepared to take the risk of a change in policy to meet a pressing need. Fifteen hundred people died last year who should be alive today, said Gordon Nicholas.
A powerful contribution to the debate came from Dr Evan Harris, the MP who has led the setting up of the All Party Kidney Group of MPs to support renal services. As a doctor himself, he had put the motion to the BMA conference that had led to the change in policy. 'It is vital to have the BMA, and in particular its ethics committee, supporting opting out,' he said. 'The problem is that in the current system about 60 per cent of potential donors' intentions are not clear and we are asking relatives to decide.'
He hoped that the Government would commission a review of all the European schemes to prove once and for all that opt-out would increase rates of transplants. 'Supporting a move to opt out doesn't mean we abandon opting in, and I would agree we need better education,' he said. 'All we are asking is, is there a better way?'
He promised that the All Party Kidney Group of MPs would not concentrate solely on the issue of opting-out. The crisis in renal services and the shortfall in dialysis facilities were the biggest issue.
After the vote had been taken, Mr Donohoe said that even if opting out was introduced, the gift of life remained.