Bishops respond to England's new ‘opt out’ organ donation system

shutterstock 1456143602 A National Health Service sign in the U.K. | TK Kurikawa/Shutterstock

A new law treating all adults in England as potential organ donors unless they opt out "potentially undermines the concept of donation as a gift," the country's bishops have said. 

A statement by the Bishops' Conference of England and Wales May 20 noted that the Church has consistently encouraged organ donation.

"However, a system of presumed consent risks taking away the right of the individual to exercise this decision," it said.

Under the new law, which came into force May 20, all adults will be regarded as donors unless they have recorded a decision to opt out or belong to one of the excluded groups, who include under-18s, those lacking mental capacity to understand the new law and visitors to England. 

The National Health Service (NHS), the U.K.'s publicly funded healthcare system, hopes the new law will produce an additional 700 transplants a year by 2023.

The NHS's organ donation website insists that adults' organs won't be removed automatically when they die. 

"Your family would always be involved before the donation takes place," it says, adding: "Your faith and beliefs will always be taken into consideration before organ donation goes ahead."

The Anscombe Bioethics Centre in Oxford said the law change was "regrettable."

"The absence of express consent from each individual leaves room for doubt about the veracity of their choice," it said.

"While awareness of the opt out system may remain high in the period immediately following the law's passage in Parliament, it will be challenging to maintain such a level of awareness in the years ahead." 

"The law may increase the incidence of situations where someone whose consent has been deemed had never discussed organ donation with their family and friends, leaving their actual wishes difficult to ascertain and thereby adding to the distress of family members." 

"There is also insufficient evidence to suggest that an opt out system on its own leads to an increase in the availability of organs for transplantation." 

The bishops of England and Wales issued guidelines Wednesday explaining how Catholics can record their decision on the NHS Organ Donation Register

Bishop Paul Mason, the lead bishop on healthcare and mental health, said: "These guidelines hope to provide you with some information to help you make a well-informed decision about donating your organs after death. It is important to discuss this with your family and loved ones so that they are aware of your decision and can honor it."

"In turn, it is hoped that this may help to start a conversation so that you too are able to make an informed choice about loved ones when the time comes."

He noted that the Human Tissue Authority (HTA), the public body regulating the removal, storage and use of organs, had updated its code of practice. He said the HTA had strengthened the sections relating to faith and brought "further clarity" to the potential case of a family objecting to the donation of a relative's organs where consent has been presumed. 

Bishop Mason recently wrote to NHS Blood and Transplant (NHSBT), which oversees the supply of blood, organs and tissues within the NHS, concerning organ donation and the coronavirus pandemic. 

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In reply, NHSBT said: 'We continue to offer families the opportunity to seek advice about organ donation from a faith leader, in this case a priest. Our specialist nurses would facilitate those discussions and depending on the situation in the hospital, this would be supported, either face to face or by phone. It will come down to local hospital policies whether or not such practices can continue due to COVID-19."

It added that those who tested positive for COVID-19 or were exposed to the virus would not be considered as organ donors.

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