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19 Jan 2016

Bereaved families who want to override the decision of a loved one to donate their organs may have to provide their reasons in writing under changes being considered in the United Kingdom to respect donor wishes.

NHS Blood and Transplant (NHSBT) has announced it is considering a range of measures to reduce the number of occasions in which families veto the decision of organ donors amid evidence the practice has cost hundreds of lives in the last five years.

The organisation has released figures showing that since 1 April 2010, 547 families in the UK have overridden the request of their loved one that their organs be donated, resulting in around 1200 people missing out on a potentially life-saving transplant.

Across the UK almost 6580 people are estimated to be currently waiting for a donated organ, and around 1000 people in need of a transplant die while waiting each year.

Families are overriding patient wishes despite evidence that the majority thinks this is wrong. A survey conducted by the NHSBT found 73 per cent thought it unacceptable that next of kin could veto a donation decision, while just 11 per cent supported it.

“While most families approached about donation support their relative’s decision to donate as recorded on the Organ Donor Register, a number of families each year override a previously made donation decision,” NHSBT Director of Organ Donation and Transplantation, Sally Johnson, said.

In response, the organisation is looking at options to curb the practice, including no longer formally asking families for consent, making it clear that their consent is not legally necessary, and asking them to provide a written explanation of their objection – something that is already required in Scotland.

“We think our proposed changes would make the existing legal situation clearer to families and, hopefully, help them to support their relative’s decision,” Ms Johnson said.

While there is no suggestion yet that Australian authorities might take similar action, there is great concern about the country’s persistently low organ donation rate.

There has been only a modest lift in the rate of deceased organ donors in the last seven years, from 12.1 per million to just 16.1 per million, despite a $250 million Government campaign.

Former Assistant Health Minister Fiona Nash sparked controversy last year when she announced a review of the Organ and Tissue Authority, with its then-head, television presenter David Koch, resigning in protest.

Mr Koch said the Authority had raised Australia’s world ranking in organ donation from 32 to 19 since it was launched in 2009, and accused Senator Nash into caving into the demands of the ShareLife advocacy group, which he claimed wanted to “take control of the money”.

The AMA has supported efforts to boost organ donor rates.

Late last month, AMA President Professor Brian Owler reiterated his call for people to consider becoming an organ donor, and to discuss the issue with their family.

“Becoming an organ donor can, quite literally, be a lifesaving decision,” Professor Owler said. “Just one donor can transform the lives of 10 other people.”

But he said that because organ and tissue donation would not proceed against the wishes of the family, it was vitally important that those who wanted to be donors “share your decision…with others, especially family members,” Professor Owler said.

The AMA’s Position Statement on Organ and Tissue Donation and Transplantation, last updated in 2012, can be viewed at:

Adrian Rollins

Published: 19 Jan 2016