Yesterday MP’s in the commons voted to change the law on organ donation to make it an opt-out rather than an opt-in system. This means that, whereas the current law means that if individuals feel they want to be considered as organ donors they should sign up to the organ donor register, they will in future need to opt out of organ donation, therefore making a very specific statement in life that they do not wish their organs to be donated in the event of their untimely death.
It is believed that by changing this law, another 500 lives a year could be saved.
However, there are several fundamental points here which have not really been explored. When talking about an opt-out system, many people assume that in the event someone has not opted out of donation, their organs will automatically be harvested if they are eligible. In fact many people assume that even now, if someone is signed up to the organ donor register, their organs will automatically be harvested for transplant in the event of their death and assuming the circumstances of their death make them eligible. This is in fact not the case, and in the event someone is declared brain dead and the circumstances of their death would make them eligible organ donors, the final decision still rests with their next of kin. This means that someone who is signed up to the organ donor register may still not donate their organs if their next of kin are fundamentally opposed to the idea, or, conversely, someone who might not have wanted their organs donated might still become an organ donor if the next of kin fundamentally believe in organ donation.
In the event that an opt-out system passes into law, this will not change, and the next of kin will still have the overriding decision. This means that, rather than looking at opting in or out of a system, individuals should instead be speaking to their family, their partners, parents, children, about their wishes in the event of their untimely death, so that people are aware of what the deceased would have wanted to happen to them.
Opt out does also have one other fundamental part which I take issue with. As things currently stand, the next of kin would have the overriding power of decision. However, changing of the law does open up a reality where, unless you opt out, the law will make allowance for the fact that in the event of your death your body will become the property of the state. Many people will argue that of course decisions would never be made without the consent of your loved ones, but the truth here is that once something is enshrined in law, it doesn’t take much to change that law in order to achieve a desired outcome.
In life we as individuals demand the right to bodily autonomy. Why then would anyone believe that it should be ok to relinquish that autonomy in the event of our death?
I do not have any issue with organ donation. My organs are not of any use to me where I’m going, and as such, should I end up in a situation where such conversations need to be had, I don’t have issue with my organs being donated if eligible. I do however have an issue with this being done autonomously without the potential knowledge of my family who are my next of kin, and while that may not currently be the case, I have issue with a law which could allow it to become the case.
As such, if opt out becomes law in the UK I will be opting out on the basis that conversations with my family mean that in the event of my untimely death my wishes will still be carried out, but they will be carried out on the authorisation of those who knew them and who are the ones who have to live with the aftermath, not by the state to whom I am just another potential organ donor.
It is important that your family know your wishes. The organ donor rate can only increase if people communicate in life with those who have the overriding decision making powers in death.