The Welsh Assembly has passed legislation which will see the system of organ donation in Wales move to one of presumed consent. What does that actually mean? Here is an overview of the situation
The Human Transplantation (Wales) Bill was approved following a debate is the Senedd
What is the current system?
People wanting to donate their organs after their death must sign the NHS Organ Donor Register – or their families agree to their loved ones’ organs being donated.
So what is being proposed in Wales?
Ministers want to change the system to one where people opt out rather than opt in. They say it will drive up transplant rates. Currently, 266 people are awaiting transplants in Wales. The change will create two forms of consent in law – “deemed consent” of those people who have not registered to opt out of donating an organ, and “express consent” by those who have registered to say they wish to be a donor.
How will they know who wants what?
A single register will be created and record whether or not someone wants to be an organ donor. Donors will also have the option to to donate certain organs but not others.
To whom will the new law apply?
Everyone over 18 who has lived in Wales for the past 12 months.
Is there anyone to whom this does not apply?
Yes, students not from Wales will not be affected by the law as well as Welsh people who die in another part of the UK. Also exempt are individuals lacking the mental capacity to make a decision on the matter.
How many people could stand to benefit?
Ministers hope to drive up transplant rates by a quarter. Based on current figures, this would see around 15 additional donors and 45 extra organs donated every year.
What organs are up for grabs, so to speak?
The same as with the current system. This include kidneys, heart, liver, lungs, pancreas and the small bowel.
Where will any organs end up?
Any organs donated in the system will not just stay in Wales. Like the current set-up, they can go anywhere in the UK.
What about families’ wishes?
Health Minister Mark Drakeford has promised to give families a “clear right of objection”. And he has also said any organs will not be taken unless a family member is present.
But what about if a family does not know what their loved one wanted?
In this case, the default position is the deceased was in favour of donation and, as a matter of law, the deceased’s consent is deemed. Relatives will be told that the deceased had not opted out, and had made no further wishes known“.
So, in that situation an organ will definitely be donated ?
In theory, no. Although the family has no legal veto, the last decision will ultimately rest on clinicians – who have a duty not to add distress to families of someone who has died. Even if it passes that stage, clinicians have a range of other factors to take into account.
Well, as well as establishing a match with any potential recipient, doctors also have to assess the deceased’s medical history as well as the condition of the organs being considered.
Who is in favour?
Aside from ministers, several charities including Kidney Wales Foundation have lauded the scheme. Also past donors have spoken about the tense wait they endeared while waiting for a donor.
And who is against?
Opposition has come from Christian churches as well as within Muslim and Jewish communities. Critics claim it will cause extra distress for bereaved families, and could put medical staff in a difficult position.
Opponents want families to be able to stop a donation if their relative did not express an opinion either way.
When is the new system due to start?
Once given Royal Assent, the law will come into effect from 2015. Ministers need to launch a two year publicity campaign to alert people of the changes – costing around £8 million.