Clause 3 - ''Appropriate consent'': adults
Human Tissue Bill
3:00 pm
Dr Evan Harris (Oxford West and Abingdon, Liberal Democrat)
I thought that I had made that clear. Exactly what the hon. Gentleman wants would apply. The relatives would be asked whether there was an opt-out—whether the person did not want their organs to be used. The hon. Gentleman is making the point that they are not given an opportunity to guess on the basis of the values of the person concerned, and I accept that that could be an issue. However, if they feel strongly that the person would not have wanted their organs to be used—let us remember that the opt-out would come up all the time, on every trip to the post office and on almost every official form—they would have the opportunity to say that they were distressed because, even though the matter had never been discussed and the person had never taken advantage of the opt-out, they do not think that the person would have wanted to be a donor. That is what happens abroad. There have been a few cases—for example in Belgium—of such reasons being posited, and organs have not been taken. We would be maximising respect for the patient's wishes, but giving scope to meet the stress of relatives as fully as now.
A further point is that there is now good research to show that many relatives, who at the height of their grief say no to donation because they cannot deal with the decision—they are asked for their decision and not the wishes of their loved one—come to regret not having given their consent at that acute moment, particularly when they hear stories later on about people whose lives have been saved through donation. Some follow-up has taken place, although it is difficult to do, and those are the findings. Such an opt-out system with presumed consent is of benefit to the relatives in not only the acute stage but down the line.
For those reasons, we have an a priori obligation to consider changing the system, particularly given the terrifying number of people on the waiting list for transplants. The number has risen inexorably from 5,410 in 1993 to 6,507 in 1998, and from 7,072 in 2002 to 7,278 in 2003. That increase occurs almost every year. There is a similar steady rise in the number of people dying while waiting. Despite the great efforts
that have been made, under the current system the number of cadaveric organ donors continues to drop, from 853 in 1993 to 757 in 1998, picking up over four years to 766 in 2002, but dropping in the past full calendar year—2003—to 710. Although one can pick out the financial year of 2002–03 in which there may have been an increase in cadaveric donors, the figures for 2003 are very disappointing.
People are dying while waiting, organs are being lost and the majority view of people who want to donate, which is up from 70 to 90 per cent. is not being considered, because 50 per cent. of relatives who are asked for their opinion say no. Therefore, we urgently need to consider the change, and there is good evidence of public support for it.
Support exists in not only listeners' polls; a survey of 2,000 people carried out by the National Kidney Research Fund in July 2000 showed that 57 per cent. of those questioned would support a system of presumed consent. A telephone poll conducted by ''Watchdog Healthcheck'' in February 2001 attracted some 52,000 people and found that 78 per cent. of respondents supported a shift to presumed consent. Again, they are responsive polls not scientific samples, so we clearly need more information on the matter. The Department of Health's response that there has not been demonstrable public support and no public debate, when it has not initiated a debate or a fair survey of public opinion, makes it difficult to conclude that the question has been settled.