LEICESTER, United Kingdom – Moving to an “opt-out” system of organ donation in England is “regrettable,” according to the country’s leading Catholic bioethics center.
As of May 20, most people in England will be considered organ donors unless they record a decision not to donate.
“This change in the law is regrettable as it undermines the very idea of ‘organ donation’; the absence of express consent from each individual leaves room for doubt about the veracity of their choice,” said the Oxford-based Anscombe Bioethics Centre in a statement.
“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 statement continued.
The Catholic Bishops’ Conference of England and Wales issued a statement noting that although the Catholic Church “has consistently encouraged its followers to consider organ donation … a system of presumed consent risks taking away the right of the individual to exercise this decision, and therefore potentially undermines the concept of donation as a gift.”
The bishops issued guidelines for Catholics on organ donation, which include a brief outline on Catholic teaching and instructions on how to record a decision online via the Organ Donation Register (ODR).
“Preparing for death should not be feared,” said Bishop Paul Mason, who heads the healthcare desk at the bishops’ conference.
“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 honour 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,” Mason explained.
The Anscombe Bioethics Centre noted in their statement that Catholic teaching requires “that vital organs which occur singly in the body can only be removed after death.”
“For some, the definition of death used in hospitals may be grounds for opting out even if they were not otherwise opposed to organ donation. Many organ transplantations occur when the patient has been declared dead by neurological criteria (commonly known as ‘brain death’) and there continues to be debate about whether this form of diagnosing death is accurate,” the statement continues.
In his remarks, Mason expressed gratitude that the Human Tissue Authority had retained and strengthened sections relating to faith in its final code of practice relating to organ donations.
“The Code of Practice has also provided further clarity on the potential case of a family objecting to the donation of the deceased’s organs where consent has been deemed, as well as the role of the specialist nurses (SNs) in this scenario. We are grateful to the Human Tissue Authority for taking our consultation response into account and for providing these assurances,” the bishop said.
In a letter to faith groups, Professor John Forsythe, the Medical Director for Organ Donation of NHS Blood and Transplant – the office which deals with organ donations issues for Britain’s nationalized health systems – together with Dr. Dale Gardiner, the section’s National Clinical Lead, said they wanted to give “greater clarity, to people who want to donate but want more reassurance around how their faith or beliefs would be respected if they can donate their organs or tissue when they die.”
“Our specialist nurses explore someone’s faith and beliefs when discussing the possibility of donation, to ensure that if donation does go ahead it only does so if in line with these beliefs. The family can consult a faith leader if they so wish. If a family has any concerns, our specialist nurses will support them to address these and agree the best approach,” Forsythe and Gardiner wrote.
“The essential principle we want to reinforce is that a person’s faith and beliefs will be respected in discussions with their families about donation, should the opportunity arise – whether or not they have recorded their decision in the register,” the letter said.
There are exceptions to the new law: Those under 18, those who lack the mental capacity understand this arrangement, visitors to England, those not living in England voluntarily and those who have lived in England for less than a year before their death.
In addition, those who have had COVID-19, or have been exposed to the virus, will not be considered as organ donors.
When asked by Mason to clarify about organ donation in light of the coronavirus pandemic, NHS Blood and Transplant said medical personnel are continuing to approach the family of every potential organ donor to discuss whether their loved one would have wanted to donate their organs.
“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,” the NHS told the bishop.
“We are conscious that it is a very difficult time for families. Hospitals are functioning as best as they can in very challenging circumstances. But rest assured, our specialist nurses remain committed to supporting donation conversations and the donation process, where it is possible to proceed, with the same care, dignity and compassion as always.”
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