Organ Donation

Image by stephen.spillane via FlickrThe Department of Health and Children are currently holding a public consultation on the issue of Consent for the Donation of Organs after Death for Transplantation. The consultation sets out three basic ways of how organ donation could be done in Ireland. They are:

A) Opt-out (presumed consent)
The person is presumed to have consented to donate his or her organs after death unless he or she has specified otherwise.

B) Opt-in (explicit consent)

The person can decide in advance to consent to donate his or her organs, or to nominate someone to make the decision on his/her behalf after death. Where the deceased has not made a decision his or her family may do so.

C) Mandated choice and required request
People would be required by law to specify whether or not they wish to donate their organs after death. This could be done at specified times such as when applying for a State service or benefit. The provision of the service or benefit would not be dependent on the choice made. If a person is a potential organ donor, “required request” means that the person’s wishes, or their family’s, must be ascertained before death, for example in a hospital A & E Department or Intensive Care Unit.


The more detailed PDF document breaks down these options to in total 10 options. They are

A1) Hard opt‐out system (without exemption)
Doctors can remove organs from every adult who dies –unless a person has registered to opt out. This applies even if relatives know that the deceased would object to donation but had failed to register during life. A country that uses this system is Austria.

A2) Hard opt‐out system (with provision for exemptions)
Doctors can remove organs from every adult who dies –unless a person has registered to opt out OR the person belongs to a group that is defined in law as being against an opt‐out system. Singapore uses this system where Muslims chose to opt out as a group.

A3) Soft opt‐out (without family consultation)
Doctors can remove organs from every adult who dies –unless a person has registered to opt out OR the person’s relatives tell doctors not to take organs. It is up to the relatives to tell the doctors because the doctors may not ask them. Belgium uses this system.

A4) Soft opt‐out (with family consultation)
Doctors can remove organs from every adult who dies –unless a person has registered to opt out. It is good practice for doctors to ask the relatives for their agreement at the time of death. Spain is an example of this system

B1) Soft opt‐in system (with family veto)
Doctors can remove organs from adults who have opted in. It is up to each person to decide if they want to opt in. It is normal practice to let relatives know if the person has opted in and doctors will not proceed if faced with opposition from relatives. This is the system currently used in Ireland

B2) Soft opt‐in system (with family consultation)
Doctors can remove organs from adults who have opted in. It is up to each person to decide if they want to opt in. It is normal practice to let relatives know if the person has opted in and doctors can decide not to proceed if faced with opposition from relatives, although they have the legal entitlement to proceed according to the individual’s wishes. This is the system used in the UK.

B3) Hard opt‐in system (without family consultation)
Doctors can remove organs from adults who have opted in. It is up to each person to decide if they want to opt in. Relatives are not able to oppose the person’s wishes.

C1) Soft mandated choice system
People are asked to register their choice to opt in or opt out at specified points and CAN choose whether to do so or not.

C2) Hard mandated choice system
People are asked to register their choice to opt in or opt out at specified points and MUST choose one option.

C3) Required Request
A system of required request would require that a person’s wishes MUST be determined before death. Potential donors are identified in hospital Accident and Emergency Departments and Intensive Care Units and the individual or his / her family must be approached and their wishes in relation to organ donation determined.

The picture above is my Organ Donor Card. It is a bit battered but it shows how long, I have had it. Both my parents know I want to be an organ donor, in the event of my death. I think it is about time the Irish Government had a look at how the system works in Ireland.

So what is my preffered option? I personally am in favour of an opt-out one. I am not sure of which one though. Im not sure about the soft opt-outs (A3 and A4) as the family being asked at the time of death can be hard for them to deal with. So of the two that is left I would probably pick A1. Mainly because I cannot think of any major group in Ireland wanting to opt-out. Individuals can opt out themselves.

The Opt-in ones have proven they dont really work here. Organ donation is low, which is a huge pity. I know there is a part of the drivers license about Organ Donation, but I also know that many people forget to sign it.

With the madated system, I dont see how that can work well. Can you imagine the Nurse taking your details as you enter A&E, Do you wish to become an Organ Donor? Not exactly as nice question to be asked going into hospital.

Which do you think would work? Let the Government know! Written responses by individuals, groups or organisations are welcome and should be sent by e-mail to: tissue_legislation@health.gov.ie or posted to: Tissue Legislation Consultation, Department of Health & Children, R. 324, Hawkins House, Hawkins Street, Dublin 2.

Latest date for receipt of responses is 28th February 2009.

There is a list of questions to help with your response. I will be working on my proper one during the week and I will post it here aswell.

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