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Submission on presumed consent for organ donation

Published: 17th May 2011

Summary

  • Christian Medical Fellowship is described (1-3)
  • CMF makes no comment on the legal issues arising from the devolution settlement (4)
  • We express ethical and public policy concerns about the concept of presumed consent for organ donation (5-10)
  • We conclude that presumed consent should not be introduced anywhere in the UK (11)
  • We conclude there would be particular cross-border dangers should Wales alone introduce presumed consent for organ donation (12-13)

Christian Medical Fellowship

1. Christian Medical Fellowship (CMF) is interdenominational and has as members around 4,000 doctors and 1,000 medical students throughout the United Kingdom and Ireland. 154 doctors reside in Wales and there are 63 student members at the two Welsh medical schools. All are Christians who desire their professional and personal lives to be governed by the Christian faith as revealed in the Bible.

2. We have members in all branches of the profession, and through the International Christian Medical and Dental Association are linked with like-minded colleagues in more than 90 other countries.

3. We regularly make submissions to governmental and other bodies on a whole range of ethical matters (available on our website at www.cmf.org.uk/ethics/submissions/), and welcome this opportunity to comment to the House of Commons Welsh Affairs Committee consultation on pre-legislative scrutiny of the proposed Legislative Competence Order in Council on Health and Health Services: Presumed Consent for Organ Donation.

4. We have no competence or mandate to comment on legal issues arising from the devolution settlement and confine ourselves to brief ethical and public policy comments.

Re (4): To what extent is there a demand for legislation on the matter(s) in question?

5. We appreciate that the British Medical Association, the Royal College of Nursing, and several medical charities such as the British Heart Foundation and Kidney Wales Foundation support presumed consent, and of course we are as concerned as they are about patients on waiting lists.

6. However, we place much emphasis on the theological basis for our support for the principle of donation - namely that of altruistic free gift in a context of fully informed consent. Any national opting-out policy (be it UK-wide or in one devolved nation) would mean that at death the body effectively became the property of the state. For many Christians this would conflict with the respect owed in biblical and church tradition to the dead body. We commented extensively on this perspective in 2002 in our submission to the Department of Health on 'Human Bodies, Human Choices'.

7. We repeated these concerns in our 2007 submission to the House of Lords, and again in a supplementary submission in 2008, emphasising that 'the language of "donation" becomes inappropriate when organs are "taken" rather than "given"'.

8. In an extensive 2010 submission to the Nuffield Council on Bioethics' very wide-ranging inquiry, we restated the cardinal concept: 'we argue that the altruistic gift aspect of donation (which has genuinely arisen from fully informed consent) fulfils our Christian obligation to love our neighbour as ourself. Christians therefore support the principles of organ and tissue donation and emphasise the primacy of altruism as a selfless gift to others.'

9. We acknowledge however that an opting-out system seems attractive and if the UK is to continue opposing it, we must all do more to increase rates of donation. We have previously made some specific suggestions about ways in which the Christian church could promote the concept of donation.

10. We note the support for opposition to presumed consent from:

  • the House of Lords EU committee
  • the Department of Health's Organ Donation Task Force
  • Patient Concern, a lobby group which promotes choice for patients

We further note that the Health, Wellbeing and Local Government Committee of the Welsh Assembly itself was unable to support presumed consent.

11. With this amount of principled opposition, we conclude that presumed consent should not be introduced anywhere in the UK.

Re (5): Are there any cross-border issues relating to the LCO?12. As stated above, we can only comment on practical clinical and policy issues which might arise should Wales 'go it alone' regarding presumed consent.

We cannot imagine what impact such legislation might have in practice and raise questions such as:

  • Presuming that legislation would only apply to permanent residents of Wales, what might happen to a Welsh person seriously ill or dying in England, Scotland or Northern Ireland?
  • What would happen to visitors from these countries dying in Wales who had not opted out?
  • Which jurisdictions would handle any patient or family complaints?
  • Which jurisdictions would handle any subsequent litigation?
  • What would be the impact on European Union harmonisation policies?
  • What might be the impact on the opting-in policy in the rest of the UK?

13. Our opposition to the Welsh Assembly going it alone within the UK to adopt a presumed consent policy is primarily a principled one, but we have many pragmatic cross-border concerns about what might follow.

Conclusion

We are grateful to the House of Commons Welsh Affairs Committee for this opportunity to comment, and are willing to help further if requested.

References

1. Submission from the Christian Medical Fellowship to the Department of Health on 'Human Bodies, Human Choices - the Law on Human Organs and Tissue in England and Wales'. 2002 www.cmf.org.uk/publicpolicy/submissions/?id=23

2. Submission from the Christian Medical Fellowship to the House of Lords Select Committee on the European Union re their Inquiry into the EU Commission's communication on organ donation and transplantation: policy actions at EU level. October 2007 www.cmf.org.uk/publicpolicy/submissions/?id=48

3. Supplementary Submission from the Christian Medical Fellowship to the House of Lords inquiry into the European Commission Communication: Organ donation and transplantation - policy actions at EU level. February 2008 www.cmf.org.uk/publicpolicy/submissions/?id=50

4. Christian Medical Fellowship submission to the Nuffield Council on Bioethics consultation: Give and take? Human bodies in medicine & research. 2010 www.cmf.org.uk/publicpolicy/submissions/?id=127

5. See Ref 2, Para 6: Can the Christian church do more?

6. House of Lords European Union Committee Report. Increasing the supply of donor organs within the European Union. 2008: Para 312 www.publications.parliament.uk/pa/ld200708/ldselect/ldeucom/123/123i.pdf

7. Bosely S. Taskforce opposes presumed consent for organ donors. The Guardian 18 November 2008.

www.guardian.co.uk/society/2008/nov/18/organ-donation-health1

8. Joyce Robins, co-director, quoted in 'Welsh Assembly considers opt-out scheme for organ donation'. British Medical Journal 22 January 2011; 342: 194-195. (BMJ 2011:342:d273)

9. Health, Wellbeing and Local Government Committee of the Welsh Assembly. Inquiry into Presumed Consent for Organ Donation, 2008: pages 7-8www.assemblywales.org/cr-ld7192-e.pdf

For further information:

Philippa Taylor (CMF Head of Public Policy) 020 7234 9664
Steven Fouch (CMF Head of Communications) 020 7234 9668

Media Enquiries:

Alistair Thompson on 07970 162 225

About CMF:

Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 4,000 British doctor members in all branches of medicine. A registered charity, it is linked to about 65 similar bodies in other countries throughout the world.

CMF exists to unite Christian doctors to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.

Christian Medical Fellowship:
uniting & equipping Christian doctors & nurses
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