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CMF to the House of Lords Select Committee on the Inquiry into The EU Commission's Communication on organ donation and transplantation: policy actions at EU level

Published: 8th October 2007

1. Introduction

Christian Medical Fellowship (CMF) is interdenominational and has as members around 5,000 doctors throughout the United Kingdom and Ireland who are Christians and who desire their professional and personal lives to be governed by the Christian faith as revealed in the Bible. 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. This includes formal links with the associations in 16 other European Union nations.

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 Lords Select Committee on the European Union on their Inquiry into the EU Commission's Communication on organ donation and transplantation: policy actions at EU level.

2. The scope of this submission

Some individual members of CMF, working in the field of transplantation, have already made submissions to the Inquiry in their professional capacities. We believe we can best contribute corporately by concentrating on 'questions which may arise in relation to organ donation and transplantation from a faith-based point of view' and from that perspective to comment briefly on some ethical issues.

3. Christian support for the principles of donation and transplantation

3.1 Although surprisingly little has been written, Christians have since its advent generally been supportive of the principle of organ transplantation and see no major ethical problems per se. There was some initial concern when heart transplantation was first performed, in that the Bible speaks regularly of 'the heart'. However, Scripture is referring to the totality of the identity, beliefs and character of the individual, and this confusion was rapidly dispelled as churchgoers came to realise that the heart being transplanted was only a sophisticated mechanical pump and had no special spiritual significance.

3.2 The Old Testament gives the over-arching themes that God is the Creator, Sustainer and Lord of all life and that we are accountable to him for what we do in the world.1 All human life is made in the image of God, belongs to God and should be treated with the utmost respect from its beginning to its end.

3.3 In the New Testament Jesus summarises the entire Law in the command to love, applied in two dimensions: 'Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind' and 'Love your neighbour as yourself'.2 The famous Parable of the Good Samaritan, recorded among the four gospels only by Luke the physician,3 makes clear that we should respond compassionately as best we can to anyone we come across in need, and has been taken by Christian health professionals as a paradigm for care.4 It is highly significant that the caring Samaritan was of an alien race to the victim; hence the love for neighbour which is advocated must cross national boundaries. This concept is relevant to the Inquiry in that it provides support for the principle of a European organ donor card.

This obligation to love is heightened when Jesus Christ says, just before giving his life for all mankind - 'My command is this: Love each other as I have loved you'.5 He continues with the text that above all has inspired Christians to give sacrificially: 'Greater love has no-one than this, that he lay down his life for his friends'.6 Offering organs after one's death or even offering live donation of a paired organ is compatible with this level of love that the Lord expects of his people.

3.4 As transplantation is such a clinically effective and cost effective treatment for organ failure, it fits well within our stewardship responsibility. The altruistic gift aspect of donation which arises from fully informed consent fulfils our Christian obligation to love our neighbour as ourself. Christians therefore support the principles of organ donation and transplantation.

4. Promoting ethical practice

4.1 Justice issues in allocation

Justice is an important concept throughout the Bible, and Christians must therefore strongly support principles of equity and equal access to scarce organs for those in need. Recognising that the necessary clinical prioritisation is contentious, CMF affirms that, regarding the patients themselves as people, we should 'give effective service to those seeking our medical care irrespective of age, race, creed, politics, social status or the circumstances which may have contributed to their illness'.7 We have already emphasised that positive 'neighbour love' should cross boundaries.

4.2 Opting-in versus opting-out

We have not yet been able to hold a full debate within our membership about this difficult question. We are aware that the policy of the British Medical Association is to support an opting-out principle and are aware of figures in several EU countries that report increased retrieval rates after introducing opt-out policies.

However, in a preliminary discussion we placed much emphasis on the theological basis for our support for donation – namely that of altruistic free gift in a context of fully informed consent. A national opting-out policy would mean that at death the body effectively became the property of the state, and 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'.8 Pragmatically, there remains much concern in the UK about the retention of tissue and organs following the Alder Hey scandal, and this may have motivated Parliament when it recently rejected an opting-out policy.

We recognise though the low rates of organ transplantation in the UK. 68% of the public say they are certain or likely to donate their body (for research or teaching), their organs or their tissues but only 5% have already taken the necessary steps to do so.9 We understand why 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 make some suggestions in 6 below.

5. Preventing unethical practice

5.1 Selling organs

Although some philosophers and ethicists argue that the current taboo on payment for organs is hard to justify, our preliminary view is that we have an over-riding Christian obligation to protect the vulnerable. The only people who would be attracted to sell their organs would be the poor and disadvantaged. They would not be making an autonomous choice but being exploited by the wealthy. Old Testament strictures support the poor, and checks and balances built in there to limit the buying and selling of private property10 may be relevant to this debate.

5.2 'Transplant tourism'

Like many others we raise the obvious questions about the source of the organs. Have they been donated willingly by people able to give fully informed consent? We therefore support all EU attempts to fight illegal organ trafficking.

In this context we note that, whatever individuals' views on sexual behaviours are per se, there is widespread condemnation of the concept of 'sex tourism'. We believe that measures against transplant tourism would receive widespread European support.

6. Can the Christian church do more?

We conclude that more teaching should be given within the Christian church to support the principles of organ donation and transplantation. Any outstanding questions should be answered. Such a policy should raise the numbers of Christians on the donor register.

To the extent that Christian teaching influences public choices we hope that this would increase national rates of organ donation, though we note that people dislike planning for death because they do not like intimations of mortality.

Some celebrities have lent their support to blood donation and bone marrow donation. Prominent Christian figures should join such role models in encouraging organ donation.

7. Conclusion

We are grateful to the Select Committee for this invitation to comment and are willing to help further if requested.


References

  1. Genesis 1 especially verses 28-31
  2. Luke 10:27
  3. Luke 10:30-37
  4. Fergusson, A. Hard Questions about Health and Healing. London: CMF, 2005. p98-100
  5. John 15:12
  6. John 15:13
  7. Christian Ethics in Medical Practice - an Affirmation. www.cmf.org.uk/fellowship/doctors/cmf_ethics_affirmation.htm
  8. 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'. www.cmf.org.uk/ethics/submissions/?id=23
  9. Dyer, C. Two thirds favour organ donation after death, but only one in 20 take steps to facilitate it. BMJ 2007; 335:533
  10. See for example Leviticus 25:8ff

For further information:

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 5,000 doctors, 900medical and nursing students and 300 nurses and midwives as members in all branches of medicine, nursing and midwifery. A registered charity, it is linked to over 100 similar bodies in other countries throughout the world.

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

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