Written evidence submitted by the Christian
Medical Fellowship
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'.1
7. We repeated these concerns in our 2007 submission
to the House of Lords,2 and again in a supplementary
submission in 2008,3 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,4 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 suggestions5 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.6
- the Department of Health's Organ Donation Task
Force.7
- Patient Concern, a lobby group which promotes
choice for patients.8
We further note that the Health, Wellbeing and Local
Government Committee of the Welsh Assembly itself was unable to
support presumed consent.9
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.
February 2011
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/ethics/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 7-8
www.assemblywales.org/cr-ld7192-e.pdf
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