Memorandum by the British Humanist Association
1. The British Humanist Association (BHA)
welcomes the opportunity to submit evidence to the inquiry into
organ donation and transplantation.
2. The BHA is the principal organisation
representing the interests of the large and growing population
of ethically concerned but non-religious people living in the
UK. It exists to support and represent people who seek to live
good and responsible lives without religious or superstitious
beliefs. It is committed to human rights and democracy, and has
a long history of active engagement in work for an open and inclusive
society. The BHA's policies are informed by its members, who include
eminent authorities in many fields, and by other specialists and
experts who share humanist values and concerns.
OUR POSITION
3. Humanists generally support scientists
and researchers in their quest for knowledge, and support scientific
and medical advances for the improvement of our health. Most of
us would not object to our body parts and organs being donated
and used for good ends. We believe that better public education
about organ donation and transplantation is essential, and that
policy actions at both state and European levels are needed in
order to increase the number of organ transplants and so save
lives.
4. We are also very concerned that the low
number and availability of organs donated across Europe is contributing
to unnecessary deaths for want of transplants and to an increased
trafficking in organs, and in human beings for the purpose of
removal of organs, from outside of Europe and that this will create
serious ethical issues and is contributing to systematic human
rights violations of some of the most vulnerable people from across
the world.
5. This response is from a humanist perspective
and covers in particular issues arising from that view, the health
and social welfare benefits and ethical issues of organ transplantation,
the use of living donors and, especially, the "presumed consent"
approach and the arrangements for taking into account the views
of relatives. We wholly oppose general policy being made on the
basis of religious dogma or superstition—though we recognise
that provision must be made to accommodate the personal wishes
of individuals based on such considerations -and we support policy-making
based on evidence, rational decision-making and that which seeks
to maximise the well-being of individuals and so society more
generally.
6. With any change to the approaches for
organ donation for transplantation, there must be appropriate
safeguards in place to protect the wishes of the deceased individual,
and the health of both living donors and those needing an organ
transplantation.
PRESUMED CONSENT
7. Humanists are concerned with the maximisation
of well-being of individuals for the social good and benefit of
society as a whole. Humanists believe in individual rights and
freedoms—but believe that individual responsibility, social
cooperation and mutual respect are just as important. In terms
of organ donation and transplantation, most humanists would consider
that we have a moral responsibility to allow our organs to be
used for transplantation, if that will improve the quality of
life for others and contribute to the well-being of the human
family.
8. The BHA holds that the current system
where individuals must "opt in" to have their organs
removed for donation after their death has contributed to the
present shortage of organs and so to many preventable deaths every
year. We fully support the replacement of the opting in approach
to one of "presumed consent", whereby individuals must
actively opt out should they not wish their organs to be used
for donation after their death.
9. The presumed consent approach would better
match the fact that the majority of the population support organ
donation for transplantation, would be likely to vastly increase
the number and availability of organs suitable for transplantation,
would decrease the trafficking in organs and human beings, would
increase awareness of organ donation more generally and would
better assist individuals and families to make decisions about
organ donation.
10. Under the present system, unless someone
has actively opted in, it is usually left to relatives to consent
to donation of the deceased's organs. There is a range of reasons
why relatives may not wish the individual's organs to be donated—historical,
cultural, social, religious and so on—but these may actually
have been in direct conflict with the views of the individual.
Under a system of presumed consent, supported by good public information,
education and awareness of that system, if an individual has particularly
strong objections to organ donation after death, then she is able
make her feelings clear and opt out, while she is alive. Moreover,
the presumed consent system seems better able to protect the wishes
of someone who had not opted-out, even if the relatives themselves
have strong views against organ transplantation, because the individual
should have been given good enough information to make an informed
choice when she was alive and the presumed consent should usually
be taken as paramount.
11. This is not to say that relatives' views
should never be taken into account. We would support the British
Medical Association's "soft" system of "presumed
consent", whereby organ donation (for those over the age
of 16) is the default position, but where relatives would not
be asked to consent to donation (as in the present system), but
would be told that the individual had not opted out and would
be asked if they are aware of any unregistered objection[1].
We believe that this would help decrease the number of objections
from relatives.
LIVING VOLUNTEERS
12. The BHA would support a policy move
to promote the altruistic donation of organs, such as kidneys,
from living donors. As with any change to the organ donation after
death system, this would need to be accompanied by raising public
awareness through comprehensive education and information. If
someone wishes to be a living volunteer donor, that must be an
individual choice. She must have enough information to make a
rational choice for herself about the risks of such a procedure
to her well-being and life compared with the benefits to the well-being
and health of the person needing that organ. We wholly endorse
the present ban on a sale of organs.
January 2008
October 2007
http://tinyurl.com/2yc7u9
1 British Medical Association (2007) "Organ donation-presumed
consent for organ donation", Back
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