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Chief medical officer advocates opt-out system of organ donation

In his 2006 Annual Report, On the state of public health, the Chief Medical Officer, Sir Liam Donaldson, called on the government to introduce an opt-out system of organ donation in the UK.1 This would mean that adults would automatically be registered as organ donors unless they opted out of the system. The report emphasises the need to make opting out easy and accessible and to introduce strict measures to protect vulnerable groups who may not have the capacity to decide for themselves.

There has always been a severe shortage of organs for transplantation in the UK: demand far outstrips supply, resulting in at least one person dying on the transplant waiting list every day. The UK lags behind many other countries in this area: both Spain and Austria, for example, have an opt-out system and have a higher rate of organ donation than the UK. From a global perspective, the report noted that inadequate domestic strategies can contribute to the worldwide problems of organ tourism and trafficking, and there is a duty to ensure that national legislation does not have a detrimental effect on either domestic citizens or citizens of other countries. This issue was addressed in 2004 at the 57th World Health Assembly, where the World Health Organization adopted a resolution urging governments to tackle measures to protect the poorest and most vulnerable people from the detrimental effects of organ tourism and trafficking.

All articles are written by Danielle Hamm, Veronica English, Caroline Harrison, Rebecca Mussell, Julian Sheather and Ann Sommerville, BMA Ethics Department; ethics@bma.org.uk

The report makes several other recommendations aimed at increasing the number of organ donors, including bringing the organ donor register to patients’ notice when they register with a new GP and targeted campaigns to increase donations among minority ethnic populations. Donaldson …

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