MPs in Favour of Presumed Consent

Given the recent statement by the Organ Donation Taskforce last week, I had hoped that presumed consent had, indeed, been consigned to the back burner. However, the Sunday Observer is pressing ahead with its campaign and has asked MPs what they would like to see. The results are hardly surprising.

An overwhelming majority of MPs support adopting a new system of organ donation, because the shortage of donor kidneys, hearts and lungs is so severe, a survey carried out by The Observer has found. Of the 120 who responded to a poll last week, 97 said they were in favour of proposals to change current rules, so that everyone would automatically be considered a donor after their death, unless they had opted out during their lifetime, or relatives objected.

As I said, hardly surprising. MPs are where they are because they think they know best; because at heart, they are control freaks. There are some party political divisions, which are again, hardly surprising; most of the dissenters come from the Conservative party with Labour and the LibDems pretty much unanimously in favour.

Also, apart from the political (enemy) class, there is division among medical groups.

The British Medical Association, the Royal College of Surgeons and the Royal College of Pathologists all came out in support of The Observer’s campaign for a switch to the new opt-out approach, saying that the time had come for more ‘positive action’ to combat the severe shortages.

But the Royal College of Physicians is unconvinced, arguing that there are ethical problems with assuming consent.

Ah, at last, someone who really gets it. The Royal College of Physicians is spot on – it is an ethical issue. As I’ve said before during this discussion; taking without asking, simply because the justification is “saving lives”, doesn’t change the underlying ethics.

Actually, I don’t consider this a civil libertarian issue. Nor do I consider it one of sovereignty over bodies. I regard it as an ethical one. The proposal is relying on a combination of apathy and ignorance on the part of prospective donors. While offering an opt-out, it relies on people being too lazy or insufficiently informed to do so – this is the only way that it would successfully increase the number of available organs.

In no way is that informed consent – and, as such, is highly unethical. Pragmatism and the public good are not sufficient arguments for what is an unethical concept.

The most recent proposals put forward by the Transplant Taskforce are much more in line with a high standard of ethics in that they are looking at improving coordination (which is one of the major problems) and informing people. That is an excellent way forward and one that I fully support.

I will never be persuaded that presuming someone’s consent is ever an acceptable way forward. The only way you can guarantee that someone consents, having been fully appraised of the situation, is to ask them, not to make presumptions.

The day you sacrifice ethics in favour of pragmatism, you open Pandora’s box. Put aside for a moment, the matter of organ donation as it clouds the underlying issue and is an appeal to emotion. What we are talking about here is the state taking advantage of people’s laziness or ignorance in order to make a decision on their behalf; a decision that is not remotely informed. Once we accept that, we accept the principle, and once we accept the principle, sooner or later it will be used for something else, which, too, will be “pragmatic” and “for the common good”. Altruism is no excuse for unethical behaviour and that MPs think it is merely means that they have lived down to my already low expectations of them.