Wednesday, May 14, 2014

Organ Donation: Presumed Consent or Informed Consent?

The topic of consent with regards to organ donation is highly debated upon. Canada’s current policy regarding organ donation is one of informed consent, in which a citizen fills out a donor card in order to donate. Another option is presumed consent, in which a citizen is automatically considered as having given their consent to donate their organs, unless they inform the government that they do not. There are several factors that must be considered regarding a change in policy, and there have been many statements made against it. Some factors to be considered are the policy’s greater ease and efficiency in finding organ donors and it is already instated in many other countries. Some cases made against the policy are a reflection of religion as well as a concern for the taking of organs without consent of the patients loved ones.

The system of presumed consent is already in practice in over twenty European countries. Statistics show that these countries have a significantly higher organ donation rate than countries who use informed consent (Mulholland, 2012). As Canada has a reputation for peace and kindness, it is disappointing to discover it has one of the lowest organ donation rates in the world and hundreds of people die yearly while on waiting lists. This is damaging for Canada’s reputation. Were Canada to adopt this method of presumed consent as well, the amount of donations in Canada would inevitably rise.

More importantly, the implementation of a presumed consent system would be much easier and more efficient than the current system. Currently, 80% of Canadians support organ donation, yet only 20% sign up to be a donor (Busby, 2010). The act of initiating a presumed consent policy would remove the step of signing up. As most Canadians support organ donation yet have not taken time to sign up, this would cause a positive effect for most people. While there are still people who are opposed to organ donation, these people may choose not to donate as they please. Rather than supporting the small portion of the population who opposes donation of their organs, this policy proposes supporting the much greater portion of Canadians who want to donate their organs after death. There are also likely to be a significant amount of people who are undecided or have no opinion on the matter. In this case, their non-opinion would impact society in a much more positive way than if the current policy remains.

Religion is not an acceptable means to apply a policy on an entire population. Currently, a large reason for opposition to the presumed consent stems from religious causes. In one of Pope John Paul II’s speeches, he stated that organ donation must be a free act of donation and a presumed consent system would destroy that (Wang, 2013). A presumed consent policy, however, would not be obligatory. It cannot be understated that, even if this policy were enacted, one would still be able to opt out. As there would be no fee imposed for doing so, it would still be a donation if not opting out. Furthermore, different religions have many different views on the matter and there is no one policy that can satisfy all religions.

One concern is that a presumed consent policy will allow the repeat of an incident that occurred at Alder Hey Hospital from 1988 until 1996. The incident resulted in the unauthorized removal, retention, and disposal of children’s organs, particularly hearts (Wang, 2013). This created a fear that hospitals all over the world were storing children’s organs without parents’ consent and the informed consent policy seemed a solution; it would be strictly illegal for any part of a child to be reserved unless permission otherwise was given from the parent. However, in a policy of relaxed presumed consent, the parents of the child, and relatives of the deceased in any other case, would still be given final say over whether or not to donate the organs of their loved one(s). Especially for such a young age as a child, it would remain illegal for a doctor to remove the young child’s organs without the parents’ consent.

The most significant factor in deciding what form of organ consent is the understanding that organ donation determines whether someone survives or dies. As so many Canadians currently support organ donation yet are not signed up, they are all potential donors who could saves lives. However, they will not be because they have not taken the time to sign up and our government is not doing it for them. The current policy allows hundreds of people to die who could be saved by a simple change in policy that would have no effect on most people. This is the primary reason why a presumed consent system would be of much greater benefit than our current system.

Due to these reasons, a change from informed consent to presumed consent in Canada would have a strong, positive impact. It is already practiced in many nations, is much easier and more efficient than our current system, many oppositions can be easily resolved, and, more importantly, it would prevent countless unnecessary deaths. As one may easily decide not to donate their organs while under the presumed consent policy, it does not deny a person their right to choose what happens to their remains after death. Unless we enforce this policy and a surprise setback occurs, there is no reliable reason why this could not work.


References:

Busby, C. (2010, October 16). How a simple policy change could increase organ donation. Toronto Star. Retrieved January 17, 2014, from http://www.thestar.com/opinion/editorialopinion/2010/10/16/how_a_simple_policy_change_could_increase_organ_donation.html 

Mulholland, A. (2012, May 25). Should all Canadians be automatically considered organ donors?  InCTV News. Retrieved January 17, 2014, from http://www.ctvnews.ca/should-all-canadians-be-automatically-considered-organ-donors-1.831544

Wang, S. (2013, July 4). The ethics and implications of ‘presumed consent’ organ ‘donation’ in Wales. In Bridges and Tangents. Retrieved January 17, 2014, from http://bridgesandtangents.wordpress.com/2013/07/04/the-ethics-and-implications-of-presumed-consent-organ-donation-in-wales/