Informed consent

The Irish Kidney Association wish to clarify and explain its stance that informed consent should remain as the position for Irish organ donation with modifications and investment in donor coordinators.                          

In January, '08, the UK Department of Health published a report from their Organ Donation Task Force with 16 recommendations for changes to improve Organ Donation in the UK by 50% over the next five years.   These changes did not include moving to presumed consent, and the Task Force undertook a subsequent examination, and reported in September '08.  Again, their recommendations did not include changing the law to presumed consent. 

Embedded in this report are changes and improvements for the UK, many of which could be adopted by the Irish Health Service. The lobby debate in Ireland on presumed consent is incorrectly using the Spanish model of transplantation as a basis for its arguments.

When you look at the Spanish model for organ donation, you see the best figures in the world. The Spanish have a presumed consent law - but they do not use it in practice. This is the reality on the coalface in all European countries with presumed consent laws. It is unworkable and no intensivists (people working in intensive care units) are prepared to go against the wishes of the next of kin, regardless of the laws of the land.

The Spanish have a similar 'refusal to donate' rate of 15% to Ireland. What they have that we do not have is fully-trained donor coordinators in every acute hospital. These people are active in looking for organ donor opportunities throughout their hospital, not just in the Intensive Care Unit but also in Accident and Emergency, high dependency and other departments. The Spanish know that this is what is making their donor rates the largest in the world - not the unworkable law. The other good donating countries, Austria and Belgium, have also adopted the Spanish model of organisation. Their people equally agree that it is not the change in the law, rather the change in clinical practice that has made the difference in improving organ donor numbers.

To know the full views of the IKA's stance on the debate read the Chief Executive, Mark Murphy's recent address at a conference held at the Coach House in Dublin.   This is available on the ww.ika.ie

The UK Task Force report is available from:  http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_090312