Some would argue that it is simply unequivocal that removing consent in organ procurement is unethical and defies the pillars of modern medicine and human rights. Undoubtedly, there is a serious, horrifying problem with the amount of people awaiting transplantation, yet depriving people of autonomy over their body and removing their ability to express views against it for religious reasons is immoral.
Clearly, consent is the basis of the pillars of medical ethics and it is the defining factor separating modern healthcare from the archaic paternalistic practice. Removing the requirement for consent in organ procurement removes the right over our own bodies and contradicts the basic core values of the NHS and all healthcare practitioners, who should aim to provide patient-centered care that is sensitive to their preferences and what they are comfortable with. In what other medical situation would we claim that consent was not needed? Would doctors then be able to enforce certain treatments, would we not recognise a patient’s wishes in terms of palliative care and would we ignore legal documents such as “Do not resuscitate” where patients are also deceased? Consent is such a powerful tool for a patient’s holistic care, which is why there is so much emphasis on Gillick-Competence and capacity to consent in all aspects of medicine, as well as law. Obviously, we are in desperate need of organ donations, it is undeniably a pressing issue yet we cannot relinquish the basic principles of medicine and defile the trust that patients and families place in healthcare practitioners to value their wishes and dignity in their time of need.
Removing patients’ ability to consent is unethical. Undoubtedly, donors have an amazing ability to save lives but are our rights really suddenly meaningless after death? A paper by Ulster Medical Journal found organ donation without consent in the donor’s lifetime violates three sections of the European Convention on Human rights: Article 3 as it is inhumane if consent is not obtained during their lifetime, Article 8, which is the right to family life and privacy as spousal rights would be removed and Article 9 as freedom of thought and religious beliefs may be ignored.Undoubtedly, we must look to increase the number of organ donors but this is a dishonourable and ill-thought out method of achieving it that could never succeed in the modern world where our human rights are so rightfully valued.
Not only does unconsented organ procurement strip away the dignity and rights of the donor, it could also be a harrowing ordeal for a newly grieving family. At such a vulnerable time in their lives, loved ones may have to face the ethical dilemma and injustice of their deceased relative’s views being ignored and their consent seen as worthless. If we not only disregard the views of the patient concerned but also their family, the detrimental ethical implications are endless. Do we then not value next of kin’s wishes in cases of life support or palliative care, will parents and guardians lose the ability to consent on behalf of their child in certain situations? Consent is the basis to all decision making and laws surrounding medicine, surely it is clear that disregarding it is a ludicrous suggestion? How can we suddenly say that those whose religions strictly prohibit organ donation, such as Hindus and Jehovah’s Witnesses, rights to freely express their religious views are no longer valid?
The knock on implications of removing consent for organ procurement are deeply worrying. Would organs always automatically be harvested even if they may not end up being required? How can we then prevent a black market for donated organs if doctors themselves are trivializing the importance of consent and valuing the ethical issues surrounding the very private issue of donations? Rather than creating unpopular obligations that the public will protest against, why not give the assumed consent system longer to see its effect (as it was only introduced in May 2020) and then look to continuous and more in depth education about donation rather than removing our rights to the choice.
90% of the UK’s public claimed to be in favor and we are constantly seeing scientific and medical wonders relating to organ transplantation, for example the first successful pig kidney being transplanted into a human in the US just months ago. Why take the rash and unethical decision to remove patients’ autonomy when we can look to more constructive methods of winning support and true understanding about the transformative nature of organ donation, ensuring real support for the cause into the future.
Sophie Farr, Youth Medical Journal 2022