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UK Transplant Laws

Scotland

On the 11 June 2019, the Human Tissue (Authorisation) (Scotland) Bill was passed by the Scottish Parliament. The Bill will provide for a system of 'deemed authorisation' for organ and tissue donation for transplantation purposes. This is commonly known as an opt out system. The Bill amends the Human Tissue (Scotland) Act 2006 which provides for the existing opt in system. It is expected that the Bill will receive Royal Assent in Summer 2019.

Under the proposed opt out system, most adults aged 16 years and over will be considered to be willing to donate their organs and tissue when they die, unless they have recorded an opt out decision, or otherwise stated that they don’t wish to donate. Certain groups of people will not be subject to the new law including:

  • Those under 16 years of age
  • Adults who lack capacity to understand the new arrangements (for example, someone with dementia)
  • Those who have been resident in Scotland for less than 12 months

They will continue to be able to donate if they have authorised donation themselves, or if authorisation is given by a family member where it is known that the person would not have been unwilling to donate.

Only around 1% of people die in circumstances where organ donation is possible, usually in intensive care. These are usually patients who no longer have activity in their brain stem due to a severe brain injury or the irreversible loss of function of the heart and lungs after a cardiac arrest.

Donation remains an act of great generosity. Importantly, under the opt out system people will still be able to make a choice about donation. The Bill includes the following options:

Opt in - people will be able to record their decision to donate via the Organ Donor Register.

Opt out - people will be able to record their decision not to donate via the Organ Donor Register.

Deemed authorisation - If a person who dies in circumstances where they could become a donor has neither opted in, nor opted out, they will be considered to be willing to donate their organs/tissue and may have their authorisation deemed.

The support from donor families is incredibly important to the success of donation and that will continue to be the case under the opt out system. The Bill does include safeguards which mean that a potential donor’s family or friends will be asked about their loved one’s latest views on donation.

The safeguards enable families or friends to provide information about the deceased's latest views. The Bill also enables information to be provided about what the potential donor’s views would be in the particular circumstances. This is to take into account the fact that some people might have different views about donation depending on the circumstances of their death, for example for religious reasons. These safeguards are included in the Bill to ensure that it is the potential donor’s views which establish whether donation is authorised and to ensure donation doesn’t go ahead where the donor would have been unwilling to donate.

For more information read Your questions answered

England

From spring 2020, all adults in England will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups. If there is no recorded decision for you on the NHS Organ Donor Register, it will be considered that you agree to be an organ donor when you die.

Organ donation remains an act of great generosity. Adults covered by the change in the law will still have a choice about whether they want to be an organ donor and their families will be consulted about donating their organs when they die.

More information: https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-england/

Wales

The legislation for Wales is ‘deemed consent’. This means that if you haven’t registered an organ and tissue donation decision (opt in or opt out), you will be considered to have no objection to becoming a donor. If you want to be a donor, you can either register to be a donor (opt in) on the  NHS Organ Donor Register or do nothing.

You can still opt in to the register if you want to do so, but it is not required in order to give consent for donation. You can also nominate up to two representatives to make the decision for you. These could be family members, friends, or other people you trust, such as your faith leader. This legislation was introduced in December 2015.

More information: https://gov.wales/organ-donation

Northern Ireland

The current legislation for Northern Ireland is to opt in to organ and tissue donation; you can do this by joining the  NHS Organ Donor Register  and sharing your decision with your family. You can also record a decision not to be a donor.

You can also nominate up to two representatives to make the decision for you. These could be family members, friends, or other people you trust, such as your faith leader.

Following detailed consideration of the issue, the Northern Ireland Assembly decided in 2016 not to proceed with any changes to the basis of consent for organ donation.

More information: https://www.organdonationni.info/