Plan for presumed consent law could see an increase in BAME organ donors in England

A new organ donation system is being discussed in Parliament and could be introduced as a way to increase the availability of organs and decrease waiting time for transplants.

This means people’s organs could be used when they die unless they expressly said otherwise. 

The law would change the current opt-in system to an opt-out system and potentially help the shortage of BAME donors.

An organ donation box. Photograph: Getty Images

Ethnic minorities are disproportionately represented in the UK for organ donation.

From the NHS Organ Donation and Transplantation Data for BAME Communities 2016/17, only 6% of organ donors in the UK are Black, Asian and minority ethnic (BAME), which makes it difficult to find suitable matching organs for these patients on the transplant list.

Just like with blood donation, blood and tissue types differ across ethnic groups so transplanted organs will last longer in the recipient if they receive the best matched organ.

There is a higher burden of kidney disease and diabetes associated with BAME communities, and therefore a demand for kidney transplantation.

But these groups wait on average, six months longer for a kidney transplant than a white patient.

The British Transplantation Society (BTS) is in favour of the possibility of new legislation.  They said: “It is clearly beneficial, as it will achieve more organs available for transplant whilst not imposing on the individual’s right to choose whether or not to be an organ donor.”

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The BTS is concerned however that any change in the law where consent becomes the default could be a disincentive for people to view organ donation positively.

Ndazi Bambi, 19, from Hertfordshire, is against the proposals.  She said, “I don’t like the idea of it, it makes it seem like human bodies are a commodity which I don’t believe is ethical.  The only people who can be a valid organ donor are those who voluntarily give them away.”

Anyone wishing to donate their organs has to opt in under the current system via the organ donor card scheme run by NHS Blood and Transplant. A family member can also agree to the donation of organs if the person had not made their wishes previously known.

Under the new system, people who are against the idea of presumed consent would be able to opt-out.

The BTS believe that trust is a key factor for people especially from ethnic backgrounds about their decision to donate.

Fiona Loud, Policy Director at the charity Kidney Care UK, also agrees.  She said: “Not all communities trust doctors depending on their own heritage.  It’s right to say that people don’t always trust the doctors to do the right thing for them. Depending on your own level of education, your trust may be greater.

“If you’re third generation, you might be quite happy and trusting because you’ve grown up in Britain and you understand how the NHS works. But if your grandparents came from a different culture and their parents opposed organ donation, that can pass on.”

Similar to blood donation, myths, a lack of education and awareness about how important ethnicity is with organ donation could be a contributory factor as to why there is a lack of BAME donors.

Fiona believes younger people can change this.

She said: “Young people are change makers, we need to encourage them to talk to their grandparents and parents about it.”

Wales has had a presumed consent system since 2015 and has consequently seen an increase in organ availability.

The Organ Donation (Deemed Consent) Bill 2017-19 is currently in the committee stage in Parliament.