Stephen J Wigmore: Organ consent a tough call

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The demand for transplants continually outstrips the supply of donated 
organs, meaning that every year people die for want of a transplant.

This saddens the medical community because we know many more lives could be saved.

Transplantation is a unique branch of medicine because there is no other area where the treatment of patients is so entirely 
dependent on the support of society. The transformation in health of individuals who receive a transplant is often amazing and transplants not only save lives but allow people to work, study, have children and make all the normal contributions to society that, as healthy 
individuals, we all expect. and enjoy.

In practical terms, presumed consent means that it is presumed that an individual would want to donate their organs (if they were to die in circumstances which permitted this to happen) unless they had stated a contrary view in life. In the UK, donation of organs has always been considered as a gift freely given without conditions. The issue of presumed consent has been said to challenge this notion and this is where some of the arguments against presumed consent have come.

The Organ Donor Taskforce made a number of recommendations which have been implemented. over the past few years. These changes have improved donor identification and management across the UK and also improved donation numbers.

The medical teams involved in transplantation have a conflict of interest and do not want to be 
directly involved in soliciting a decision for presumed consent. What we can do is make clear the huge health benefits of organ donation and transplantation.

• Professor Stephen J Wigmore is clinical director of general surgery and transplantation at Edinburgh Royal Infirmary