Presumed consent in England and Scotland? One in ten people refuse to donate their organs

Publié le 19 Nov, 2018

Following on from Wales, which adopted this system in 2015, the British government is considering changing the organ donation system in England and Scotland to switch to presumed consent by 2020. The aim, which is highly commendable, is to increase the number of organs available. This is particularly relevant today because whilst 90% of the UK population support organ donation, only 38% of British people are actually on the organ donation register.


Presumed consent assumes that the person in question has consented to organ donation unless they have indicated otherwise. And, after all, the government proposal still gives families the option to refuse donation.


Led by Doctor Jordan Miller, researchers at Stirling University interviewed 1,202 people and found that one in ten (9.4%) plan to opt out of organ donation in this context. This was attributed to significant emotional barriers with those interviewed finding it difficult to think about their own death or expressing disgust about organ donation. The biggest obstacle is that “organ donation would violate the physical integrity of the body”, explains Jordan Miller, the lead physician.


The work doesn’t stop there. They are also thinking of how to change people’s mind-set. Factual organ donation campaigns actually have minor impact when it comes to changing how individuals perceive the subject. Such campaigns are therefore unlikely to alter perceptions and attitudes in the attempt to boost the number of donors. And that’s precisely what it’s all about. A stronger focus on feelings and emotions should steer campaigns closer to their target and increase donor intention.


Whilst the countries are changing, methods have reached stalemate… Most surprising of all is that, to reach a target, it seems normal to implement measures that will gradually alter the way people think especially when the aim is clear-cut from the outset.

Is it really ethical to target the clear conscience or feelings of a population to reach a desired goal? An influential tool or a tool for propaganda—couldn’t the compassionate argument (see “Modern man has a hard heart and sensitive stomach” (Bernanos)) be open to abuse?


For further reading:

Organ donation: the “ethical weakness” of presumed consent

Sylviane Agacinski: “The law should not lose its civilising mission” when confronted with bioethical issues

Sylviane Agacinski: Organ donation, “leave the body outside the marketplace – the body is not a commodity”

Sylviane Agacinski: “Technical progress is certainly on par with the fear and trepidation of social alienation”

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