The Royal College of Nursing has announced its formal support for an opt-out system of consent for organ and tissue donation after death across the UK.
The move follows a review of its official position on organ donation in response to planned changes to the law in England and Scotland that would mark a major change of stance.
“Our members from across the UK have given overwhelming support to an opt-out as long as clear conditions are applied”
In January, it launched a survey of views on consent for organ and tissue donation after death. It surveyed members in all UK countries for its first consultation on the issue for almost a decade.
Organ donation rates have increased significantly in the last decade, but the shortage of donors means hundreds of people die waiting for transplants each year, noted the college.
Today, the RCN stated that its members agreed there were not enough registered donors and a significant majority believed an opt-out system could help increase the number of organs available – reversing the view from the last consultation back in 2009.
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Overall, 71% of the 7,700 members who responded to the latest survey supported a move to the opt-out system. In each country of the UK, a “clear majority” supported an opt-out, the RCN said.
In addition, only 10% believed their patients had given much thought to donating organs and tissues after death, while 89% of members agreed that not enough people donated their organs and tissue.
Its professional nursing committee decided to adopt the new position, noting members’ calls that any opt-out “come with resourcing, evaluation and clear conditions attached to how it operates”.
“When people still die because suitable organ donors cannot be found, nursing staff agreed it was time to reopen the debate”
These conditions included limiting the opt-out to adults, putting in place awareness and education programmes in advance of any changes and engaging with families in the process.
As a result, the committee said it was giving its “qualified support” for an opt-out system of consent, with any change limited to adults and routinely reviewed based on the rate of successful donations.
In addition, the RCN called for an awareness and education programme for all health professionals and clear guidance on the operation of any opt-out scheme.
The survey also found that only 25% of RCN members said they felt confident enough to speak about organ donation with patients and their families, highlighted the college.
Legislation to introduce opt-outs in England and Scotland is set to be debated during 2018.
A private member’s bill in Westminster received initial parliamentary support in February. If ultimately passed, it would bring England into line with Wales where a soft opt-out system of consent for organ and tissue donation was introduced in 2015.
Scotland is expected to introduce similar legislation in the next few months. However, attempts to introduce opt-out legislation in Northern Ireland failed in 2016.
But the RCN warned that, before any opt-out system is introduced, the relevant governments must increase investment in the number of specialist nurses in organ donation.
Governments must also launch public awareness campaigns no less than a year before any change and continue campaigning to ensure individuals know how to opt out, said the college.
Janet Davies, RCN chief executive and general secretary, said: “When people still die because suitable organ donors cannot be found, nursing staff agreed it was time to reopen the debate.
“Our members from across the UK have given overwhelming support to an opt-out to give countless people awaiting transplants a fighting chance, as long as clear conditions are applied,” she said.
“Where individuals feel strongly, for whatever reason, they must be supported in opting out,” noted Ms Davies.
She added: “Where governments pursue an opt-out anywhere in the UK, we will ensure our members’ views are heard and will call for the system to be communicated clearly with the public and health professionals.”
The new RCN position statement on consent for organ and tissue donation has been published on the college’s website.
The survey was anonymous and open to all RCN members. It was available on the RCN website from 15 January until 11 February 2018.