New Bill will introduce presumption of consent for organ donation

Altruistic kidney donation will be permitted in Ireland for the first time as part of new legislation on organ donation to be published on Thursday.

The Cabinet on Wednesday approved proposals by Minister for Health Simon Harris to publish the general scheme of the HumanTissues Bill which will also provide for an opt-out system of organ donation.

The draft legislation will regulate the removal, retention and disposal and also set out the conditions for organ donation and transplantation from both deceased donors and living donors.

A key change which will be brought about by the new law will be an opt-out system of consent. It will mean that for the first time it will be presumed that the deceased person had consented to donate major organs, including kidneys, heart, lungs and liver.

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Under the present system the decision rests with the next-of-kin even where the deceased person had an organ donor card or indicated their wish to be an organ donor on their driving licence.

The new system will presume consent unless the deceased, whilst still alive, had specifically stated they did not want to donate organs. There is a “soft” element to the change, in which the next-of-kin is still consulted and, if they object, the donation does not proceed.

The draft Bill will also provide for non-directed altruistic kidney donation. Until now people who have wished to make “living” donations of kidneys have had to do so outside the State.

Speaking after Wednesday’s Cabinet meeting, Taoiseach Leo Varadkar welcomed the changes that will allow opt-out consent, as well as altruistic donation, in Ireland for the first time.

Missed deadlines

The long-promised legislation was first recommended 12 years ago, and has consistently missed deadlines for publication since then, including one set by Mr Harris for early 2018.

The proposed legislation arose out of recommendations made by the Madden Report in 2006. That committee, chaired by UCC law lecturer Dr Deirdre Madden, examined practices where organs were removed from the bodies of deceased children and infants without the consent of their parents. The report laid down a framework to obtain the consent of parents and next-of-kin.

The latest figures for organ donation in Ireland show that the number of deceased who donated organs fell from 99 in 2017 to 80 last year. It allowed 231 transplants to be carried out in 2018.

Ireland remains one of a few EU countries not to have an opt-out system.

Transplant surgeon Prof Jim Egan of the Mater Hospital, and chair of Organ Donation and Transplant Ireland, welcomed the imminent publication on Wednesday night.

He told The Irish Times: “The Human Tissue Bill is an important milestone for organ donation and transplantation in Ireland. Organ donation saves lives. In 2018, 274 lives were saved by organ donation.

“We look forward to enhanced infrastructure with specialist nurses to support families who participate in organ donation.”