Culture change needed for move to opt-out organ donation system, MSPs told

There must be a change in the culture around organ donation if Scotland is to move to an opt-out system, a Holyrood committee has been told.

MSPs heard evidence from experts on Tuesday as they consider legislation that would mean a person’s consent for donating is presumed unless they have stated otherwise.

Currently, individuals must opt in to the organ donor register.

If passed, the Human Tissue (Authorisation) (Scotland) Bill would follow legislation introduced in Wales in 2015, which allows parts of an adult’s body to be used in transplants in the absence of express permission.

There has been debate over how much say a family will have in choosing whether or not to allow their relative’s organs to be donated.

Organ opt-out law
Organ opt-out law

Dr Emily Postan, from the University of Edinburgh, told the committee it could be difficult to implement the law if health professionals are encouraged to acquiesce to the wishes of family members rather than following those of the deceased individuals.

She said: “If it’s going to be hard to make that change then that’s a real problem for the success of this law because it’ll be saying one thing and something else will be happening.

“That will serve to undermine the importance of anything that’s like consent or authorisation, which is full information and full understanding of the undertaking that you are signing up for when you’re opting in or opting out.

“So if the law cannot function the way it is written because the culture is too hard to change, that strikes me as a real problem.”

Dr Postan added the attitude towards organ donation must support the proposed new system if the legislation is to be successful.

“For the Bill to work as it’s written, that culture change needs to be supported,” Dr Postan said.

“It needs to be supported in the healthcare setting, it needs to be supported in the changing of social norms and public awareness, and publicity of the significant change that this bill as drafted that it is the wishes of the deceased person cannot be overturned by the wishes of their family, only by what their family can bring to bear in terms of evidence that their wishes have changed.”

Professor Alison Britton, of the Law Society of Scotland, agreed the plan to move to a new system must have backing from the public.

She said: “The legislation alone is not going to be enough. The idea of a cultural change in people’s attitudes needs to accompany this.

“There has to be buy-in, there has to be an understanding, there has to be an education.

“What you’re doing is fundamentally changing an active process of opting-in to arguably a more passive process.

“To be able to get the support that that’s how this is going to be, has to involve the support of families, has to be brought about by education understanding that we’re putting forward a fundamental change in culture and approach here”.

Public Health Minister Joe FitzPatrick acknowledged a need to inform wide ranges of communities about any change to the system of organ donation.

An information campaign has previously been suggested, which could include presenting information in different languages and communicating the information effectively to people with disabilities.

Mr FitzPatrick said: “There is a need for us to have a strong publicity campaign to encourage people not just to get on the donor register but to make sure they have that conversation with their family.

“We obviously need to work with all of our partners to make sure that the messages reach the widest possible groups of people.

“We’ve agreed to work with religious groups to make sure that if there is particular issues there that we can make sure that people understand what the legislation means.”