Consent Authorisation

Opinion polls suggest that as many as 90% of the UK population support donation and transplantation. However, another measure of society’s support for donation – the family consent / authorisation rate - hovers around 60%, with this shortfall perhaps reflecting the difference between what an individual might wish to happen after their death and the reality that faces a grieving family. An increase in consent/authorisation rates to 85% would deliver almost five hundred additional donors annually, and as a result is widely regarded as the element of the donation pathway most in need of improvement. It is also an element that for most parts of the UK has hitherto proven stubbornly resistant to change.

There are three broad and complimentary approaches to increasing consent rates for organ donation – alteration of the way in which donation is raised with a family, promotional behaviour change strategies that seek to improve the public's support for donation and legislative reform that might 'reset' societal expectations. A system of 'deemed consent' for organ donation was introduced into Wales in December 2015; for more information on this click here.

Figure 1

UK consent / authorisation rates for donation after brain-stem death (DBD) and donation after circulatory death (DCD)

Family refusal rates are the biggest single identified obstacle to organ donation in the UK. Interventions to reduce refusal rates should be a priority for all donation committees and collaboratives. If the introduction of an opt-out system into Wales proves successful, it is possible that similar frameworks may be adopted elsewhere in the United Kingdom.

Next section: Donation After Brain-stem Death

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