LATEST NEWS Making Organ Donation the Norm in Ireland

We hear that the Human Tissue Bill 2022 may be passed before the end of the summer. This is great news for those with CF awaiting any form of transplant, with the introduction of a new organ consent that has proved so effective in other jurisdictions including the UK and Spain. CFI has been at the forefront of this change as part of the Irish Donor Network.

Despite much public goodwill towards organ donation in Ireland, second to no other country in Europe, combined with excellent clinical expertise and dedication, organ donor and transplant rates in Ireland are below average when compared with our European neighbours. Ireland was only in 18th place out of EU28 for transplants in 2020 and only in 17th place for deceased organ donation that same year.

The national transplant programmes in Ireland are undertaken in three hospitals - the Mater Hospital (heart and lung); Beaumont Hospital (kidney) and St Vincent’s Hospital (liver and pancreas). These programmes further rely on the support of all major ICU hospitals around Ireland and for coordination by the Office for Organ Donation and Transplantation Ireland (ODTI).

Action is needed to move Ireland into the top 10 EU countries for donation and transplantation. In this context, The Irish Donor Network supports the introduction of Soft-Opt-Out organ donation consent in the Human Tissue Bill.

Consent and Consultation

Currently, the decision on organ donation in respect of a deceased person rests entirely with the next of kin, including where the deceased person held an organ donor card or had indicated their wish to be an organ donor on their driving licence. These efforts have been worthy and should continue as awareness initiatives, but they are no longer adequate on their own.

Under the proposed opt-out system, all adults in Ireland will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate on an opt-out register, or are in one of the six identified excluded groups, which provides important protections for vulnerable people.

This consent system will apply to the donation of the heart, lungs, liver, kidneys and pancreas (solid organs). A separate consent process will be undertaken for the donation of other organs or for tissues and cells from deceased donors.

The next of kin will continue to be consulted before any action is taken, and the wishes of the deceased should be central to this decision. Soft-Opt-Out differs from Hard-Opt-Out in relation to the point of consultation with next of kin. In the Hard-Opt-Out approach (not envisaged for Ireland) next of kin would not be consulted.

A Soft-Opt-Out Organ donation system relies on people knowing about their options and being able, easily and quickly, to opt out if that is their wish through a secure Online Register. It is not about forcing people into donation. It is about making it as easy as possible for an individual’s willingness to donate organs after their death to be acted upon.

One organ donor can potentially save seven lives. There are also benefits to recipient families and Irish society in general, including the Irish health system and the wider economy in promoting transplantation and working towards the most effective organ donor system possible. As Minister Donnelly stated to the Oireachtas at the second stage of the Human Tissue Bill in January 2023:

"In all scenarios, family members will continue to be consulted before donation takes place. The wishes of the deceased should be central to the decision but if the family objects to the donation, then it will not proceed. I want to be absolutely clear that in no way does the move towards an opt-out approach mean that individual choice on this most sensitive issue is being threatened or eroded. Those who object to organ donation, for whatever reason, will be able to record their objection on a new register that will be established under the legislation. In such cases, their wishes will be respected and their family will not be approached on the issue of organ donation. It will be possible for individuals to remove their name from the register at any time.

"The Bill also provides a framework for living donation."

The Bill is now heading to the report stage and CFI will be active in briefing Oireachtas members on why this important legislation should be supported.