You don't need to be signed in to read BMJ Group Blogs, but you can register here to receive updates about other BMJ Group products and services via our Group site.

Give the gift of giving – donate someone elses organ or how the current online system for organ donation allows you to sign up others as long as you know a few details about them. Oops.

23 Apr, 12 | by David Hunter

Hattip to Nathan Emmerich for speculating about this on Facebook and then blogging about it here: Organ Donation: Why isn’t there an App for that?

There are a number of ways you can volunteer to donate your organs when you die in the UK, you can sign up when you get a drivers license, you can even sign up when you get a rewards points card at Boots – a pharmacy chain.

You can now sign up online to donate your organs directly at the NHS website, but as Emmerich points out there seems to be a gaping hole in the current system’s security. It appears that the only information you have to provide to prove your identity is your name and date of birth – both relatively easy pieces of information to find out. This means that you could sign up anyone as long as you have this information. They do send out a letter to confirm their consent but seeing as you can enter any address this doesn’t seem to be likely to prevent potential abuses.

I’m honestly surprised I haven’t heard about this already from the Daily Mail, it seems such an obvious and easily criticisable mistake for the NHS to make. Perhaps they don’t have any stock images of people looking confused as their organs are being removed…

Still now that we are here let’s discuss organ donation. There is considerable debate about whether we ought to have an opt in or opt out system of organ donation – this appears to be a new option “an others opt you in system…” And there doesn’t seem to be any way to change your mind and opt out using the online system. This seems well short of any appropriate standard of informed consent, or a useful system for organ donation.

Personally I suspect there is much to recommend changing the default setting to organ donation rather than not donating – think of it as nudging if you will. Certainly if this is all that respecting autonomy requires a robust opt out system will not violate it.

That said I suspect rather than concentrating on the head line question of opt in vs opt out, a fair number of lives could be saved simply by refining and improving the current system.

This also seems to present a moral dilemma for any consequentialists out there, think about all the lives you could save by volunteering your friends organs…

So what kind of system should we have for organ donation?

By submitting your comment you agree to adhere to these terms and conditions
  • http://twitter.com/BioethicsUK Nathan Emmerich

    Hi David, you do need the right address as this is also checked against the NHS patient register. So it is not entirely open to abuse… Nathan

  • David Hunter

    Well that takes some of the edge off – although I’d be interested in testing it to see whether that is the case, since patient’s addresses are often not up to date. In any case, it does allow you to switch your friends to opt out rather than opt in
    .

  • http://twitter.com/BioethicsUK Nathan Emmerich

    I dunno how up to date peoples addresses are. The NHS registry will be updated if you move GP surgeries, but some might move, stay with the same GP and not let them know. Also, I am not sure you can *withdraw* from the registry online (arguable you should be able to). It seems you can only register as a full or partial donor. I think you need the same info to withdraw over the phone though, so the point stands. 

You can follow any responses to this entry through the RSS 2.0 feed.

Latest from JME

Latest from JME

Blogs linking here

Blogs linking here