Welsh 2013 deemed consent legislation falls short of expectations

• Published in: Health policy (Amsterdam) 2018-09, Vol.122 (9), p.941-944
• Main Author: Parsons, Jordan Alexander
• Format: Article
• Language: English
• Subjects: Biological organs; Blood & organ donations; Brazil; Consent; Donors; Expectations; Health administration; Health care policy; Health Policy; Humans; Legislation; Organ donation; Policy development; Policy making; Presumed consent; Presumed Consent - legislation & jurisprudence; Rates; Spain; Statistics; Tissue and Organ Procurement - legislation & jurisprudence; Tissue and Organ Procurement - statistics & numerical data; Transplantation ethics; Transplants; Transplants & implants; Wales
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2018.07.019

•Wales introduced deemed consent for organ donation, hoping to improve donor rates.•Improved donor rates in Spain, where presumed consent exists, were supporting evidence.•A recent Welsh Government report has shown no improvement in donor rates.•Alternatives to legislative change are now being more seriously considered.•Presumed consent support in England remains significant despite no improvement in Wales. Wales, in 2013, was the first country in the United Kingdom to pass legislation introducing presumed (or deemed) consent for organ donation, and remains the only one. It was introduced in an attempt to increase the number of life-saving transplants taking place in the UK, in a move that policy makers hoped would mirror Spain’s success. More recently, pressure has been mounting for England to follow suit, with a public consultation currently in progress. However, the Welsh system has been far from a success, raising the question of why campaigners are so adamant that it should be replicated. Before the Welsh Government introduced the Human Transplantation (Wales) Act there had been no strong evidence to suggest it would make a difference, with countries boasting both high organ donation rates and presumed consent legislation demonstrating no clear causal relationship between the two facts. In addition, a recent report evaluating the Act has highlighted its failure to improve donation rates, and has even presented some potentially concerning statistics that may suggest a negative impact. This paper first considers presumed consent in other countries – Spain and Brazil – before illustrating the underwhelming progression of Wales’ new system and the need to look to other options.