News Analysis

Britain: Hearts and minds

The Church is preparing for battle over compulsory organ donation

Earlier this year Joe Ball and his family made a 500-mile round trip from Devon to Winsford, Cheshire, to visit a boy called Max Johnson. Mr Ball, 35, wept as he embraced the 10-year-old and then he took a stethoscope and put it to the youngster’s chest so he could listen to the beating of his late daughter’s heart.

His little girl, Keira, had suffered a severe head wound in a car crash the previous summer and died after three days in hospital.

Mr Ball consented to the donation of her organs and they saved four lives in total, among them that of Max who was at risk of “imminent death”, having waited 196 days for a new heart.

Their story served to alert the public to the need for organs for transplant so other people who are suffering like Max can possibly be saved too.

At present organ donation in England is running at its highest rate, with 1,169 donors and 3,293 transplants between 2016 and 2018. But according to the Government, 6,500 patients are on waiting lists and about three of them die every day.

It would be hard to imagine any reasonable person not wanting the best possible outcome for such patients, and Max Johnson’s case was seized upon by those seeking an “opt-out” system of organ donation, where people are deemed to have given consent unless they have explicitly stated in advance that they object.

Among them was the Prime Minister, Theresa May, who announced earlier this month that from next spring everyone over the age of 18 will be considered an organ donor unless they have recorded a wish not to be. Wales adopted such a system in 2015.

The aim of her policy is to save an additional 700 lives a year. No doubt her intentions are noble, yet there are other sincere voices which disagree and which have consistently urged caution.

They include a group called My Body My Gift, which argues that a system of “presumed consent” would crucially reverse the principle of medical consent, undermine bodily autonomy and assume incorrectly that the public could be aware that consent will be presumed.

The group argues that presumed consent contradicts the definition of organ donation as a choice made freely to help another person and instead is simply “the state appropriation of bodily remains”.

This view is shared by the Catholic Church, which made its opposition to an opt-out system clear through a written submission to the Government by the Anscombe Bioethics Centre, its academic institute in Oxford.

Anscombe said that taking organs without adequate consent was denounced by Pope St John Paul II in 1991 as “the dispossession or plundering of a body”.

The Catechism of the Catholic Church was also clear, Anscombe added, that organ retrieval “is not morally acceptable if the donor or his proxy has not given explicit consent”.

Presumed consent, it said, “would undermine the concept of donation, lessen respect for the human body, disregard the feelings of grieving relatives and threaten to alienate religious and other minority groups, without realistic prospect of increasing rates of transplantation”.

It also noted that the Welsh system had failed to deliver the anticipated increase in donors, with figures slightly decreasing over the last year while those in England went up.

It cannot be denied that Anscombe has a point. No evidence from any country, and indeed from Wales, can connect the introduction of presumed consent with increased organ donation rates.

My Body My Gift suggested that about 180,000 people opted out in Wales, probably because “they have taken exception to the Government presuming their consent”. It would be far more effective, My Body My Gift argues, if British politicians heeded the example of Spain and retained the present system while spending money on training medics to persuade families and individuals of the good that freely surrendering their organs for transplant surgery could do for other sick patients. Such a proposal is more likely to restore public confidence in the NHS than any efforts by the state to snatch the organs of the dead – or of the living.

Christians, Jews and Muslims would surely struggle with problems associated with the actual point of death. Take, for example, a person suffering a serious head injury but whose other vital organs are working perfectly well.

It would clearly be in the best interests of effective transplant surgery for those organs to be kept fresh, and to be lifted literally out of one living body to be placed in another.

Perhaps it may not unduly trouble a person who thinks the Ten Commandments came from man rather than God. But for those who view things differently, such practices raise the harrowing question of at what point exactly will death come – from the underlying illness or injuries, or at the point of a transplant surgeon’s scalpel?

Is it morally permissible to do evil so that good may come of it? The answer surely has to be no.

Simon Caldwell