‘Presumed consent’ organ donation in Guernsey now in force

A new ‘presumed consent’ system for organ donation has come into force in Guernsey following legislation that was passed in 2020.

Under The Human Tissue and Transplantation (Bailiwick of Guernsey) Law, from 1 January 2023 adults are automatically registered as organ donors unless they explicitly opt out. Previously, individuals had to opt in if they wished to donate their organs after death.

The law follows similar legislation brought into force in England, Scotland and Wales over recent years. Northern Ireland’s presumed consent system is due to begin this Spring.

Families

Anyone who has not opted out will be deemed to have given consent under Guernsey’s new law, although its Government has claimed that family members will “always be consulted”.

a lack of clear supporting evidence

The Committee for Health & Social Care’s Code of Practice states that where the family provides information that “would lead a reasonable person to conclude that the potential donor would not have consented” then organ donation “must not proceed”.

Children under 18 years old, adults who have lived in Guernsey for less than a year and those deemed to “lack capacity” are excluded from the new scheme.

‘Lack of evidence’

In 2021, academics reviewing opt-out proposals in Northern Ireland, observed: “Despite a lack of clear supporting evidence, it is often suggested that deemed consent will contribute significantly to addressing the organ shortage.”

Writing in The Lancet, Jordan Parsons and Bonnie Venter said: “Countries with both deemed consent systems and high transplantation rates, such as Spain, are often looked to in evidencing the promise of deemed consent.

“However, it is important to recognise that the success of the Spanish system is more a result of investment in education and organisation”.

They added: “Indeed, it was not until these organisational changes came 10 years after the introduction of deemed consent that deceased donation activity in Spain began to markedly increase.”