بِسۡمِ اللهِ الرَّحۡمٰنِ الرَّحِيۡمِ
The enactment of the new opt-out organ donation law has occurred in the U.K., with implementation in Wales in 2015, England in 2020, and Scotland in 2021, as detailed by Dr. Dale Gardiner. Though commonly labelled as presumed consent, this terminology is disputed, as clarified by the late Professor Robert Veatch. Under this system in the U. K., the family of the deceased is invariably consulted before any organ retrieval is considered, with their preferences duly respected. The NHS is dedicated to accommodating the religious beliefs and convictions of individuals throughout the organ or tissue donation process. Consequently, it has become imperative for all Muslim adults to comprehend the tenets of their faith regarding posthumous organ and tissue donation, alongside the implications of the new opt-out legislation.
FAQs on the New Opt-Out Organ Donation Law
Q1. If I opt-in to the organ donation programme what are the chances that my organs will actually be donated?
A1. Only about 1% of all those who die in the U.K. die in circumstances allowing for possible organ donation. So the chances of being an organ donor after being declared legally dead are small even if you decide to opt-in.
Q2. Does the new opt-out organ donation law apply to every adult in the U.K.?
A2. No, even after the law is passed some people will be exempt. These include anybody less than 18 in England, anybody less than 16 in Scotland, someone who has not been ordinarily resident in the UK for 12 months prior to death, those who lack the capacity to understand the law, visitors, and those not living in the U.K. voluntarily.
Q3. Why has the government decided to pass this new opt-out organ donation law?
A3. The main reason is due to a shortage of organs. The majority of the U.K. population support donation (80%) but only 40% are registered donors. The opt-out law will catch those people who agree with organ donation but have not registered and make it easier for hospital staff to raise the issue. The new opt-out law is also supported by the majority of the U.K. population as a whole.
Q4. Which organs are covered by the new law?
A4. The opt-out system will only include routine transplants: heart, lungs, liver, kidneys, pancreas, small bowel, corneas, and tissue (such as skin, bone, and tendons).
The opt-out system does not cover rare or novel transplants such as limb, face, or uterus donation. A person’s family would have to give explicit permission before their loved one’s limb, face or uterus could be donated.
The donor and/ or family can also specify which organs are to be donated.
Q5. Can I nominate someone to make a decision on my behalf?
A5. If you live in England, Wales or Northern Ireland, “Yes.” In Scotland, “No.”
You can appoint up to two people to make that decision for you. If you die in circumstances where donation is possible, your appointed representative(s) will be asked if your organs should be donated. The registration process requires filling a form with physical signatures from the individual concerned, the appointed representative(s), and a witness.
Q6. Is it possible that my organs are removed and then not used for donation?
A6. Unlikely. Even if you have healthy organs, the organs will only be retrieved if a suitable recipient is found on the day that you ade declared dead. Sometimes organs are retrieved but on inspection at the transplant centre are not used.
Q7. Can I choose to whom my organs are donated so that they go to a practicing Muslim?
A7. No. The organs are given to recipients based on need.
Q8. Could my organs end up being used for research rather than transplantation?
A8. Yes, if the organs are retrieved for the purpose of donation but cannot ultimately be used, with your family's prior consent, the organs might be able to be used for research, helping advance the science of transplantation.
Q9. Can I decide which organs to donate and which ones not to donate?
A9. Yes, you can. If you don't decide your family can also decide after you.
Q10. Could my organs be used in more than one patient?
A10. Yes, if you donate more than one organ these will be given to different patients. One person can potentially save up to nine different lives through organ donation.
Q11. Could my organs be sent abroad?
A11. Yes, that is possible but not likely. Organs are offered to Europe if there is no suitable recipient found in the U.K.
Q12. If I register to donate can my family overrule my decision after I die?
A12. Your family does not have the legal right to override your decision but they will be consulted in case you had made any requests or decisions prior to your death. The wishes of the family will be respected, and, therefore, in practice, they can overrule your donation decision. This emphasises the need to share your organ donation decision with your family.
Q13. If I do not register a decision will my organs be taken for transplantation?
A13. Even though it is an opt-out system with deemed consent your family will be consulted before any decision is made to remove your organs. The wishes of the family will be respected.
The NHSBT clearly states they are committed to supporting the faith and beliefs of individuals throughout the organ or tissue donation process. In the event of your death, they will tell your family that your faith and beliefs are important, they will support your family to speak to your faith leader or a representative of your belief system, and provide information to support the discussions.
Q14. Can I dictate that my organs are only taken if I am declared dead using circulatory criteria?
A14. Yes, only by letting your family know and them making this point when the donation is discussed or by nominating someone as mentioned in A5 above.
Q15. Will my funeral be delayed if I decide to donate?
A15. No.
Q16. Can I change my mind at any time?
A16. Yes. Use “Amend my details” on the NHSBT website. You even have the option of removing your details.
Q16. How do I register my decision to opt-in or opt-out?
A33. Follow the link below to register your decision. It is important to register your decision whether you wish to opt-in or opt-out. This will make it easier on your family when you die. You should communicate your decision to close family members.
https://www.organdonation.nhs.uk/register-your-decision/
Dr. A. Hussain, Ramadan 1442
Related articles by the same author
Deceased Organ Donation in Islām : FAQs by Muslims
Presumed/ Deemed Consent in Organ Donation
The Dilemma of Brain Death for HCPs