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 Despite his own task force having said that it will not succeed, UK Prime Minister Gordon Brown has said he will not give up on a plan that would see every person in the UK automatically registered as an organ donor.

Brown said of the task force and his plan, “While they are not recommending the introduction of a presumed consent system, as I have done, I am not ruling out a further change in the law.” The PM indicated that the government would “revisit” the question at the end of the “next stage” of the campaign.

Brown’s plan is to implement a system of “presumed consent,” meaning that every person in the UK would be considered a potential organ donor unless he or she specifically opted out or relatives objected. Brown maintains that it is only with presumed consent that the problem of the availability of organs for transplants can be solved.

The taskforce, however, said that a presumed consent system would do little to increase the number of transplants. Elisabeth Buggins, chairman of the Organ Donation Taskforce, said the group was concerned that an opt-out system could prevent implementation of an improved public awareness campaign. She also told the BBC there was worry among doctors that the families of patients might feel pressured to donate. She also added that presumed consent would change the donor-recipient dynamic for the worse.

“People who have received an organ said that the concept of a gift — of that organ being freely given by the family, by the donor — is very important to them,” she said.

To bring in presumed consent, the government would need to amend the Human Tissue Act of 2004, a plan that is supported by the British Medical Association, the Royal College of Surgeons and the Royal College of Pathologists.

While the task force had little to say about the ethical problems of presumed consent, and nothing to say about the ethical problems that continue to surround organ donation itself, John Smeaton, director of the Society for the Protection of Unborn Children (SPUC) has warned that such a system could directly threaten the lives of Britons.

Smeaton, writing on his blog in January, cited an International Forum on Transplant Ethics that proposed that lethal injections be given to people who are long-term unconscious, in so-called persistent, or permanent, “vegetative states,” and for whom life has been deemed “unworthy of living.” It is argued that such injections could produce better-quality organs than if the person died naturally.

“Donation of anything,” Smeaton wrote, “is customarily based on consent.”

“They are, after all, my organs. However, in an opt-out system, where most people's wishes are unknown, consent is absent and you can't really speak of organ donation any more.”

“An opt-out system,” he said, “also represents a high level of interference by the state in personal life. The dead person's body effectively becomes government property.”

Others have pointed out that the recently passed Human Fertilisation and Embryology (HFE) Bill already brings the concept of presumed consent into British health law. Keith Cardinal O’Brien, Archbishop of Edinburgh, said that Schedule 3 of the bill “enshrines the concept of ‘presumed consent’ in UK law,” meaning that the bill would allow the removal of tissue from mentally incapacitated adults or children, without their specific consent to be used to create cloned human embryos.

In a recent speech the Cardinal compared these provisions of the HFE bill to certain activities of the Nazis. “The proposals in this Bill,” the cardinal famously said, “represent a breach of 50 years of ethical medical research.”

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[17November08, Hilary White, LONDON,]