Organ 'opt-out scheme needed'

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THE serious shortage of organs for surgical transplants can only be addressed by introducing a radical 'opt-out' system, government advisers said yesterday.

Surgeons should assume that they have permission to remove organs from a dead patient unless they are aware of a specific refusal, the Advisory Council on Science and Technology (Acost) recommends in a review of medical research.

A move to an opt-out system similar to those of Belgium, France and Austria, instead of the present procedure where written permission from donors is required, should significantly improve the supply of organs, the advisory council says in a report to the Cabinet Office.

'Since past measures to increase organ supply have failed, radical actions need to be considered,' the report says.

Dr Peter Doyle, the chairman of the council's medical research and health committee, said that changing the present arrangements for organ donation would alleviate 'the chronic shortfall' of donors in Britain.

Fewer than a fifth of possible recipients received kidney transplants in 1992, he said. 'Not one kidney transplant in 1990 was done from a person carrying a donor card so we have to think of something better.'

The chronic shortfall of organ donors means that patients are not receiving the full benefits of new medical techniques in tissue transplants and gene therapy, the advisory council says.

Acost wants the Government to introduce several additional policies that would increase the

uptake of developments in medical science. Its recommendations include:

A nationally co-ordinated programme of screening the public for diseases to ensure equal availability of testing services throughout the NHS.

Government initiatives to foster the development into commercial products or services of medical breakthroughs in the NHS.

The introduction of a year's grace between publication of research and filing a patent on a potential product, which would protect many British inventions from exploitation by foreign companies.

Assessment of new surgical procedures in a more rigorous and controlled fashion to gauge the benefits to patients and the cost to the NHS.

Dr Doyle said it was necessary for the Government to introduce a 'more evaluative culture' into the NHS to assess the benefits of new and expensive medical technology.

The advisory council intends to follow up its recommendations in 12 months 'to chart progress'.

A Report on Medical Research and Health; Acost; HMSO; pounds 13.