Leading article: Time for 'opt-out' organ donation

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Each year in the UK, between 500 and 1,000 people die from kidney failure because of a shortage of organs for transplant. We have tolerated this avoidable loss of life for decades.

That is not to say that transplant rates are not improving. Far from it; there has been considerable progress in recent years. The longest-ever kidney transplant chain, reported in this newspaper today, is a case in point.

In the US, some 60 operations completed over four months allowed 30 patients with renal failure to obtain new organs. All the patients in the chain had loved ones prepared to donate an organ, but with whom they were themselves ill-matched. To solve the problem, the National Kidney Registry devised a meticulous plan linking everyone together so that each donor could give and each recipient receive, without doing so directly from or to each other.

Here in Britain, however, NHS Blood and Transplant says that although it has "aspirations", it is not yet ready to host such extensive transplant chains. But there is still much more that could be done.

The requirement for driving licence applicants to say if they would be prepared to donate their organs could be extended to other documents, for example. Or the search for donors could be extended from intensive care to accident-and-emergency departments, where the wider availability of CT scanners means patients admitted with brain damage following a stroke can be readily assessed. The measure likely to have the biggest impact, however, would be to replace Britain's "opt-in" policy – which requires individuals to signal their willingness by joining the National Donor Register – with an "opt-out" policy that assumes all are donors unless they specify to the contrary.

The proposal was rejected by the Government in 2008 on the grounds that an opt-out system was paternalistic, ran counter to the emphasis on choice, and could even damage the trust between patients and doctors. We disagree. Rather, it would establish a culture where donation is simply normal – which is as it should be. And thousands of lives would be saved.

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