Report on the Human Transplantation Bill

report-on-the-human-transplantation-bill.pdf (347.28 kb)

Executive Summary

1. The stated purpose of the Human Transplantation Bill is to save lives by changing organ donation laws, making the donation of organs the societal norm in Northern Ireland whilst preserving the principle that after death a donated organ is a gift freely given. The Bill seeks to do this by moving away from the current ‘opt-in’ to a new ‘soft opt-out’ system with appropriate family safeguards, a requirement for express consent in certain cases, and the ability for people to nominate advocates to affirm their wishes upon death.
2. The majority of evidence from stakeholders on the Bill focused on Clause 4 which introduces the concept of deemed consent. Some stakeholders supported the principle of deemed consent, while others opposed it. Following consideration of the written and oral evidence, Committee Members also came to opposing conclusions on Clause 4 and the issue of deemed consent. Fundamentally, some believed that introducing deemed consent would result in an increase in organ donations in Northern Ireland, while others believed that it could result in a reduction in the number of organ donations. A view was also expressed that a robust evidence base did not exist to demonstrate a positive or negative impact of deemed consent.
3. Members who supported Clause 4 proposed amendments to it that would require that deemed consent can only be effective if contact has been made with a family member who confirms that they have no objection to donation. These Members were of the view that the amendments would serve as a ‘double lock’ in that the retrieval of organs could not take place unless the family or a person in a qualifying relationship had confirmed that they had no objections. However, other Members felt that these amendments did not address the fundamental concerns around deemed consent, as expressed by local clinicians and others.
4. The Committee divided on the proposed amendments to Clause 4, with the majority opposing the amendments. The Committee then considered Clause 4 as drafted, and again divided, with the majority position being opposition to Clause 4 forming part of the Bill.
5. While the key purpose of the Bill is to change the law governing consent for organ donation, Members who opposed to the introduction of deemed consent, nevertheless believed that there was merit in keeping the other aspects of the Bill which do not touch on the issue of consent.
6. Clause 1 places a duty on the Department of Health, Social Services and Public Safety to promote and raise public awareness on organ donation. Members who were opposed to Clause 4 supported the retention of these duties, and therefore supported an amended form of Clause 1, which left out the reference to an annual promotional campaign on deemed consent. Members who supported Clause 4 were content with Clause 1 as drafted. The majority Committee position was to agree Clause 1 as amended.
7. Members who were opposed to Clause 4 also supported the retention of Clause 14 which places obligations on the Department to both report the statistics on transplantation activities and to undertake a wider review on the law once every five years. These Members voted in favour of an amendment to Clause 14 to broaden the scope of the wider report so that it would also cover the Human Tissue Act 2004. This was because if deemed consent is not introduced, then the Human Tissue Act 2004 will continue to be the key piece of legislation in terms of consent. Members who supported Clause 4 were content with Clause 14 as drafted. The majority Committee position was to agree Clause 14 as amended.

Download full report here