Sunday, 16 November 2008

Give Parliament a free vote on organ donor law

The Times revealed on Friday that tomorrow's Organ Donation Taskforce report will advise against a change in the law on organ donation to introduce a system of 'presumed consent'.

The Observer has been running a Donor for Life campaign for presumed consent. Today. it reports the Chief Medical Officer's opposition to the report's decision.

There are arguments to be made on both sides of this debate, including about how much difference a change in the law would make. I find it difficult to see what philosophical objection there could be to a presumed consent system if it were to include provision not just for individuals to opt out but also for their families to object even if they have not done so. (It is difficult to see how a 'soft' approach to presumed consent, applying fashionable 'nudge' theories, involves any loss of individual autonomy).

The Observer's editorial makes a good point about one of the arguments which the Taskforce is expected to make against a change in the law.

The taskforce also believes that the public is not ready for presumed consent. This is a strange argument since no concerted attempt has been made to explain the idea. A sensible debate has not properly begun.

This raises an issue which goes much broader than organ donation, about the boundaries between politics and expert advice.

It is sensible for government to commission expert and stakeholder groups to advise on the evidence base for and against policy changes, to clarify the issues at stake and particularly questions of policy design and effective implementation.

But we should be wary of a tendency to contract out issues of ethics, which are properly the realm of politics and of democratic accountability.

So MPs from different parties should now take on the responsibility for beginning an informed public debate about organ donation - and deciding how the different trade-offs involved should be resolved.

The Observer earlier this year reported a good groundswell of backbench cross-party support for a change in the law, which was particularly strong among Liberal Democrat and Labour MPs. Those MPs should now seek to persuade majorities both in Parliament and among the public. If the Prime Minister and Cabinet continue to believe in a change in the law, they should make that case too.

The government should make time for a Commons debate. Should an MP bring forward a Private Members Bill after the next ballot, there would be a good case for offering government time for Parliament to decide whether or not to change the law, while making clear that the outcome would be decided on a free vote, as is traditional on ethical issues of this kind.

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