Right of Reply: Christopher Tiarks

A member of the British Medical Association council replies to yesterday's leading article

on organ donation

IF EVER I need an organ transplant, I dearly hope that it will have been given and not stolen from the donor. It is not over-dramatic to suggest that, were the system of presumed consent implemented, the problem of "stolen" organs would arise.

If we proceed with this "opt-out" option, what will be the next ethical principle sacrificed on the altar of expediency? None of us can yet answer that question but speculation is certainly mind-boggling. Of course, we all wish that every patient awaiting a transplant could have their needs satisfied quickly, but we must not let emotion cloud our judgment. We must seek a different way.

We are caught up in the inexorable drive to push back the barriers of medical knowledge. Unfortunately this drive is not matched with a similar desire to foresee the ethical dilemmas such advances will expose: an ethical cost-benefit analysis, if you will.

The principle of informed consent is enshrined in all medical practice on the living. Why should this change once one is dead? If you die intestate, the state doesn't immediately seize your assets. Why, then, should it seize your body?

Presumed consent will disadvantage the underprivileged, the illiterate, those with learning difficulties and the poorly informed. If the proponents of this change believe that an education campaign can avoid confusing someone's wishes, by the same token a similarly robust campaign should ensure that those who wish to donate their organs are able to sign up to it.

The principle of presumed consent has the potential to abuse human rights. If the principle is accepted, some people are bound to have organs removed who don't wish it. One such case will be one too many.