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Make all bodies available for transplants,
 says professor

By Nigel Bunyan


BODIES should become public property to help make up the growing shortage of transplant organs, an expert in medical ethics said yesterday.

Prof John Harris also advocated the introduction of "a limited ethical market" in such live donor organs as hearts, kidneys and corneas. While both measures might appear unpalatable, they were necessary if the lives of thousands of patients were to be saved.

Prof Harris, of Manchester University, believes that the Government should introduce laws allowing hospital doctors to retrieve parts from the dead without having to establish their willingness to be donors. In a reversal of the present voluntary donor card system, all patients would be regarded as potential donors. The only exceptions would be when individuals could register conscientious objections "for the strongest of reasons". Prof Harris, a former member of the British Medical Association's ethics committee, said: "They would have to explain why they would wish other people to die rather than have their organs used."

Prof Harris, who will detail his proposals to academics attending a weekend conference at the university, said: "The current system has failed to make adequate inroads into the shortages of almost every donor product. In Britain alone there are more than 4,500 people awaiting donor kidneys.

"While it is difficult to know how many people die because of the lack of organs, conservative estimates put the percentage as around 25 per cent. That is more than 1,000 people a year. In the United States there are 70,000 people waiting for kidneys and in India 70,000. Globally, the problem is huge. Something radical needs to be done."

Prof Harris, the Sir David Alliance Professor of Bioethics, claims that at the moment the wishes of many would-be donors are thwarted because they do not have their donor cards with them at the time they are injured. In other cases distraught relatives make their own objections, and hospital staff do not overrule them for fear of being sued.

While it was theoretically possible to establish a system whereby a donor's consent was presumed, Prof Harris believed that this would be unworkable. Disputes were most unlikely to occur in a "no consent" system. Prof Harris, who carries a donor card, acknowledges that some will regard his proposals with distaste. However, he hopes that they will overcome this when they consider the plight of patients. He said: "I don't think we are entitled to protect ourselves from feelings of unease at the cost of other people's lives."

Prof Harris, 53, an atheist who is married with a 10-year-old son, believes most objections to the "no consent" removal of donor organs will be cultural. The established churches, for example, had long accepted the need to have post mortems. He said: "If there is a public interest in finding out the cause of death, how much greater is the public interest in saving the life of a citizen at risk? I am not suggesting that it is reasonable to ride roughshod over people's beliefs. But we perhaps need to be more sensitive to the feelings of patients and the relatives who see them suffer."

He insisted that his proposals would not result in organs being "bought in Bombay for transplants in Harley Street". He said: "There would be no private deals. Instead, a central purchaser, like the NHS, would purchase organs and distribute them according to medical priorities." The provenance of each organ would be both registered and monitored, so that any attempts at corruption could be detected.