It has been about a year since a new law on organ donation from deceased persons was passed in France, in an effort to boost donation numbers in the country. Although presumed consent was already in place in France prior to 2017, donation would not take place unless accepted by the family. The new law was supposed to overcome this barrier by offering people easy ways to express their refusal to donate one or several organs. One option consists in subscribing to an online “refusal registry” allowing people to specify which organs one agrees to donate or not.
In addition, it is possible for the family of the deceased person to report a refusal “expressly stated to the family either in writing or orally”. The responsibility is thus on the person reporting on his/her next-of-kin’s refusal to sign a document confirming such refusal. Although convincing in theory, these measures are unlikely to be sufficient in practise: unless patients can also expressly state their willingness to donate (in addition to not donate), in practise doctors would not take organs from a deceased person against the will of the family. Belgium has recently adapted its national legislation on the matter (presumed consent in place since 1986) with the law now requiring that all citizens aged 18+ fill in a form where they specifically state whether they are for or against organ donation. This has enabled organ donation in Belgium to increase from 33000 donors in 2005 to 220 000 donors in 2015.
In order for donations numbers to grow, it appears quite clearly that a legal mechanism supported by awareness raising on the need for all to inform their family or public authorities of their position on organ donation is key. Having said that, the importance of setting up a dedicated body responsible for implementing the legal framework and fostering coordination, training and information – shall not be underestimated.