A new discussion paper from the New South Wales (Australia) Ministry of Health raises the possibility of eliminating the veto-power over organ donation that families of potential organ donors currently hold. NSW has the largest donor registry in Oz, but that hasn't translated into high transplantation numbers, largely because 45% of families choose to veto the harvesting of organs from their loved ones who'd signed up to be organ donors. This article summarizes some responses to the proposal. Transplant Australia, Kidney Health Australia and the Australian Medical Association all line up in favor of the change, but, interestingly, a spokesman for transplant lobby group ShareLife opposed the move, arguing that it could undermine people's willingness to sign up to be donors, and pointing out that the countries with the most successful transplant programs (Spain, Portugal, Croatia) all respect the wishes of the family. What matters isn't the legal regime, but the quality of communication with the families.
The discussion paper also raises the possibility of moving from the current opt-in system to a "presumed consent" system where patients would have to opt out of donation, but it does so only formally, noting (correctly) there's little international evidence in favor of making that move. Finally the paper suggests scrapping the NSW Roads and Maritime Services donor register and transferring its content to Medicare's national register.