Organ donation has always been a controversial and inflammatory topic and in the last few days it has been in the headlines again.

This is because England’s Chief Medical Officer has told the house that an “opt out” system of organ donation should exist. That would mean that everyone would be considered as a potential donor when they died unless they had expressly said that they did not wish to donate. The CMO Dr Liam Donaldson said that a system of presumed consent was the best way to tackle organ shortages. Currently around one person dies each and every day due to the fact a suitable donor cannot be found for them.

The move is being considered as previous campaigns such as the donor card system or the NHS donor registration system have simply failed to get the people that want to donate organs to participate. Only 13 million of the UK population is on the register and this is despite the fact that surveys have shown that more than three times that number actually want to donate their organs after death!

There needs to be a substantially larger pool of donors than there are people waiting for organs as often the way someone dies makes them an unsuitable donor.

The lack of volunteers for organ donation was recently brought to worldwide attention when Endemol (the makers of Big Brother) broadcast a reality TV show where the ‘winner’ (chosen by the public vote) was to receive the organs of a terminally ill woman. The show was in fact a hoax designed to raise awareness of the crisis surrounding the shortage of organs and to encourage people in the Netherlands to sign up for donation.

The UK is not the first country to consider a system of presumed consent – in fact several countries around the world already have this system in place. In Spain, the donation rates have almost doubled since the system was introduced in 1990. Other countries that have the opt-out system include Austria, Belgium, Sweden, Denmark, Finland, France, Italy, Norway and Singapore.

The way in which the system is used is different around the world – for example in Spain the views of relatives are sought after death and respected and even if the individual has not opted out themselves, the relatives can refuse. In other countries, the views of relatives are not even taken into account

But there are other issues at play regarding the rate of organ donation: in Sweden where the opt-out system exists, the rate of donation is actually lower than here in the UK. Experts have suggested that one of the reasons why Spain has such a high rate is because of the large numbers of young and healthy people that are killed in car accidents there.

Organ transplant campaigners and the British Medical Association have welcomed the move to an opt-out system and in the future, as transplant techniques and the surgeons skills improve, there is no doubt that the issue of organ donation will be one that we must constantly consider.