A Bill to introduce a move in Scotland to an ‘opt-out’ system of organ and tissue donation will be debated in the Scottish Parliament today. Members will be asked to agree to the general principles of the Human Tissue (Authorisation) (Scotland) Bill. This comes on the same day that similar plans to move England to an opt-out system of consent are expected to be passed into law.

The Nuffield Council on Bioethics strongly supports organ donation where it is in line with people’s wishes. In our 2011 report, Human bodies: donation for medicine and research, we argue that opt-out systems can be ethical if people are well-informed, families are appropriately involved (well-supported and not pressured), and trust in the organ donation system is not compromised.

At the time, we recommended that there should be robust research on the effects of an opt-out system if introduced in Wales, in order to obtain a clear evidence base for any proposals for change elsewhere in the UK.

We have worked to inform the debate in England on the Organ Donation (Deemed Consent) Bill, advocating for appropriate support for families to remain at the heart of the donation process and for investment in ongoing public awareness campaigns. Ahead of today’s debate in Scotland, we sent a briefing highlighting some important ethical considerations which may affect how the system of consent is implemented.

Whatever legal system is in place, we think it is vital that any changes to the organ donation system must be done so in a way that minimises the risk of any loss of trust.