Parliamentary bill fronted by nine-year-old boy spells landmark moment for organ donation

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Everyone’s talking about Max’s Law

Image credit: Twitter @NHSOrganDonor

The Private Members’ Bill introduced by Geoffrey Robinson MP has passed its second reading in the House of Commons, in what has been described as a landmark moment for organ donation law that could help save hundreds of lives. Next stage: committee.

Passed without division, the Organ Donation (Deemed Consent) Bill intends to amend the Human Tissue Act 2004 by introducing an opt-out organ donation system whereby consent to donate organs in the event of death will be presumed unless the individual has opted out. The current opt-in system requires consent before tissues and organs are removed from a deceased person. An individual’s consent can be inferred from an express view made during their lifetime or by appointing a representative to consent on their behalf. If a decision on organ donation has not been made, at the moment of death the family will be asked to give consent.

The legislation will, Prime Minister Theresa May says, shift “the balance of presumption in favour of organ donation and [work] on behalf of the most vulnerable”.

The new law has been coined ‘Max’s Law’, in honour of nine-year-old Max Johnson who benefited from a heart transplant and has been campaigning to change the current legislation. In a letter to Max, May wrote: “When I read your inspirational story, I knew I had to act to change the organ donation rules to an opt-out system. I also read that you thought it would be fun to name the change in the rules after you. I think that is a brilliant idea, so, while it will have to have a bit of a boring title when it goes through parliament, I and my government will call it Max’s Law.”

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The proposed reform, first announced by the Prime Minister in October 2017, comes at a time when, despite the significant increase in organ donation rates in the UK in the past decade, there is still a shortage of donors. NHS Blood and Transplant, the authority responsible for coordinating organ donation across the UK, reported that in 2016/2017 456 adults and 14 children died while on the transplant list and a further 157 people were removed from the list because they were too ill for surgery. There are currently 6,500 people on the donor waiting list.

The proposed opt-out system will put England in line with the approach currently adopted by Wales and the vast majority of European countries, while the Scottish government has announced its commitment to introducing legislation in the current parliamentary session. What England purports to create is a system similar to the one adopted in Spain — the country with the highest rate of organ donation and consent internationally. This ‘soft’ opt-out system includes authorised doctors removing organs from every adult who dies unless they have registered to opt out, although it is good practice for doctors to ask relatives for their agreement at the time of death.

England seems, therefore, to have excluded a ‘hard’ opt-out system where doctors can remove organs from every adult who dies unless the person belongs to a group that has been defined in law as being against an opt-out system. This has been confirmed by the Parliament Under-Secretary of State for Health, Jackie Doyle-Price, who stated:

“The system that we are looking to introduce has much in common with that in Spain. The issue is not so much about the register moving towards an opt-out system, but the wraparound care that goes with it, such as the specialist nurses who speak with relatives when they are going through the trauma of losing a loved one, and the public debate that raises awareness. Taken together, they are what will lead to more organs becoming available.”

The bill has achieved support across political parties, with a series of touching speeches by several MPs including Labour’s Julie Elliott, whose daughter is currently on dialysis for a chronic kidney disease, and Tory backbencher Dame Cheryl Gillan, who said she had changed her mind on the issue after seeing a friend’s son struggle with a chronic liver disease.

However, there are concerns about the new legislation. The Nuffield Council on Bioethics (NCB) has argued that the proposed law may undermine public trust and, in turn, discourage organ donation. The NCB used data from Wales to show how the opt-out system has not increased organ donation so far, while organ transplant has decreased from 214 to 187 between 2015/16 and 2016/17. Experts have suggested that without clear evidence, ministers should focus on more effective factors such as training nurses to discuss donation and raising public awareness.

Costanza Maccari is a final-year law with criminology student at London South Bank University. Her interests include politics, international affairs, national security and human rights.

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It takes a special kind of c*nt to deprive somebody of their life by not being on the organ donor register.


No-one will want my liver by the time I’m done with it.


It takes a special kind of c… to equate not being on a donor list, with depriving someone of life 😀

Just Anonymous

Does this change matter?

I ask because NHSBT apparently operates a bizarre policy whereby the family of the deceased can veto donation – even if the deceased were on the donor register:

Accordingly, if this veto still exists, I don’t see why this change would make a difference.

In fact, it could even make the problem worse. Currently, the fact of being on the register is positive evidence the deceased explicitly considered and wanted to donate his/her organs.

Under an opt-out, the family would no longer have that positive evidence, so they might be even more likely to veto!


It is not in any way a bizarre policy to allow a family to veto the government’s assumption of presumed consent. This is because the family is the last bulwark against the coercive power of the State. The truth of this is demonstrated in the fact that many individuals have no kin and will be exponentially more vulnerable to State coercion under presumed consent. The logical next step from presumed consent for donation is enforced donation.

Not Amused

The issues surrounding this are far too important and far too complex to be dealt with by way of a private member’s bill.

It is particularly important that the issue involves reason and not emotion and using the issue of a sick child to highlight the case smacks of emotional manipulation and not logic or reason.

We should think very carefully before we give the state control of our bodies.


This post has been removed because it breached Legal Cheek’s comments policy.


I emphatically agree!!
Then of course we would have to wonder, would the list work in the opposite stream? So that if we registered not to be a donor.. would it actually be adhered to?
hmmmm… This is a bit sticky.. a question of sovereignty. We are a freewill planet.
What happens to us after death should also be a freewill decision. Not one I have to opt out of.
there are spiritual questions in this for me. For myself I do not believe in extending my life beyond the time I am (or my body) is ready to leave.. I don’t begrudge others doing so if they choose. But making this into a broad brushstroke which assumes you do rather than you don’t, seems like a slippery path into other topics of sovereignty which would be weakened also if this were passed.

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