Emergency medicine, organ donation and the Human Tissue Act

The Human Tissue Act 2004, which governs all activity relating to the human body, organs or tissues, is grounded in the principle of fully informed consent in line with societal expectations. The associated intention to deal with the current deficit of transplantable organs has paradoxically been translated into the legitimisation of non-consensual organ preservation manoeuvres after death. The procurement strategy targeted under this new statute is "uncontrolled" non-heart-beating donation, and the clinical arenas would be accident and emergency departments and acute medical wards. Practitioners in these fields need to have an understanding of the process and the associated ethical, logistical and legal hurdles to defensible implementation. In the light of these hurdles, there is an obvious need for more widespread professional and public consultation before adoption of this programme.