People who refuse to donate organs still cannot register

02-09-2003

Precisely a year ago, a new transplant law came into effect in the Czech Republic, stipulating the terms under which organ transplants can be conducted and organ donations accepted. However, one year on, an important institution required by the law has not yet been established - a registry of people who refuse to be organ donors.

When Radio Prague reported on the transplant law last year, we spoke to the Head of the Czech Transplant Centre and President of the Czech Transplantation Society Dr Stefan Vitko.

"This is our first transplant law. The main difference from the former transplant directive is that everybody who is not willing to donate organs for transplant purposes, could be registered without any explanation in a central registry of non-donors. The new Czech transplant law is based on presumed consent, that means that everybody who did not object to organ donation during his lifetime, could be a potential donor after death."

However, the central registry has not been created yet and many things remain unclear. The Health Ministry says there is still time until next September. Until then, doctors will still be working on the principle of presumed consent. The head of the Civic Association for the Protection of Patients Vladimira Boskova says, though, that people do have a right to refuse to be organ donors after death.

"Beside the transplant law, there is an older transplant directive which stipulates that a person can make a declaration saying they do not wish their organs to be removed after death but it does not say where to send the declaration. The new transplant law does not take that into account - there is no way of finding such a document and therefore the wish of the deceased may not be respected. If organs are removed and such a declaration is found some time later, the hospital may face severe legal consequences. So the Health Ministry has one year to correct the legal inconsistencies."

It is still not clear who will administer the registry and whether people will be able to adjust and check their data if they change their mind on organ donorship. But it should specify whether a person wishes to donate only certain organs or make them available only to his or her own family. The spokesman for the Heath Ministry Mario Boehme says that people can now inform their GP about their stance on organ donorship.

"A patient can write a declaration in a health centre, in the presence of his doctor and one witness. The declaration will then be part of the patient's medical record which follows the person everywhere."

It is customary in more developed countries, but also in post-communist Hungary or Poland, to consult the family of the deceased prior to any manipulation with the dead body of their relative. According to Vladimira Boskova, families have very little say in the Czech Republic, even despite the fact that as a member of the Council of Europe the country should respect one of its amendment protocols that recommends always consulting the family.

Although the Health Ministry had translations of the more advanced transplant laws from a dozen developed countries at its disposal, unfortunately, it failed to learn from them. Vladimira Boskova from the Civic Association for the Protection of Patients says the situation might change after the Czech Republic joins the European Union next year.

"I think that after accession the atmosphere will improve. Maybe more people from developed countries will work in this country and once they are confronted with our imperfect regulations, there will be some healthy pressure to harmonise the regulations. We have a lot to learn and I hope we will be pushed by the developed world to study and apply what is positive in western legislation. Instead we are still going the Czech way of trial and error and we are looking for some third ways which do not exist."

02-09-2003