Monday, December 18, 2006

Consenting adults?

The question of consent has come up several times in the past few days in a couple of different contexts. Firstly, the question of whether organ donation should be opt-in or opt-out. Personally, I have no hesitation in advocating an opt-out system so long as such a mechanism exists and is clearly available. I've never understood the argument for having an opt-in system. With an opt-out, lives would be saved through the inertia principle, but those that really cared about it would still be able to say that they don't want their organs removed.

The opt-in has the inertia principle as well, but in the opposite direction. Lots of people wouldn't object to their organs being used after death, but never get around to making the active decision to do so, thus leaving us with a shortage of organs for donation.

The Today programme this morning had another illustration on the consent question, this time in relation to online NHS records. The main thing that worries me about this (apart from general concern about Government incompetence when it comes to IT systems) is that there seems to be no easy way to opt out of the system once your details are on. You apparently have to be able to show that it would case you serious mental strain to have your details removed from the system.

For me, this is the heart of the problem: you don't have control of your own information. The Government is taking away control of something very personal and trying very hard to keep control of it. Although it might seem that I'm contradicting myself here with my pro-opt-out stance for organ donation, the main thing for the latter (for me at least) is that you would retain the ability to opt out at any time and with no questions asked. And, indeed, if such a policy was adopted with the NHS IT programme, then I probably wouldn't have as much of a problem with that (although I refer back to my earlier point about large-scale Government IT projects).

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