FEW DECISIONS in life can be as heart-rending as whether to donate the organs of a loved one after his or her death.

But that decision can be made much harder and far more emotional if it is left until the time of death, when grief can make clear-thinking – especially for the squeamish – an impossibility.

Much of that agony and torment could soon be taken out of the hands of bereaved relatives under new proposals being consulted on by the Department of Health.

Currently anyone who wants to donate their organs after death must “opt in” through the donor card scheme. And doctors must still seek approval from the dead person’s family before pressing ahead with an organ transfer.

But family members may no longer have a say over whether their loved ones donate their organs upon death as part of the new opt-out proposals.

The consultation has created the potential for the deceased to make the decision alone by paving the way for consent to be presumed, with an option for that permission to be made by the patient without family input. In other words, it will be assumed that an adult’s body can be used in transplants unless the deceased has expressly opted-out.

Whether or not the system will change is likely to depend on the results of the consultation, which closes on March 6. It has so far received more than 11,000 responses.

The plan to look again at the controversial issue was revealed last year by Prime Minister Theresa May, who said: “Our ability to help people who need transplants is limited by the number of organ donors that come forward. So to address this challenge that affects all communities in our country, we will change that system – shifting the balance of presumption in favour of organ donation.”

The NHS recently revealed that 457 people died in England in 2016 while waiting for a transplant.

NHS Blood and Transplant (B&T) said 1,100 families in the UK decided not to allow organ donation in the same year because they were unsure what their relatives would have wanted.

There are about 6,500 people currently on the transplant waiting list.

According to NHS B&T, West Yorkshire has almost 1,900 people alive today after surviving organ transplants and the number of people on the NHS Organ Donor Register has increased by 23 per cent over the past five years to 731,335 people, compared to 592,683 five years ago. In Bradford, 140,807 people are signed up, compared to 116,325 five years ago.

Sally Johnson, director of Organ Donation for NHS B&T, said: “More people than ever in West Yorkshire are committing to organ donation and that is saving more lives than ever.

“However, there is still a long way to go. Around three people still die a day in need of a transplant.

“Every one of those people who died could be a mother or a father, a daughter or a son, who might be alive today.”

But not everyone is convinced and there is fierce debate over whether an opt-out system can actually make a difference.

Consultant transplant surgeon Keith Rigg said it might have been better to wait for results from a similar opt-out scheme launched in Wales in 2015.

Latest figures show there were 33 cases in Wales where presumed consent was applied last year, and 13 cases where the families did not support the decision to donate an organ. Although based on small numbers, that suggests a 60 per cent donation rate with the opt-out in Wales, compared to 50 per cent for the opt-in model in England.

Mr Rigg said cultural and religious beliefs, and not knowing a patient’s preference, are the main two obstacles to increasing donation rates: “There is that view that opt-out is seen as the best thing since sliced bread... But there is a much wider perspective. Assuming opt-out does come in, it’s hard to know how much difference that will make.”

However, Dr Dale Gardiner, deputy national clinical lead for organ donation at NHS B&T, said: “If a person has an opt-out, it makes it so much easier (for family) to say: they would have opted out, I don’t have to think about it too much, I’ve got so much else happening and just say ‘yes’.

“If that makes their grief easier, that’s a good thing.”

Whatever the result of the consultation, it seems the sooner families face up to the difficult conversations about death, the better.

An NHS B&T surveys shows that although more than 80 per cent of people say they support organ donation, only around 50 per cent have ever talked about it.

Bradford Hospitals’ clinical lead for organ donation, Dr Andrew Baker, says people need to discuss it with their families: “That chat might be the next time you sit down for a meal, when you are shopping or working, or when you are just driving in the car.

“If you want to be a donor, your family’s support is still needed for donation to go ahead, even if you are on the NHS Organ Donor Register.”

* Have your say at: organdonation.nhs.uk/supporting-my-decision/consultation