Anne McTaggart asks, who are we to say the Spanish are wrong and why the minister won't look at the evidence. 

Ms McTaggart says surveys by the British Heart Foundation and others show that soft opt-out is the way forward. 

Public Health Minister Maureen Watt says we are not convinced this bill will achieve the increase in organ transplantation that you hope. 

Ms McTaggart asks what will then. 

The Labour MSP ask: "Why are we the worse in the UK for organ donation rates, why should we not strive to be better?". 

Professor John Forsythe says he has watched people dying being saved by organ donation 

"They're behind you." Says Ms McTaggart.

Professor Forsythe says he has seen the other side, where a seven year old girl was laid out in a bridesmaids dress after her organs were donated.

The professor says he admire Ms McTaggart's passion but adds:" I am just as passionate about transplantation and organ donation."

He repeats he has concerns about the legislation. 

Anne McTaggart says she's not sure whether cry or ask a question.

She says she is appalled at some of the mis-truths heard this morning which will affect the most vulnerable in society.

Ms McTaggart say this bill was never meant to solve everything but is part of a three-pronged approach.  

Labour's Anne McTaggart published plans to introduce a "soft opt-out" system for organ donation in Scotland in the Summer. 

Ms McTaggart has support from MSPs of all parties for her bill. 

The current "opt-in" system requires a proactive choice by an individual to register to become an organ donor on their death. 

The Scottish government said it would examine the bill to see if a "convincing case" could be made for a move to an opt-out system. 

The new legislation would mean people would have to actively opt out or else their name would be added to the NHS Organ Donation Register. 

Under the terms of the "soft opt-out" system, families of deceased patients would be given a say on donation if they could confirm their relative had made an unrecorded objection during their lifetime. 

Committee convener Duncan McNeil asks if the minister will need to come back and apologise in a year from now if the difference has been made in Wales. 

Ms Watt says: "No, because what we are saying is we don't believe this bill is actually going to achieve what we all want to achieve which is an increase in transplantation."

Mr Brown says the Scottish government is "not passive" on organ transplantation, we have a seven year plan, but reviews and evidence are constantly taken. 

Public Health Minister Maureen Watt says the organ transplantation process is constantly under review. 

Image source, Scottish government

Gareth Brown from the Scottish government points to the Donation and Transplantation Plan for Scotland 2013-20, external.  

SNP MSP Bob Doris says there have been a lot of concerns about the unintended consequences of this bill.

Gareth Brown says the AIPs may disagree with the family and there is potential for risk. 

Professor John Forsythe says there is potential for individuals to perceive the state has taken their loved one's organs. 

This could lead people to be more risk averse, he says. 

Mr Chisholm asks why Maureen Watt has changed her mind having signed a motion calling for opt-out to be introduced.

The minister repeats that she is not against opt-out per se and she has seen substantial progress being made in organ transplantation.   

Mr Brown says if the family is still going to be consulted what is the point of having an AIP.

Labour MSP Malcolm Chisholm says besides the AIP, what harm can this bill do.

Professor John Forsythe replies the effect of getting presumed consent wrong would be to hit organ donation across the boards. 

He says there is the potential for risk with this legislation and there are bits of this bill that concerns me. 

Gareth Brown from the Scottish government says it is not just opt-out that should be looked at, for example the introduction of reciprocity would mean that people only received organs if they were a donor themselves.

Public Health Minister Maureen Watt says the government is not against opt-out per se but against the complexity of this bill would impact on the system. 

Gareth Brown says the Welsh legislation did not introduce the complexities Ms McTaggart's bill does.    

Professor John Forsythe the Lead Clinician for Organ Donation and Transplantation in Scotland says the most important thing is the families and extending the time the donor's family has to wait can increase their distress. 

There is a potential for such stories to damage the whole donor process, he says.    

Gareth Brown discusses the role of SNODs in organ transplantation with Rhoda Grant.

A SNOD is a Specialist Nurse in Organ Donation.

Image source, Thinkstock

According to the NHS: 

• Specialist Nurses – Organ Donation, also known as SN-ODs, are nearly always senior nurses from a clinical background usually in intensive care or emergency medicine. 
• The role of the SN-OD encompasses an on-call element to support the facilitation of organ donation in addition to a role within the Hospital, Trust or Hospital Board to which they are allocated. 

• The SN-OD is the focal point of contact for organ donation within the Hospital / Trust; the role encompasses many different aspects, which all come together in the identification and referral of potential organ and tissue donors. 

MSPs have been told that parts of the medical profession are split over possible changes to organ donation. 

The Royal College of Physicians of Edinburgh (RCPE) said its fellows had expressed mixed views about the Transplantation Bill. 

It would permit people to nominate a proxy to confirm their desire to donate and possibly overrule opposing family. 

The RCPE said in that situation clinicians could be placed in a difficult position. 

However, the British Heart Foundation (BHF), the British Medical Association (BMA) Scotland and the Scottish Youth Parliament (SYP) have all come out strongly in favour of the bill. 

The BMA has also questioned why family members should be allowed to veto organ donations amid research showing nearly half refused when the wishes of the deceased were not known. 

Ms Grant says the legislation could be amended to remove AIPs or proxies if necessary.

She says proxies appear to work well in the rest of the UK. 

Gareth Brown from the Scottish government says the AIPs and the proxies will cause delays in the transplantation process.  

Labour MSP Rhoda Grant says the number of donors could double with this legislation and says patients waiting for a transplant will be furious about the approach the government is taking. 

Ms Grant says people will die while the Scottish government waits to see the evidence from the Welsh introducing a soft opt-out.   

Committee convener Duncan McNeil ask if it is reasonable to review the Welsh evidence after one year. 

Ms Watt says the government could start a consultation after a year or two of Welsh evidence. 

Professor John Forsythe the Lead Clinician for Organ Donation and Transplantation in Scotland says there were 98 donors last year. 

The professor says if he was certain that legislation would increase the amount of donors he would be "pushing people out of the way to get into the queue for that". 

He says he is not convinced the bill will do that and he says we probably should wait to see what happens in Wales. 

The bill must be absolutely perfect to ensure it does not have a negative impact.