EVERYONE IN Britain should become a potential organ donor at death unless they opt out, the British Medical Association decided yesterday.

In a historic vote that reversed the association's 30-year policy doctors overwhelmingly backed an "opt-out" donor scheme to save some of the thousand-plus lives a year that are lost while people wait for transplants.

Under the scheme, which would require a change in the law, doctors would have an automatic right to remove the organs of any patient who died, on the presumption that they consented, unless that patient had registered opposition.

BMA representatives also took the opportunity to express their revulsion at attempts to impose restrictions on the use of organs, after the disclosure this week that a donor's family had attached a "whites-only" condition. They backed a motion stipulating that organs "must only be accepted unconditionally" after Ian Bogle, the BMA chairman, said he was "ashamed" of the incident.

The BMA will now mount a campaign to win public support for the "opt out" change and to lobby the Government.

The 1,000 representatives at the conference backed thechange. Dr Michael Wilks, chairman of the ethics committee, said: "I rather think the Government has been waiting to see today's result. I hope the size of the vote will impress them."

The Department of Healthissued a statement, promising to consider the BMA's views, but referred to a survey published last week that indicated that only 28 per cent of the population backed an opt-out scheme, compared with 50 per cent who favoured the existing law. "Any changes in the existing arrangements clearly must command the confidence of the public," it said.

Similar schemes in other countries, including Belgium and Austria, have doubled the availability of donor organs without provoking public opposition. In Belgium only 2 per cent of the population have registered their decision to opt out of the donor scheme.

In the UK, the supply of organs has been falling in recent years because of improved road safety. Accident victims are one of the chief sources of organs. About 1,000 patients a year die waiting for kidneys and up to 250 for hearts, lungs and livers. The number of kidney transplants fell from 1,875 in 1990 to 1,527 in 1998 and the waiting list has risen over 50 per cent.

Existing BMA policy, established in 1970 is based of patients opting in, by carrying a donor card or leaving instructions with relatives for their organs to be used. About five million people have cards but often they cannot be found at the time of death or the relatives object.

John Sterland, a GP in West Hertfordshire, said transplants offered "a rare opportunity to plant a seed of hope in the garden of death".

But Dr Chris Tiarks, a GP in Eigg, told the conference: "If you die intestate the state does not automatically seize your assets. Why should it seize your body?"