By Doug Kennedy
BBC News Online Scotland
Doctors in Scotland are urging a full debate on modernising the system for donating organs for transplant.
There is a serious shortage of organs
The British Medical Association said that adopting measures like presumed consent would save more lives.
A number of European countries already operate the system, under which consent for organ donation is automatic, with the individual opting out rather than in.
Over the past 10 years the average waiting time for organ transplants in Scotland rose from 18 months to nearly three years.
Dr Bill O'Neill, Scottish secretary of the BMA, believes presumed consent would not solve the problem but is one of the basic changes needed.
"These measures need legislative change because as it stands the law is still unclear on donation," he said.
"There are elements that need to be brought up to date, not just presumed consent but also the issue of brain stem death, the distinction between related and unrelated donors and the use of live donors.
"The main problem is that there is a significant proportion of people willing to be organ donors, about 70%, but out of them only 15% carry donor cards.
"What we need to do in the meantime is work out how we move that 55% to carry organ donor cards."
Dr O'Neill said that there appears to be no appetite to take forward presumed consent but that there needs to be more discussion, more debate and greater education.
"There is a lot of work to be done to increase donation but presumed consent does seem to reduce the number of people on waiting lists.
"In Scotland last year there were about 500 people waiting for organ donation, 16 of them children, but there were only 58 donors and 34 living donors.
"So there is a need for legislation, which needs to take account of all issues, tied in with a major education campaign.
Transplant patients face a three year wait
"The debate on presumed consent has to be taken forward, recognising the religious and cultural dimensions so as not to cut across those sensibilities."
A spokesman for the Scottish Executive said moves to advance the debate were welcomed.
Last June the Scottish Transplant Group, which advises the executive on the issue, rejected a move towards presumed consent.
It said more should be done to promote the current system.
The spokesman said measures funded by the executive included work to increase emphasis on live donation, ongoing publicity to encourage donation and educational work in schools.
Marking national transplant week, the UK Government has said it would like to see 16 million people carrying donor cards by 2010.