Women whose babies develop fatal defects in the early stages of pregnancy will be given advice on going ahead with the birth so the NHS can harvest their organs, The Mail on Sunday can reveal.
Most expectant mothers opt for termination after being told the devastating news their child has no chance of survival once born.
But now, amid a chronic shortage of donated organs, mums will be 'supported' to have the baby at nine months so that the child's vital organs can be taken for transplant.
Last night the proposal sparked an ethical debate – with one critic describing it as a 'ghoulish suggestion' that would undermine public confidence in organ donation.
The move was revealed at a medical conference where NHS transplant surgeons said they wanted to take more organs from babies nationally to address a dire shortage.
As part of this drive, midwives and other NHS workers are to be educated about the potential for using babies' organs in transplants.
In the past two years, only 11 babies under two months have become organ donors. But doctors believe they could raise that figure to around 100 a year.
Speaking of obtaining more organs from newborns, transplant surgeon Niaz Ahmad, of St James's University Hospital in Leeds, said: 'We are looking at rolling it out as a viable source of organ transplantation nationally.
'A number of staff in the NHS are not aware that these organs can be used. They need to be aware. These can be transplanted, they work, and they work long-term.'
One specific case medics are considering are babies diagnosed with a brain defect called anencephaly, which can be detected by routine scans as early as 12 weeks and which gives babies no chance of survival.
Under the new proposals, mothers would give birth in the normal way and once doctors had certified the infant dead, its vital organs would be removed. However, donation would not be raised when a woman was still deciding whether or not to have an abortion – and nobody would be compelled to donate their baby's organs.
In some cases, where donation has been agreed, babies could be certified brain dead but their bodies kept alive by artificial ventilation. Surgeons could then remove organs from these so-called 'heartbeat babies' when they are fresh, maximising what can be used and the chance of successful transplant.
More than 7,000 people are currently on the organ waiting list, and three of them die every day.
CHILLING ECHOES OF 'NEVER LET ME GO' BODY PARTS SCHOOL
Clones: Andrew Garfield, Keira Knightley and Carey Mulligan in the film
The proposal to harvest babies' organs has parallels with the sinister plot of the acclaimed 2005 novel Never Let Me Go by Kazuo Ishiguro.
The book was made into a film of the same name starring Carey Mulligan, Keira Knightley and Andrew Garfield.
The story centres around students at a fictional boarding school called Hailsham who, it emerges, are actually clones, created and reared to provide vital organ donations to prolong the lives of others.
At the school, they are strongly encouraged to look after their health and smoking is regarded as taboo.
Towards the end of the book, when they are still relatively young, they go through cycles of 'donations', and once their organs are harvested, they die, or 'complete'.
The student clones are portrayed as understanding and accepting of this without question, and they are largely preoccupied with trying to live their short lives to the full and attempting to find ways to prolong them.
Many sick children die before a suitable organ becomes available, and the UK has to rely on baby organs being flown in from abroad.
Kidneys and liver cells from donor babies cannot be transplanted to other babies but could be used to help young adult patients.
At the moment, doctors will not raise the issue of donation with expectant mothers first, but wait for the women to approach the NHS transplant service themselves. However, that could change. Mr Ahmad told The Mail on Sunday: 'There is a real potential for using these organs [and] we are going to discuss whether it is an option, somehow, to tell women in this situation, that organ donation is an option.'
At the moment, about 230 babies with anencephaly – where most of the brain fails to develop – are aborted every year in Britain. Only a dozen are born alive. Raising the issue of organ donation with parents was discussed at the annual meeting of the British Transplantation Society in Glasgow.
A committee has been set up by NHS Blood and Transplant, tasked with boosting organ donation from newborns and very young babies. A lead nurse has also been appointed to co-ordinate efforts to educate NHS staff about talking to parents about such a sensitive issue.
Ethically controversial, but increasingly practical
Taking organs from newborns has always been ethically problematic.
Guidelines prevented most organ retrieval from babies under two months, but last year rules changed, enabling doctors to take organs from newborns with much greater ease, with the parents' consent.
In 2014, Teddy Houlston became what was then Britain's youngest organ donor after dying just 100 minutes after birth. Teddy's parents were told their baby would be born with virtually no brain after their 12-week scan, but decided against abortion.
His two kidneys and heart valves helped save an adult's life.
Doctors have been sounded out about their attitudes to the 'ethically controversial, yet increasingly practical issue' of harvesting organs from babies with anencephaly.
Dr Joe Brierley, a specialist at Great Ormond Street Hospital in London, surveyed medics working with newborn babies and found three-quarters thought it 'acceptable to carry out donation from anencephalic infants'. However, one in five thought it might jeopardise how the public viewed organ donation.
Dr Brierley said: 'We are seeing more women saying, 'I don't think it is right to terminate.' It is then a case of them having conversations with NHS staff about the options.'
NHS Blood and Transplant said: 'Under no circumstances would our staff or anybody else within the NHS pressure women to continue with a pregnancy solely for the possibility of organ donation.'
I welcome anything that improves number of donors
ARGUMENT FOR by Dr Joe Brierley, consultant, Great Ormond Street Hospital
Given that three people a day die waiting for an organ transplant, I welcome anything that improves the number of donors.
Helping the families of those dying in intensive care to have the best information to make this decision is vital. With anencephaly, such discussions occur with a woman who has been told her pregnancy may result in stillbirth, or – if the baby is born alive – it will die as a newborn.
Whilst provision of such information is the cornerstone of good care, my view is that this should not be used to persuade a woman not to undergo termination.
However, if a decision is made to continue the pregnancy for other reasons, then all palliative care options – including donation – ought to be discussed.
People often don't realise amid the tragedy of a child's death that organ donation can happen. Often due to size issues, children's organs can only help other youngsters – but sometimes the smallest children's organs can also help an adult. In my experience, the overwhelming generosity of people in such sad times saves lives and can offer comfort to families going through bereavement.
Of course organ donation is not for everyone, and the role of professionals is to support people in whatever choice they make. And even if a baby is born, there are still reasons donation might not be possible.
There have been 11 organ donors under 60 days old in the last two years – the courage of their families should inspire us all to discuss and consider organ donation.
It could save lives... but at what cost to our humanity?
ARGUMENT AGAINST by Dr Trevor Stammers, Director for Bioethics St Mary's University
It would be frankly abhorrent if transplant doctors were to ask women whose unborn children have been diagnosed with severe defects to let their baby go to term for the sole reason that its body can be raided for its organs.
Mothers electing to carry babies with such severe defects to term – because they would love the child as it is for as long as it should live – have, up till now, often been pressured to abort anyway.
They have been regarded as foolish to continue the pregnancy. It is concerning that mothers will now be encouraged to go to term with the express intention of the child's organs being taken. What happens if they change their mind once they see their newborn son or daughter?
It is a ghoulish suggestion that can only undermine public confidence in transplantation – one the greatest medical advances of my lifetime.
The concept reduces the baby to nothing more than a utilitarian means to an end – a collection of spare parts – rather than respecting life for its own sake.
Yes, I know those organs can potentially save the lives of others, but at what cost to our humanity?
The integrity of transplant medicine has already been compromised by using organs from euthanised adults.
Raiding the bodies of children born only for their organs will further tarnish the profession – and could well lead to a broader decrease in the rates of organ donation.