Organ Donation: Debating the Merits of Consent-Based or Presumed Consent Approaches
Organ donation policies are all over the place globally. So, which method is better: opt-in or opt-out? A group of researchers from the UK decided to find out by examining the organ donation protocols of 48 countries for a span of 13 years.
The opt-in system requires people to actively register on a donor list to have their organs donated posthumously. On the other hand, the opt-out system assumes that everyone is a donor unless they explicitly request otherwise before death.
Prof. Eamonn Ferguson, the research leader from the University of Nottingham, acknowledges that the systems rely on individuals making a choice, which could have drawbacks such as procrastination, loss aversion, or thinking that the decision has already been made for them.
While inaction in an opt-in system may contribute to false negatives, meaning people who could have been donors don't end up donating, inaction in an opt-out system could potentially result in false positives, with people who don't wish to donate unintentionally donating organs.
The US currently uses an opt-in system. Last year, about 28,000 transplants were carried out thanks to organ donors. Unfortunately, around 18 people die every day due to a lack of donated organs.
The researchers from the University of Nottingham, University of Stirling, and Northumbria University compared the organ donation systems of 48 countries. They discovered that countries with an opt-out system had higher total kidney donation numbers, an organ that most people in need of a transplant are waiting for. Opt-out systems also had a greater overall number of organ transplants.
However, opt-in systems had a higher rate of living kidney donations. The impact of policy on living donor rates is a new finding, according to Prof. Ferguson.
The study has limitations, such as not distinguishing between degrees of opt-out legislation and not assessing other factors that might impact organ donation.
The researchers suggest that their findings could be used in future decisions on policy, but could be more robust with the collection and availability of international organ donation data. They also suggest studying individual beliefs, wishes, and attitudes towards organ donation as a way to gain a better understanding of how consent legislation affects donation rates.
It's worth noting that countries with opt-out systems still experience donor shortages, indicating that simply changing the system may not solve the problem. The authors suggest considering consent legislation or adopting aspects of the "Spanish Model," which has the highest organ donation rate in the world.
Spain credit's their success to measures such as a transplant coordination network that works on both local and national levels, and improved public information about organ donation.
There's also the question of whether farming animal organs for human transplants could be a solution to the organ shortage or if it's a problem that can be addressed through changes to organ donation policy. Stay tuned for updates on this topic.
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- The researchers' study found that countries with opt-out organ donation policies had higher total kidney donation numbers and a greater overall number of organ transplants, compared to those with opt-in policies.
- While opt-in systems had a higher rate of living kidney donations, the impact of policy on living donor rates is a new finding, according to Prof. Ferguson.
- The study acknowledges that countries with opt-out systems still experience donor shortages, indicating that simply changing the system may not solve the problem.
- The researchers suggest studying individual beliefs, wishes, and attitudes towards organ donation as a way to gain a better understanding of how consent legislation affects donation rates.
- The authors suggest considering adopting aspects of the "Spanish Model," which has the highest organ donation rate in the world, to address organ donation shortages.
- There's a question of whether farming animal organs for human transplants could be a solution to the organ shortage or if it's a problem that can be addressed through changes to organ donation policy, according to the study.
