Organ Donation: Should It Be Opt-In or Opt-Out as a Default?
Organ donation policies worldwide show a significant disparity. Is it better to have a donation system where people actively opt in or automatically opt out? To dig deeper, a UK-based research team scrutinized organ donation protocols in 48 countries to find the most effective approach.
In an opt-in system, individuals need to register to donate organs post-mortem. In contrast, opt-out systems enforce organ donation automatically unless an explicit request is made before death for organs to not be taken.
Prof. Eamonn Ferguson, the research's lead author from the University of Nottingham, acknowledges some drawbacks associated with relying on active decisions from individuals:
"People may not act due to numerous reasons, including loss aversion, effort, and the belief that policy makers have made the 'right' decision."
However, lack of action in an opt-in system can lead to individuals who wish to donate not doing so (a false negative). Meanwhile, inaction in an opt-out system could potentially result in someone not wishing to donate still becoming a donor (a false positive).
The United States employs an opt-in system. Last year, over 28,000 transplants took place thanks to organ donors, with 79 people receiving transplants daily. Unfortunately, 18 people still die daily due to organ shortages.
The researchers from the University of Nottingham, University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries over a span of 13 years, with 23 using opt-in and 25 employing opt-out systems.
They discovered that countries using opt-out systems had higher total numbers of kidneys donated. Opt-out systems also registered more overall organ transplants. However, opt-in systems had a higher rate of kidney donations from living donors.
Researchers noted that their study had limitations, such as not clearly distinguishing between the degrees of opt-out legislation and omitting factors that may influence organ donation.
They propose that future decisions on policy could be informed by their findings, which indicate that opt-out consent may lead to an increase in deceased donation and a decrease in living donation rates. Additionally, they suggest an increase in the number of livers and kidneys transplanted.
However, they admit that completely changing the system of consent is unlikely to solve the organ donor shortage. Instead, they suggest that consent legislation or adopting elements of the "Spanish Model" could improve donor rates. Spain leads the world in organ donation rates due to opt-out consent, a transplant co-ordination network, and high-quality public information on organ donation.
Recently, Medical News Today published a feature on whether farming animal organs for human transplants could solve the organ shortage or if it's a problem that requires changes to donation policy.
- The research findings suggest that opt-out systems could potentially lead to an increase in deceased organ donation and a decrease in living donation rates, thereby increasing the number of livers and kidneys transplanted.
- In an opt-out system, the researchers found a higher total number of kidneys donated and more overall organ transplants compared to opt-in systems.
- The contextual analysis of organ donation systems in 48 countries over 13 years revealed that the Spanish Model, consisting of opt-out consent, a transplant coordination network, and high-quality public information on organ donation, could help improve donor rates.
- The science of organ donation highlights the disparity in policies worldwide, with some countries employing opt-in systems and others opt-out, leading to various medical-conditions related challenges, such as the organ donor shortage.
- Policymakers and legislators frequently discuss the implications of policy-and-legislation changes on health-and-wellness concerns, like organ donation, as well as related ethical, political, and general-news issues.
