Debate over Consent Methods for Organ Donation: Which Approach, Opt-In or Opt-Out, Yields More Success?
Organ donation policies across the globe aren't one-size-fits-all. The big question is whether it's better to have an opt-in or opt-out system. To explore this, researchers from the UK embarked on a study, analyzing organ donation protocols in 48 countries.
In opt-in systems, people need to actively register to donate their organs post-mortem. Conversely, opt-out systems automatically assume donation unless the individual specifically requests otherwise before death.
Prof. Eamonn Ferguson, lead author from the University of Nottingham, acknowledges potential drawbacks of reliance on individual decisions:
"People might not act for numerous reasons, including loss aversion, effort, and the belief that policy makers have made the 'right' decision and one that they trust."
While inaction in an opt-in system can lead to false negatives, i.e., individuals who'd want to donate not donating, inaction in an opt-out system could potentially lead to false positives, making an individual who doesn't want to donate become one.
The US operates under an opt-in system. Last year, 28,000 transplants were made possible thanks to organ donors. Yet, around 18 people die each day due to a scarcity of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University studied organ donation systems in 48 countries over a 13-year period. They found that countries using opt-out systems had more kidneys donated, the organ most people on transplant lists are waiting for. Opt-out systems also had a higher overall number of organ transplants.
Interestingly, opt-in systems had a higher rate of kidney donations from living donors. This influence on living donation rates, Prof. Ferguson notes, hasn't been reported before.
The study had limitations; it didn't distinguish between the degrees of opt-out legislation or account for factors outside organ donation that might influence donation rates.
The researchers suggest their results could guide future policy decisions. However, they propose collecting international organ donation information regularly and making it publicly available. They also suggest further studies examining individuals' beliefs, wishes, and attitudes towards organ donation.
Although opt-out consent can increase deceased donations but decrease living donation rates, it's still associated with an increase in the total number of livers and kidneys transplanted. The authors note that opt-out consent alone may not solve donor shortages. Instead, they suggest applying aspects of the "Spanish Model" or rethinking organ donation policy could be ways to boost donor rates.
Spain boasts the highest donation rate globally. Experts attribute this success to a transplant coordination network working at both local and national levels, as well as improved public information about organ donation.
Recently, Medical News Today considered whether farming animal organs for human transplants could be a solution to the organ shortage. While this is a complex issue that calls for further debate, it highlights the urgency of addressing the organ donation problem.
- The science behind organ donation policies varies globally, with some countries implementing opt-out systems that automatically assume donation unless an individual opt-outs, while others use opt-in systems that require active registration.
- In the context of medical-associated policies, opt-out systems could potentially lead to false positives, making an individual who doesn't want to donate become one, whereas opt-in systems might result in false negatives, as individuals who'd want to donate may not register, hence not donating.
- The United States operates under an opt-in system, but despite over 28,000 transplants last year, approximately 18 people still die daily due to a shortage of donated organs.
- Despite opt-out consent being linked to an increased number of livers and kidneys transplants, it may not entirely solve the donor shortage. The authors of a recent study suggest applying elements of the "Spanish Model" or rethinking organ donation policy as potential ways to enhance donor rates.
