Debate over Organ Donation: Advocating for Either Consent-Based or Mandatory Registration
Organ donation policies around the globe vary significantly, leaving the question: opt-in or opt-out? A team of researchers from the UK delved into the organ donation protocols of 48 countries to determine the most effective approach.
With an opt-in system, individuals are required to proactively enroll in an organ donor registry. In contrast, opt-out systems assume consent for organ donation, and people must explicitly request otherwise before passing away.
Prof. Eamonn Ferguson, leader of the study from the University of Nottingham, UK, acknowledges the challenges of both systems:
"People may not act for numerous reasons, including loss aversion, effort, and believing that the policy makers have made the 'right' decision and one that they believe in."
Indeed, inaction in an opt-in system could result in some individuals who might want to donate not doing so (a false negative). Conversely, inaction in an opt-out system could potentially lead to someone who doesn't want to donate becoming a donor (a false positive).
The US currently employs an opt-in system. Last year, 28,000 transplants were made possible due to organ donors, with around 79 people receiving organ transplants every day. Regrettably, around 18 people die daily due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University in the UK evaluated the organ donation systems of 48 countries for a 13-year period. They found that countries using opt-out systems had higher overall numbers of kidney donations, which is the organ most sought after by people waiting for transplants. Opt-out systems also saw the greater overall number of organ transplants.
Opt-in systems did have a higher rate of kidney donations from living donors. This influence of policy on living donation rates "has not been reported before," says Prof. Ferguson, adding, "and is a subtlety that needs to be highlighted and considered."
The authors of the study admit their limitations, as they did not differentiate between varying degrees of opt-out legislation in some countries and failed to assess other factors influencing organ donation.
Prof. Ferguson suggests future research that examines individual attitudes, beliefs, and wishes regarding organ donation, using a combination of survey and experimental methods.
The authors note that countries using opt-out consent still experience organ donor shortages. A total shift in the system of consent might not resolve the issue fully. Instead, they propose that consent legislation or adopting aspects of the "Spanish Model" could potentially enhance donor rates.
Spain boasts the highest organ donation rate worldwide. Their success is attributed to measures such as a transplant coordination network that operates both locally and nationally and improved quality of information regarding organ donation available to the public.
In recent years, the question of whether animal organs should be farmed for human transplants has arisen as a potential solution to the organ shortage, or is this an issue that should be resolved through changes to organ donation policy?
- Under opt-out systems, people are presumed to consent for organ donation, but they must explicitly opt-out before passing away if they disagree.
- The study conducted by researchers from the UK found that opt-out systems had higher overall numbers of kidney donations and organ transplants compared to opt-in systems.
- The US, which employs an opt-in system, saw a higher rate of kidney donations from living donors, a finding that was not previously reported.
- To address the ongoing issue of organ donor shortages, the authors suggest examining individual attitudes towards organ donation and adopting aspects of the "Spanish Model," which includes a robust transplant coordination network and improved public information regarding organ donation.
