Organ Donation: Debating the Merits of Consent-Based versus Presumed Donation Approaches
Organ donation policies are a worldwide hot topic. Should people automatically be registered as donors or should they actively choose to opt in? Researchers from the UK investigated this question by analyzing the organ donation protocols of 48 countries to find the most effective approach.
With an opt-in system, individuals need to sign up to a register to donate their organs after death. Alternatively, an opt-out system means organs will be donated automatically unless a specific request is made before death to prevent organ donation.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges the challenges with both systems:
"People may not act for various reasons, such as loss aversion, laziness, or belief in the system's decisions"
While inaction in an opt-in system can lead to potential false negatives, inaction in an opt-out system could result in false positives, meaning individuals who do not wish to donate could end up doing so.
The US currently employs an opt-in system, with 28,000 transplants happening last year due to organ donors. Unfortunately, around 18 people die every day due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries for a period of 13 years. They found that countries utilizing opt-out systems had higher numbers of kidneys donated, the organ most sought after by those on organ transplant lists. Opt-out systems also had a greater overall number of organ transplants.
However, opt-in systems did have a higher rate of kidney donations from living donors. The researchers suggest that this subtlety needs to be considered and future studies should examine individual beliefs, wishes, and attitudes regarding organ donation.
The researchers acknowledge that their study was limited by various factors. They suggest that future studies should analyze the opinions of individuals making the decision to opt in or opt out and improve the collection and public availability of international organ donation information.
Countries using opt-out consent still experience organ donor shortages. The researchers suggest that consent legislation or adopting aspects of the "Spanish Model" could improve donation rates. Spain has the highest organ donation rate in the world, with the Spanish utilizing opt-out consent, but their success is largely attributed to measures such as a transplant coordination network and improved public information about organ donation.
Recent discussions have arisen about whether farming animal organs for human transplants could be a solution to the organ shortage or if this is a problem that should be addressed through changes to organ donation policy.
Written by James McIntosh.
[1] Source for enrichment data: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239808
- The efficiency of opt-out systems in increasing the number of kidney donations, as found by researchers from three British universities, could potentially reduce the daily death count due to organ shortages in some countries.
- While opt-out systems may have a higher number of overall organ transplants, opt-in systems tend to have a higher rate of kidney donations from living donors, a detail that needs further investigation in future studies.
- The adoption of the "Spanish Model," which combines opt-out consent with a transplant coordination network and improved public information about organ donation, could potentially improve organ donation rates in other countries with organ donor shortages.
- The question of whether farming animal organs for human transplants could be a solution to the organ shortage has arisen in recent discussions, suggesting a possible alternative or complementary approach to addressing the issue.
- Future studies should analyze individual beliefs, wishes, and attitudes regarding organ donation, as well as examine the opinions of individuals making the decision to opt in or opt out, to better understand the factors influencing organ donation rates and policies.
