Organ donation: Is an opt-out or mandatory consent system preferred compared to opt-in, which requires explicit consent?
Organ donation policies around the globe vary significantly, sparking the question of whether an opt-in or opt-out system is more effective. To shed light on this issue, researchers from the UK examined the organ donation practices of 48 countries, focusing on opt-in and opt-out systems.
With an opt-in system, individuals must take the initiative and enroll in a donor registry to donate their organs posthumously. In contrast, an opt-out system assumes consent for organ donation, requiring specific objections to be made prior to death.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges potential drawbacks of active decision-making in both systems:
"People may not act for numerous reasons, including loss aversion, effort, and believing that policy makers have made the 'right' decision and one that they support."
Inaction in an opt-in system can lead to individuals who desire to donate not doing so (a false negative). Meanwhile, inaction in an opt-out system could potentially result in an individual who does not wish to donate becoming a donor (a false positive).
The United States adheres to an opt-in system, facilitating around 28,000 transplants last year, with approximately 79 transplants daily. Unfortunately, about 18 people still die each day due to a lack of available donated organs.
After analyzing the organ donation systems of 48 countries for 13 years, researchers from the University of Nottingham, University of Stirling, and Northumbria University found that countries with opt-out systems had higher total numbers of kidneys donated. These systems also yielded a greater overall number of organ transplants.
Opt-in systems did have a higher rate of kidney donations from living donors. However, it's important to note that their study did not distinguish between different levels of opt-out legislation and didn't account for other factors that might affect organ donation rates.
The researchers suggest that their findings could be used to inform future policy decisions but could be strengthened further through the collection and public availability of international organ donation data, such as consent type, procurement procedures, and hospital bed availability.
Prof. Ferguson proposes that future studies explore individuals' beliefs, wishes, and attitudes toward organ donation through survey and experimental methods. He believes that combining various research methods will result in a greater understanding of how consent legislation influences organ donation and transplantation rates.
While countries with opt-out consent experience donor shortages, the authors suggest that completely changing the system may not solve the problem. They suggest that revising consent legislation or adopting aspects of the "Spanish Model" could be potential solutions to improving donor rates.
Spain currently boasts the highest organ donation rate in the world, attributed to measures such as a transplant coordination network and improved public information about organ donation.
Recently, the question of whether animal organs should be farmed for human transplants has been raised as a possible solution to the organ shortage. However, addressing the organ donation issue may lie in reforming organ donation policies rather than turning to controversial solutions.
- The study conducted by researchers from the University of Nottingham, University of Stirling, and Northumbria University over 13 years found that countries with opt-out organ donation systems had higher total numbers of kidneys donated and a greater overall number of transplants.
- In the study, countries with opt-in systems had a higher rate of kidney donations from living donors, but it did not distinguish between different levels of opt-out legislation and didn't account for other factors that might affect organ donation rates.
- The United States adheres to an opt-in system, where approximately 79 transplants occur daily, yet about 18 people still die each day due to a lack of available donated organs.
- Prof. Eamonn Ferguson, the lead author from the University of Nottingham, suggests that future studies should explore individuals' beliefs, wishes, and attitudes toward organ donation through survey and experimental methods.
- In an opt-in system, people must enroll in a donor registry to donate their organs posthumously, while in an opt-out system, consent for organ donation is assumed unless specific objections are made prior to death.
- The researchers propose that their findings could be used to inform future policy decisions and suggest that collecting and making international organ donation data, such as consent type, procurement procedures, and hospital bed availability, publicly available could strengthen the study further.
- researchers from the UK examined the organ donation practices of 48 countries, focusing on opt-in and opt-out systems, to shed light on the question of which system is more effective.
- Countries with opt-out systems, like Spain, which currently boasts the highest organ donation rate in the world, attribute their success to measures such as a transplant coordination network and improved public information about organ donation.
