Debate over Organ Donation: Advantages of Consent versus Presumed Consent Systems
Organ donation policies across the globe exhibit a wide variety. The age-old debate pertains to whether an opt-in or opt-out system is most effective. A team from the UK delved into the organ donation protocols of 48 countries to settle this controversy.
Opt-in systems require individuals to sign up for organ donation in the event of their demise. Alternatively, an opt-out system means organs will be donated automatically unless explicitly requested not to.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges the drawbacks that arise when relying on individuals to make decisions. People might not act due to reasons like loss aversion, lack of effort, or trust in the policy makers' decisions.
However, it's worth noting that inaction in an opt-in system can lead to individuals who would've wished to donate inadvertently not donating (false negatives). Conversely, inaction in an opt-out system might result in individuals unwilling to donate unknowingly becoming donors (false positives).
The US employs an opt-in system. Last year, 28,000 transplants could be performed thanks to organ donors. Regrettably, approximately 18 people lose their lives daily 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 over 13 years. 23 countries used an opt-in system, while 25 used an opt-out system.
The study revealed that opt-out systems resulted in higher total numbers of kidneys donated, the organ most organ recipients are waiting for. Opt-out systems also boasted greater overall organ transplant numbers.
Opt-in systems, however, boasted a higher rate of kidney donations from living donors. This influence that policy has on living donation rates "has not been reported before," shares Prof. Ferguson.
The authors concede that their study was limited by not considering varying degrees of opt-out legislation and other factors that may affect organ donation. They propose that collecting international organ donation data like consent type, procurement procedures, and hospital bed availability and making it public could strengthen their findings.
Prof. Ferguson suggests future studies investigate the opinions of those making the decision to opt in or opt out. By combining survey and experimental methods, researchers can gain a deeper understanding of how consent legislation influences organ donation and transplantation rates.
The authors admit that countries using opt-out consent still face organ shortages. Wholesale system changes are unlikely to solve this issue, but they propose that modifications to consent legislation or adopting aspects of the "Spanish Model" could boost donor rates.
Spain currently boasts the highest organ donation rate in the world. Experts attribute their success to measures such as a transplant coordination network and improving public information about organ donation.
In recent times, Medical News Today published a feature on whether animal organs can be farmed for human transplants. Is this a potential solution to the organ shortage, or should changes to organ donation policy be the focus?
- The research study conducted by the University of Nottingham and other universities analyzed the impact of contextual factors on organ donation rates, including the consent type (opt-in or opt-out), over a period of 13 years.
- The findings indicated that while opt-out systems led to higher total numbers of kidneys donated and overall organ transplant numbers, opt-in systems had a higher rate of kidney donations from living donors.
- The study also revealed groundbreaking insights about the influence of consent legislation on living donation rates, a factor that had not been reported before.
- Science and medical-health conditions like organ shortage and successful organ transplants may be significantly impacted by retargeting our focus towards understanding and optimizing health-and-wellness policies related to organ donation and consent legislation.
