Organ donation: Should it be based on individuals affirmatively opting in or automatically opting out?
Organ Donation: To Opt-In or Opt-Out? That's the Question!
Here's the skinny on organ donation policies across the globe. You might find yourself wondering which approach—opt-in or opt-out—is the most effective. A team of UK-based researchers has set out to solve this dilemma by examining the organ donation practices of 48 countries.
In opt-in systems, individuals have to actively sign up to donate their organs following their demise. Opt-out systems, on the other hand, assume consent for organ donation unless a specific request forbids it before one's death.
Prof. Eamonn Ferguson, the lead researcher from the University of Nottingham, acknowledges that both systems depend on individual decisions, which can sometimes create issues:
"Individuals may not act for several reasons like loss aversion, effort, and the assumption that policy makers have made the right decision."
Inaction in an opt-in system might result in individuals who desire to donate missing out (a false negative), whereas inaction in an opt-out system might lead to an individual who doesn't want to donate unwittingly becoming a donor (a false positive).
The United States utilizes an opt-in system, with 28,000 transplants made feasible last year, thanks to organ donors. Regrettably, around 18 people die every day due to a shortage of donated organs, despite requiring them.
So, should we opt in or out?
The researchers from the University of Nottingham, University of Stirling, and Northumbria University examined the organ donation policies of 48 countries over a 13-year period, including 23 that used opt-in and 25 that used opt-out systems.
The researchers measured the total number of donors, transplants per organ, and the overall number of kidneys and livers transplanted from both deceased and living donors.
Interestingly, they found that countries with opt-out systems donated higher numbers of kidneys—the organ most sought after by patients on transplant lists—and had a greater overall number of organ transplants.
Opt-in systems, however, exhibited a higher rate of kidney donations from living donors, which is a finding that hasn't been documented before, according to Prof. Ferguson.
The authors noted that their study had limitations, such as not distinguishing between the varying degrees of opt-out legislation and not considering other factors that impact organ donation.
Stepping up the game
The researchers' findings, published in BMC Medicine, suggest that "opt-out consent may lead to an increase in deceased donation but a reduction in living donation rates. Opt-out consent is also associated with an increase in the total number of livers and kidneys transplanted."
They recommend that their research could be useful for policymakers but could be further strengthened through the consistent gathering of international organ donation information, such as consent type, procurement procedures, and hospital bed availability. This information should then be made publicly available for future reference.
Prof. Ferguson also suggests that future studies should explore individuals' beliefs, wishes, and attitudes towards organ donation:
"More research is needed to examine issues from the perspective of the individual. Using a mixture of surveys and experimental methods, researchers can develop a greater understanding of the impact of consent legislation on organ donation and transplantation rates."
According to the researchers, countries with opt-out consent still contend with organ donor shortages. Altering the system of consent entirely may not be the sole solution. They recommend that changes in consent legislation or adopting aspects of the "Spanish Model"—which combines strong health care infrastructure, wide public trust, and effective transplant coordination—could help improve donor rates.
Spain boasts the highest organ donation rate in the world. Their success is attributed to factors like the transplant coordination network and the enhancement of public information about organ donation.
Have you ever pondered about whether animal organs could be farmed for human transplants? This idea has arisen as a potential solution to the organ shortage, or should it be addressed through changes to the organ donation policy?
Written by James McIntosh
- In opt-out systems, consent for organ donation is assumed unless specifically requested otherwise, leading to a higher number of kidney donations and overall organ transplants compared to opt-in systems.
- The study suggests that opt-out consent may result in an increase in deceased donations but a reduction in living donation rates, providing insight for policymakers considering organ donation policy changes.
- The researchers recommend the collection and publication of international organ donation data, including consent type, procurement procedures, and hospital bed availability, to strengthen their findings and further inform policy-and-legislation decisions in health-and-wellness.
- The idea of farming animal organs for human transplants has been proposed as a potential solution to the organ shortage, sparking discussions on whether this approach should be prioritized over changes to the organ donation policy within the context of general-news and politics.
- For a comprehensive understanding of organ donation, it's crucial to investigate individuals' beliefs, wishes, and attitudes towards donation through surveys and experimental methods, enabling researchers to better inform medical-conditions and health-and-wellness policies.
