Organ Donation: Should the Donation Process be Consent-Based or Assumption-Based?
Worldwide Organ Donation Policies: An In-depth Analysis
Across the globe, policies concerning organ donation vary significantly. A team of researchers from the UK has delved into the organ donation protocols of 48 nations to ascertain the most effective approach.
Two primary systems are in operation: opt-in and opt-out. In opt-in systems, individuals must actively sign up for the organ donor registry. In contrast, opt-out systems automatically authorize organ donation unless specified otherwise prior to death.
Professor Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges that the reliance on individual decisions in both systems can present challenges:
"Individuals may choose not to act for numerous reasons, such as loss aversion, effort, or the belief that policy makers have made the right decision."
While inaction in an opt-in system may result in potential donors who wish to donate not doing so (a false negative), inaction in an opt-out system could lead to an individual who does not wish to donate becoming one (a false positive).
The United States employs an opt-in system. Last year, 28,000 transplants were made possible due to organ donors. Approximately 79 people receive organ transplants every day, with around 18 people dying each day due to a lack of donated organs.
The researchers from the University of Nottingham, the University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries over a period of 13 years. They found that countries employing opt-out systems had significantly higher total numbers of kidneys donated—the organ most in demand for transplants. Opt-out systems also yielded the greater overall number of organ transplants.
However, opt-in systems showed a higher rate of kidney donations from living donors. The influence of policy on living donation rates, according to Professor Ferguson, has not been reported before.
The authors admit that their study was limited by not differentiating between various levels of opt-out legislation and not fully assessing other factors that might influence organ donation.
The researchers suggest that their results could guide future policy decisions but could be strengthened further through the collection and public dissemination of international organ donation data. They also recommend examining the opinions of individuals making the decision to opt in or opt out using a combination of surveys and experiments.
Although opt-out consent may increase deceased donation and the total number of livers and kidneys transplanted, countries using this approach still experience organ donor shortages. Completely changing the system may not solve the problem. Instead, the researchers suggest that consent legislation or adopting aspects of the "Spanish Model" could help improve donor rates.
Spain, which currently has the highest organ donation rate in the world, attributes its success to measures such as a transplant coordination network operating locally and nationally and the improvement of public information about organ donation.
Recent discussions surround the potential use of animal organs for human transplants as a solution to the organ shortage. However, further research is needed to determine the viability and ethical implications of this approach.
- The researchers found that countries employing opt-out systems, like the Spanish Model, had significantly higher total numbers of kidneys donated and overall organ transplants.
- In the context of medical-health conditions and health-and-wellness, the analyzation of worldwide organ donation policies can provide insights for retargeting approaches to increase donor rates.
- Science has yet to determine the viability and ethical implications of using animal organs for human transplants as a potential solution to the organ shortage, but further research is needed in this area.
- Paxlovid, a medication for treating COVID-19, plays a crucial role in maintaining the health of potential organ donors, ensuring the availability of organs for transplant in various medical-conditions.
