Organ donation: Which system - consent-based or presumed consent - makes for a more effective approach?
Title: Which Organ Donation Method is More Effective? Opt-In or Opt-Out?
Let's dive into the world of organ donation and understand the pros and cons of opt-in and opt-out systems. A team of researchers from the UK has scrutinized the donation protocols of 48 countries to determine which approach is delivering the best results.
With an opt-in system, people have to sign up on a registry to donate their organs post-mortem. On the other hand, in opt-out systems, organ donation happens automatically unless a specific request is made to opt-out before death.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges that such systems rely on an active decision from individuals, and that inaction can lead to cases where people who'd want to donate may not, termed as a false negative in an opt-in system. However, in an opt-out system, inaction could potentially lead to a false positive, where someone who doesn't wish to donate becomes one inadvertently.
The US currently has an opt-in system. Last year, 28,000 transplants were made possible due to organ donors. Sadly, around 18 people die daily due to a shortage of donated organs.
Researchers from Nottingham, Stirling, and Northumbria Universities examined the organ donation systems of 48 countries over a period of 13 years, with 23 using an opt-in system and 25 using an opt-out system. They found that opt-out systems generally yielded higher totals of kidney donations—the organ that most people on organ transplant lists are waiting for. Opt-out systems also had a higher overall number of organ transplants.
However, opt-in systems had a higher rate of kidney donations from living donors. This influence on living donation rates is a novel discovery, notes Prof. Ferguson. The study was limited as it didn't distinguish between the varying degrees of opt-out legislation, and other factors that influence donation remained unassessed.
The researchers suggest that their findings could guide future policy decisions and recommend collecting more widespread organ donation data, including consent type, procurement procedures, and hospital bed availability, for public access. They also suggest studying individual perspectives on organ donation using surveys and experiments to better comprehend the impact of consent legislation on donation rates.
Interestingly, countries using opt-out consent still grapple with organ donor shortages. They propose that altering consent legislation or adopting aspects of the "Spanish Model" could boost donor rates. Spain boasts the highest organ donation rate globally, largely due to an effective transplant coordination network and improved public information about organ donation.
The debate surrounding the ethics of farming animal organs for human transplants recently made headlines. Could this be a solution to the organ shortage, or should we address it through changes to organ donation policy? More research is needed to find definitive answers.
(Based on the provided data, opt-out systems generally have higher donation rates than opt-in systems, with notable exceptions being some countries with strong public support and organ donation awareness programs. The evidence, however, does not prove that the policy itself is the sole cause of increased donation rates.)
Sources:
- Study: Organ donation legislation and rates, but what else matters? https://www.sciencedaily.com/releases/2018/06/180618133329.htm
- How opt-out organ donation works https://www.unos.org/resources/faqs-organ-donation/how-opt-out-organ-donation-works/
- US hits record for organ donations https://www.cbsnews.com/news/us-hits-record-for-organ-donations-during-deadly-pandemic-year/
- Organ donation: The Belgians ahead of the game https://www.europarl.europa.eu/RegData/etudes/IDAN/2019/646983/EPRS_IDA(2019)646983_EN.pdf
- Organ donation rates double in Germany https://www.pbs.org/newshour/health/organ-donation-rates-double-in-germany-despite-tragedy-family-s-decision
- In the study analyzing organ donation systems in 48 countries, opt-out systems were found to generally yield higher totals of kidney donations and overall organ transplants.
- However, opt-in systems were noted to have a higher rate of kidney donations from living donors, highlighting a novel discovery by the research team.
- The research team proposed that their findings could influence future policy decisions by collecting more widespread organ donation data for public access and studying individual perspectives on organ donation for a better understanding of consent legislation impacts on donation rates.
- Opt-out consent countries still struggle with donor shortages, leading them to consider altering consent legislation or adopting aspects of the "Spanish Model," which claims the highest global organ donation rate due to an effective transplant coordination network and public information initiatives.
