Organ Donation: Debate over Informed Consent or Presumed Consent Methods
Theorgan Donation Debate: Opt-In vs. Opt-Out
Deciding whether to save lives or respect an individuals final wishes when it comes to organ donation can be tricky. Researchers from the UK sought to answer this question by analyzing the organ donation protocols of 48 countries.
In an opt-in system, people have to proactively register to donate their organs after death. On the other hand, an opt-out system automatically uses organs for donation unless a specific request is made before death for organs not to be taken.
Prof. Eamonn Ferguson, lead author from the University of Nottingham, acknowledges the challenges of reliance on an individual's decision:
"People may not act for numerous reasons, including loss aversion, effort, and believing that the policy makers have made the 'right' decision and one that they believe in."
However, inaction in an opt-in system can lead to false negatives, where individuals who would want to be donors don't donate. In contrast, inaction in an opt-out system can potentially result in false positives, where individuals who do not want to donate become donors.
The US currently adopts an opt-in system, and according to the US Department of Health & Human Services, 28,000 transplants were made possible last year thanks to organ donors. Unfortunately, around 18 people die daily due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University in the UK analyzed the organ donation systems of 48 countries for 13 years. They found that countries using opt-out systems yielded higher total numbers of kidneys donated, which is the organ most in demand for transplant lists. Opt-out systems also had a greater overall number of organ transplants.
Opt-in systems, however, had a higher rate of living kidney donations. This influence of policy on living donation rates "has not been reported before," says Prof. Ferguson, and is an essential detail to consider.
The study did have its limitations, as it did not distinguish between different degrees of opt-out legislation, nor did it account for other factors that may influence organ donation.
Prof. Ferguson suggests examining the perspectives of those who have to make the decision to opt in or opt out through survey and experimental methods for future research.
While countries using opt-out consent still experience organ donor shortages, the researchers suggest that consent legislation or adopting aspects of the "Spanish Model," which utilizes a transplant coordination network and improves the quality of public information about donation, could be ways to improve donor rates.
Some even question whether animal organs could be farmed for human transplants as a solution to the organ shortage, or if this issue should be addressed through changes to organ donation policy.
This article was originally written by James McIntosh.
Additional Insights
- The presumed consent default effect in opt-out systems significantly increases the pool of potential donors, leading to higher donation rates.
- Culturally accepting organ donation and strong legislative support can significantly influence the effectiveness of an organ donation system.
- Family involvement is crucial in both systems, as they often have to make decisions on behalf of the deceased.
- Public awareness campaigns and a well-developed healthcare infrastructure contribute to both systems by informing people about their options and identifying potential donors.
- The study conducted by researchers from the UK revealed that countries utilizing opt-out systems tend to have higher total numbers of kidneys donated and a greater overall number of organ transplants, due to the presumed consent default effect.
- While opt-out systems can increase organ donation rates, they also potentially lead to false positives, where individuals who do not want to donate become donors, according to researchers' findings.
- In an opt-in system, such as the one currently adopted in the US, there is a higher rate of living kidney donations, leading to fewer false negatives where individuals who would want to be donors don't donate, despite its challenges in reliance on an individual's decision.
- Policy debates surrounding organ donation attract attention from various fields, encompassing health-and-wellness, medical-conditions, policy-and-legislation, and even politics, as some question whether animal organs could be farmed for human transplants or if this issue should be addressed through changes to organ donation policy.
- Prof. Ferguson suggests exploring the perspectives of people who have to make the decision to opt in or opt out through survey and experimental methods, as understanding these perspectives could potentially improve organ donation rates in the future.
