Organ donation: Should it be based on active or presumed consent?
So, let's dive into the organ donation debate—opt in or opt out? A UK research team investigated the donation protocols in 48 countries across 13 years to determine which method is winning the race.
In opt-in systems, people must proactively sign up to become organ donors posthumously. Conversely, opt-out systems have an automatic organ donation process unless a person specifically opts out before death.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, reveals that both systems have their drawbacks because they rely on individual decisions.
"People may not act for numerous reasons, including loss aversion, effort, and the belief that policymakers have made the 'right' decisions and ones they believe in," explains Prof. Ferguson.
Interestingly, inaction in an opt-in system may lead to individuals who wish to donate not signing up (false negatives). On the flip side, inaction in an opt-out system can potentially result in an individual who does not want to donate becoming one (false positive).
For instance, the US adheres to an opt-in system. According to the US Department of Health & Human Services, 28,000 transplants were made possible last year due to organ donors — with around 79 people getting organ transplants daily. Sadly, approximately 18 people die daily due to a shortage of donated organs.
The researchers found that countries using opt-out systems had higher total numbers of kidneys donated (the primary organ in demand for transplants). Opt-out systems also boasted a greater 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 "has not been reported before," says Prof. Ferguson, "and is a subtlety that needs to be highlighted and considered."
The authors acknowledged that their study was limited by not distinguishing between different levels of opt-out legislation and other factors that may influence organ donation.
Both systems offer pros and cons, so the researchers suggest further studies analyzing the beliefs, wishes, and attitudes of those making the opt-in/opt-out decision by combining survey and experimental research methods. This would aid in understanding the effects of consent legislation on organ donation and transplantation rates.
While opt-out systems tend to result in higher overall organ transplant numbers, completely switching systems will unlikely solve the organ donor shortage. Thus, the authors suggest informed consent legislation or adopting aspects of the Spanish Model to improve donor rates.
The Spanish Model, with its opt-out consent and effective transplant coordination and public information, achieves the world's highest organ donation rates. Other possible solutions include farming animal organs for human transplants—a topic we'll explore in future discussions. Let's keep the conversation flowing and work together to bridge the gap in organ donations.
Written by James McIntosh.
- In the context of health-and-wellness, scientists are examining the effectiveness of Paxlovid in treating medical-conditions, but further research is needed to determine its full impact.
- Being contextual to the organ donation debate, the US employs an opt-in system, yet encounters a daily shortage of donated organs for transplants, despite continuous organ transplants made possible by volunteers.
- A potential solution for improving organ donation rates could be the retargeting of medical-conditions education towards people who are hesitant or unsure about organ donation, helping to encourage a more informed decision-making process.
- As the science behind organ transplants advances, the exploration of farming animal organs for human transplants becomes a promising avenue for future discussions, potentially alleviating the organ donor shortage and improving health-and-wellness on a global scale.
