Skip to content
General-news — Organ — Medical-conditions — Contextual — Politics — Paxlovid — Subtlety — Policies — Retargeting — Ordination — Donor — Health-and-wellness — Transplant — Nottingham — Science

Debate on Organ Donation: Advocating for either Consent-Based or Presumed Consent Approaches

Is it more effective to have an organ donation system where individuals opt-in or one where they opt-out?

,   and  Administrator
3 min read
Every 10 minutes, a fresh transplant candidate joins the queue in the United States.
Every 10 minutes, a fresh transplant candidate joins the queue in the United States.

Organ donation practices around the globe reveal a diverse landscape. The age-old question persists: should people be required to opt-in or opt-out for donating organs post-mortem? To delve into this, a team of researchers from the UK took a deep dive into the organ donation policies of 48 nations, investigating which strategy works best.

In opt-in systems, individuals must actively sign up for the donor registry after death. Alternatively, opt-out systems enforce organ donation unless a specific request is made to disqualify one's organs before passing.

Prof. Eamonn Ferguson, the lead researcher from the University of Nottingham, acknowledges that relying on individual decisions in both systems can have drawbacks:

"People might not act due to various reasons such as loss aversion, apathy, or believing the policy makers have made the right decision."

Inaction in an opt-in system may lead to false negatives - individuals who would have wanted to donate but didn't end up doing so. Conversely, inaction in an opt-out system may result in false positives, where individuals without the intention to donate are chosen as donors.

The US employs an opt-in system. Last year, over 28,000 transplants were carried out thanks to organ donors, with approximately 79 individuals receiving organ transplants daily. Regrettably, every day, around 18 people are unable to have surgery due to a scarcity of donated organs.

Researchers from Nottingham, Stirling, and Northumbria Universities in the UK scrutinized the organ donation protocols of 48 nations over a period of 13 years. They found that opt-out systems generally had higher total numbers of kidney donations, the organ most in demand for transplant recipients. Moreover, these systems also recorded higher overall organ transplant rates.

However, opt-in systems demonstrated a more significant rate of kidney donations from living donors. The influence of policy on living donation rates is a novel finding, as documented by Prof. Ferguson: "this aspect has not been reported before."

The study had some limitations, as it did not differentiate between the varying degrees of opt-out legislation in different countries and the unassessed influence of other factors on organ donation.

The researchers suggest that their results, published in BMC Medicine, indicate 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."

Future decisions concerning policy could benefit from the collection and public availability of comprehensive international organ donation data, such as consent type, procurement procedures, and hospital bed availability. The researchers recommend that future studies could also examine individual opinions, attitudes, and beliefs towards opting in or opting out.

Countries that use opt-out consent still face organ donor shortages, making a complete system change unlikely to resolve the issue. Instead, researchers suggest focusing on improving donor rates through altered consent legislation or adopting aspects from the "Spanish Model."

Spain boasts the highest organ donation rate in the world, in part due to measures like a transplant coordination network and enhanced public information about organ donation.

Recently, Medical News Today ran a feature discussing the potential use of animal organs for human transplants as a resolution to the organ shortage. Ponder whether this could be a viable solution or if focusing on changes to organ donation policy is more appropriate.

Authored by James McIntosh

  1. The study conducted by researchers from the University of Nottingham, Stirling, and Northumbria Universities found that opt-out systems generally have higher total numbers of kidney donations.
  2. In contrast, opt-in systems demonstrated a more significant rate of kidney donations from living donors.
  3. Prof. Eamonn Ferguson, the lead researcher from the University of Nottingham, acknowledged that relying on individual decisions can have drawbacks in both opt-in and opt-out systems.
  4. The US employs an opt-in system, with over 28,000 transplants performed last year due to organ donors, but regrettably, every day, around 18 people are unable to have surgery due to a scarcity of donated organs.
  5. The researchers suggest that comprehensive international organ donation data, such as consent type, procurement procedures, and hospital bed availability, could be valuable for future policy decisions.
  6. Spain, which uses an opt-out consent system, has the highest organ donation rate in the world, in part due to measures like a transplant coordination network and enhanced public information about organ donation.
  7. Medical News Today recently featured a discussion on the potential use of animal organs for human transplants as a resolution to the organ shortage.
  8. The subtlety of this solution lies in the policy-and-legislation realm, questioning whether it could be a viable option, or if focusing on changes to organ donation policy is more appropriate, given the complexities of health-and-wellness, general-news, and politics involved.

Read also:

    Related

    Latest