Debate over Organ Donation: Which System - Consent-Based or Presumed Consent - Produces More Donors?
Organ donation policies globally differ significantly, with the question of whether an opt-in or opt-out system is more effective a topic of debate among experts. To address this, researchers from the UK delved into the organ donation protocols of 48 countries to explore which approach is most efficient.
In an opt-in system, individuals must actively register to donate their organs post-mortem. In contrast, an opt-out system implies organ donation takes place automatically unless a person specifically requests not to donate before their demise.
Prof. Eamonn Ferguson, head researcher from the University of Nottingham, acknowledges the potential drawbacks of both systems: "People may not act for numerous reasons, such as loss aversion, effort, and believing that policy makers have made the 'right' decision." Inaction in an opt-in system could lead to potential false negatives, meaning individuals who would have wished to donate may not do so. Conversely, inaction in an opt-out system could result in false positives, where those who do not want to donate unwittingly become donors.
Currently, the US follows an opt-in system. Last year, transplants made possible by organ donors amounted to 28,000, with 79 people receiving transplants daily. Regrettably, 18 individuals still lost their lives daily due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries for a 13-year period, discovering that countries using opt-out systems had more kidneys donated overall, as these are the organs most in demand by those on organ transplant lists. Opt-out systems also boasted a higher overall number of organ transplants. Opt-in systems, on the other hand, had a higher rate of kidney donations from living donors.
While the research provides insight into the performance of the two systems, it is crucial to note that the study was limited by not taking distinct degrees of opt-out legislation into account. The observational nature of the study also left other factors that may influence organ donation unassessed.
The researchers suggest that the results could be leveraged in future policy decisions and recommend the collection of international organ donation information, which should then be made publicly available. Future research, they propose, could also examine individual perspectives on the issue, focusing on beliefs, wishes, and attitudes using surveys and experimental methods.
Though countries with opt-out consent still experience organ donor shortages, the authors suggest that improvements in donation rates could be achieved through changes to consent legislation or by adopting aspects of the "Spanish Model." Spain has the highest organ donation rate globally, due in part to a robust transplant coordination network and the provision of comprehensive public information on organ donation.
The debate on organ donation policies continues, with some researchers discussing the potential of farming animal organs to address the organ shortage. However, this poses its own set of ethical and practical questions that experts are yet to fully address.
- The question of whether an opt-in or opt-out system is more effective for organ donation has been a topic of debate among experts, with some pointing out that people may not act to donate under either system due to reasons like loss aversion, effort, and perceived policy maker decisions.
- A study analyzed the organ donation systems of 48 countries for a 13-year period, discovering that countries using opt-out systems had more kidneys donated overall and a higher number of organ transplants, while opt-in systems had a higher rate of kidney donations from living donors.
- The researchers suggest that the results could be leveraged in future policy decisions and recommend the collection of international organ donation information, which should then be made publicly available, to aid in further research.
- Future research could focus on individual perspectives on organ donation, examining beliefs, wishes, and attitudes using surveys and experimental methods.
- While the debate on organ donation policies continues, some researchers have proposed the idea of farming animal organs as a potential solution to the organ shortage, but this raises its own set of ethical and practical questions that experts are yet to fully address.
