Organ donation: Should it be an informed decision or presumed consent?
Peeps, let's dive into the choppy waters of organ donation policies around the world. Which system takes the gold – opt-in or opt-out? To uncover the truth, a team of UK scholars analyzed the guts of organ donation regulations in 48 countries.
With an opt-in system, folks gotta actively enroll in the organ donor registry once they kick the bucket. Opt-out, on the other hand, means your organs are automatically up for grabs unless you specifically request to Opt-Out before you say goodbye to this world.
Prof. Eamonn Ferguson, the University of Nottingham's lead scholar, admits that relying on folks to make the call can lead to some hiccups:
"People might not act for a zillion reasons, like being scared of loss, lazy, or thinking the government's got their backs."
And here's the kicker: Inaction in an opt-in system can result in folks who'd want to be a donor turning up empty-handed (a false negative). But in an opt-out system, inaction can lead to someone who doesn't want to donate unintentionally becoming a donor (a false positive).
The US sticks with the opt-in approach. Last year saw 28,000 transplants thanks to organ donors, with around 79 transplants happening every day. But sadly, about 18 folks bite the dust each day due to a shortage of donated organs.
In or Out?
The Nottingham gang, joined by the University of Stirling and Northumbria University scholars, looked at the organ donation policies of 48 countries for 13 years. 23 countries went with the opt-in approach, while 25 chose the opt-out.
They measured the number of overall donors, the number of transplants per organ, and the total number of kidneys and livers transplanted from both the dead and the living.
The results? Countries with opt-out systems showed higher numbers of kidney donations – the most sought-after organ for those on the organ transplant list. Opt-out systems also wins the race for the total number of organ transplants.
Opt-in systems, however, had a higher rate of kidney donations from living donors. The researchers say this influence on living donation rates is a new discovery worth highlighting.
The study has its limits, though. It didn't distinguish between the varying degrees of opt-out legislation and didn't consider other factors outside the scope of the research.
Moving forward
The researchers report their findings in BMC Medicine, showing that opt-out consent may up deceased donation but chop liver when it comes to living donation rates. Opt-out consent also boosts the total number of livers and kidneys transplanted.
They suggest that these results could potentially guide future policy decisions and recommend more routine collection of international organ donation information, such as consent type, procurement procedures, and hospital bed availability.
Prof. Ferguson suggests future studies should delve into the heads of those faced with opt-in or opt-out decisions:
"More research is needed to examine issues from the perspective of the individual – beliefs, wishes, and attitudes – using a combo of surveys and experimental methods."
The authors point out that countries with opt-out consent still struggle with organ donor shortages. A complete system overhaul might not solve this problem. Instead, they suggest tweaking the consent legislation or adopting aspects of the "Spanish Model."
Spain boasts the highest organ donation rate in the world. The Spanish have opt-out consent, but their secret sauce includes a transplant coordination network that works both locally and nationally, and top-notch public information about organ donation.
Recently, Medical News Today featured a piece on whether farmed animal organs could be a solution to the organ shortage. Is this the answer, or should we focus on refining organ donation policy?
Written by James McIntosh
- The study by researchers from the University of Nottingham, University of Stirling, and Northumbria University revealed that countries with opt-out organ donation consent systems witnessed higher numbers of kidney donations and a greater total number of organ transplants.
- Opt-out systems were found to be effective in increasing the number of deceased organ donors, however, they had lower rates of kidney donations from living donors compared to opt-in systems.
- The researchers suggest that future policy decisions could potentially be guided by their findings, recommending more routine collection of international organ donation information such as consent type, procurement procedures, and hospital bed availability.
- Advancing the understanding of individual beliefs, wishes, and attitudes towards organ donation through surveys and experimental methods is also encouraged, as more research is needed in this area to refine organ donation policies.
