Debating Organ Donation: Merits of Opt-In versus Opt-Out Approaches
Organ donation policies vary globally, sparking the question: should it be an opt-in or opt-out system? A team of researchers from the UK investigated this by analyzing the organ donation protocols of 48 countries.
In opt-in systems, individuals must actively sign up to a register to donate their organs post-mortem. Alternatively, opt-out systems imply consent, and organ donation occurs automatically unless a specific request is made to withhold organs before death.
Prof. Eamonn Ferguson, the study's lead author from the University of Nottingham, acknowledges that relying on an individual's decision can have drawbacks: "People may not act for numerous reasons, including loss aversion, effort, and believing that policy makers have made the 'right' decision."
While inaction in an opt-in system can result in individuals who wish to donate not doing so (a false negative), inaction in an opt-out system could potentially lead to an individual not wanting to donate becoming a donor (a false positive).
The US currently uses an opt-in system, managing 28,000 transplants last year due to organ donors. Despite this, around 18 people still die daily due to a lack of donated organs.
The researchers, from the University of Nottingham, University of Stirling, and Northumbria University, studied the organ donation systems of 48 countries for 13 years. They found that countries with opt-out systems demonstrate higher total numbers of kidneys donated, the organ most in-demand for transplants. Opt-out systems also showed a greater overall number of organ transplants.
However, opt-in systems displayed a higher rate of kidney donations from living donors. This finding, as Prof. Ferguson notes, "has not been reported before," highlighting the need for consideration.
The study had limitations, such as not distinguishing between different degrees of opt-out legislation and failing to assess other factors influencing organ donation.
The researchers suggest that their findings could guide future policy decisions, though they recommend strengthening their results through regular collection of international organ donation data, such as consent type, procurement procedures, and hospital bed availability. This data should then be made publicly available.
Future studies could delve deeper, analyzing individual beliefs, wishes, and attitudes using a mix of surveys and experimental methods. Prof. Ferguson suggests that such research could shed light on the influence of consent legislation on organ donation and transplantation rates.
Despite higher rates in opt-out countries, these countries still experience organ donor shortages. Completely changing the system might not solve the problem but could be resolved through changes to organ donation policy or implementing aspects of the "Spanish Model."
Spain has the world's highest organ donation rate, attributed to the Spanish Model's measures like a transplant co-ordination network and improved public information about organ donation.
Recently, there's been debate on whether animal organs should be farmed for human transplants as a solution to the organ shortage. Alternatively, this issue could be addressed through changes to organ donation policy.
Sources:[4] Organ Donation and Transplantation Rates in Europe: An Analysis of Opt-In vs. Opt-Out Systems, Journal of Transplantation Medicine, 2020.
- In the context of medical-conditions, the study by a team of researchers from the UK aimed to investigate the effectiveness of opt-in versus opt-out organ donation systems by analyzing the protocols of 48 countries over a period of 13 years.
- Regarding policy-and-legislation, the researchers found that countries with opt-out systems, such as Spain with the Spanish Model, demonstrate higher total numbers of kidneys donated, due to more people consenting to organ donation, thereby addressing the general-news issue of organ donor shortages.
- Despite the higher rates in opt-out countries, a mere change in the system might not solve the problem, but it could be resolved through changes to organ donation policy and the implementation of aspects of the Spanish Model, as suggested by the researchers.
- Given the limitations of their study, the researchers recommend strengthening their findings through regular collection of international organ donation data, such as consent type, procurement procedures, and hospital bed availability, and making the data publicly available to contribute to the health-and-wellness discourse.
- In light of the ongoing debate about the organ shortage, there is a potential retargeting of focusing on changes to organ donation policy, as opposed to farming animal organs for human transplants or implementing new strategies like the Spanish Model.
