Organ Donation: Debate over Opt-in or Opt-out Approach
International Organ Donation Policies: An Analysis of Opt-In and Opt-Out Systems
A study conducted by a team of researchers from the University of Nottingham, UK, has investigated the effectiveness of organ donation policies around the world, focusing on the opt-in and opt-out systems.
In opt-in systems, individuals are required to actively enroll in a donor registry in order to donate their organs post-mortem. On the other hand, opt-out systems assume organ donation unless a specific request is made before death to prevent organ removal.
Professor Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges the potential drawbacks of relying on individual decisions in both systems. "People may not act for numerous reasons, including loss aversion, effort, and trust in the decision made by policy makers," he notes.
The research found that countries implementing the opt-out system of organ donation witness higher total numbers of kidneys donated, an organ in high demand among recipients on organ transplant waiting lists. Additionally, the overall number of organ transplants was greater in countries with opt-out policies.
Opt-in systems, however, resulted in a higher rate of kidney donations from living donors. This influence on living donation rates has not been reported before, according to Professor Ferguson.
The study, published in BMC Medicine, did acknowledge limitations, such as failing to differentiate between the varying degrees of opt-out legislation in some countries and the lack of assessment of other factors influencing organ donation.
The authors suggest that their findings can contribute to future decisions on policy, but could be strengthened further through the routine collection of international organ donation information. This information, made publicly available, could include factors like consent type, procurement procedures, and hospital bed availability.
To advance research in this field, future studies could examine individual perspectives on the decision to opt-in or opt-out, using a combination of survey and experimental methods, as suggested by Professor Ferguson.
It is important to note that countries utilizing opt-out consent still encounter organ donor shortages. The researchers suggest that policy changes or adopting aspects of the "Spanish Model" might improve donor rates. Spain currently has the highest organ donation rate in the world, credited to measures such as a transplant coordination network and better public information about organ donation.
The shortage of available organs for transplantation has sparked discussions about the potential use of animal organs for human transplants, which could be a solution to the current organ shortage or a problem to be addressed through policy changes.
References:
- The research can be found in the volume 18, Article number: 32 (2020), available at: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-1751-6
- The study in BMC Medicine, conducted by a team from the University of Nottingham, delved into the effectiveness of organ donation policies, exploring the contextual difference between opt-in and opt-out systems.
- InOpt-out systems, the emphasis is on the assumption of organ donation unless a specific request is made, leading to higher numbers of kidneys donated and total organ transplants, according to the research.
- On the contrary, opt-in systems inspire a higher rate of kidney donations from living donors, a phenomenon not previously reported, according to Professor Ferguson.
- As the study highlights, countries employing the opt-out system still face organ donor shortages, and addressing this issue requires policy changes or adopting aspects of the "Spanish Model," known for its high organ donation rate.
- The debate about the organ shortage has extended to the general-news realm, with discussions surrounding the potential use of animal organs for human transplants, a solution or a problem that may be resolved through policy-and-legislation and health-and-wellness considerations.
