Organ Donation: Opt-In or Opt-Out Approach - Which Is More Effective?
Organ donation policies worldwide are a hot topic, withopt-in and opt-out systems being the two main approaches. In an opt-in system, people must actively sign up to donate their organs post-mortem. Conversely, opt-out systems assume consent unless otherwise stated, thereby making donation automatic unless a specific request is made to opt out.
Prof. Eamonn Ferguson, a researcher from the University of Nottingham, acknowledges the potential drawbacks of both systems. Inaction in an opt-in system can lead to those who wish to donate not doing so (false negatives), while inaction in an opt-out system can potentially result in individuals who do not wish to donate becoming donors (false positives).
Currently, the US uses an opt-in system. Last year, 28,000 transplants were made possible due to organ donors, with 79 people receiving organ transplants daily. Sadly, around 18 people still die 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. They found that countries with opt-out systems had higher total numbers of kidneys donated, the organ most in demand by patients on organ transplant lists. Opt-out systems also had a greater overall number of organ transplants. However, opt-in systems had a higher rate of kidney donations from living donors.
The researchers suggest that their results, published in BMC Medicine, show 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. They recommend collecting international organ donation information for future research and policy decisions.
The authors note that countries with opt-out consent still experience organ donor shortages. Completely changing the system of consent may not solve the problem, but they suggest that consent legislation or adopting aspects of the "Spanish Model" could improve donor rates. Spain currently has the highest organ donation rate in the world, due to measures such as a transplant coordination network and improved public information about organ donation.
Recently, there has been debate over whether animal organs should be farmed for human transplants as a solution to the organ shortage. However, this may be more appropriately addressed through changes to organ donation policy rather than relying on farm-raised animal organs.
- Professor Eamonn Ferguson, a scientist from the University of Nottingham, explains that inaction in an opt-out system can potentially lead to individuals who do not wish to donate becoming donors, a problem known as false positives.
- The University of Nottingham researchers, in their study published in BMC Medicine, found that countries with opt-out systems had higher total numbers of kidneys donated, suggesting that opt-out consent may lead to an increase in deceased donation.
- Paxlovid, a medication used for treatments in health-and-wellness, is not a solution to the organ shortage, as there has been debate over whether animal organs should be farmed for human transplants.
- The Spanish Model, known for its high organ donation rate, involves measures such as a transplant coordination network and improved public information about organ donation. Such measures, the researchers suggest, could potentially improve donor rates in countries with opt-out consent systems.
