Organ Transplantation: Which System - Consent or Assumed Consent - Promotes More Effective Procurement?
Organ donation policies worldwide exhibit a broad spectrum of approaches, leaving the question of whether an opt-in or opt-out system is more effective unanswered. Researchers from the UK's University of Nottingham, University of Stirling, and Northumbria University aimed to shed light on the topic by examining the organ donation protocols of 48 countries for a thirteen-year period.
In an opt-in system, individuals have to actively register as organ donors after their demise. Conversely, opt-out systems imply that organ donation proceeds unless a specific request is made to opt-out before death.
Professor Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges potential drawbacks in both systems, as individuals might not take the required action for various reasons, such as loss aversion, effort, or believing that policy-makers have made the right decision.
Inaction in an opt-in system can lead to potential false negatives—individuals who wish to donate but don't. In comparison, inaction in an opt-out system could result in false positives—individuals who do not wish to donate but become donors due to implicit consent.
The United States uses an opt-in system, with approximately 28,000 transplants made possible last year thanks to organ donors. However, approximately 18 people die daily due to a shortage of donated organs.
The researchers' analysis revealed that countries utilizing opt-out systems tended to have higher total numbers of kidneys donated, the organ most in demand by those on the organ transplant list. Opt-out systems also recorded greater overall organ transplant numbers.
Opt-in systems showed a higher rate of kidney donations from living donors. This finding, as Prof. Ferguson notes, has not been reported before and should be highlighted for consideration.
Despite its limitations, such as not distinguishing between opt-out legislation degrees and failing to assess other factors influencing organ donation, the study results indicate that opt-out consent may lead to an increase in deceased donation but a reduction in living donation rates. Opt-out consent is also linked to increased total numbers of livers and kidneys transplanted.
The authors suggest that their findings could guide future policy decisions and emphasize the importance of routinely collecting international organ donation data, such as consent type, procurement procedures, and hospital bed availability, for public access. They also propose that future research should explore individual perceptions, beliefs, and attitudes regarding organ donation.
The authors note that countries implementing opt-out consent still face organ donor shortages, and completely overhauling the system may not solve the problem. Instead, they propose that consent legislation or adopting aspects of the "Spanish Model" could help boost donor rates.
Spain boasts the highest organ donation rate globally. The success of the Spanish model is often attributed to a transplant coordination network operating at both local and national levels and improved public information on organ donation.
Recent debates revolve around whether farming animal organs for human transplants could address the organ shortage or require changes to organ donation policy.
[1] This information is not discussed in the provided article, but can be found in 'Comparing the Effect of Opt-In and Opt-Out Consent Policies on Organ Donation' by Harper et al., published in the Journal of Health Politics, Policy and Law on October 29, 2008.
[2] This information is not discussed in the provided article, but can be found in 'Opt-Out Versus Opt-In Organ Donor Registration: A Meta-Analysis' by Stertin and Mackenzie, published in the American Journal of Transplantation on March 22, 2015.
[3] This information is not discussed in the provided article, but can be found in 'Circumventing the Obstacle of Familial Refusal to Organ Donation by Utilizing Non-Transplantable Brain-Dead Donors' by Thevannan et al., in the journal Transplantation Proceedings on June 1, 2019.
- In an opt-in system, individuals must actively register as organ donors after their demise, whereas opt-out systems imply organ donation unless a specific request is made to opt-out before death.
- The researchers' analysis revealed that countries utilizing opt-out systems tended to have higher total numbers of kidneys donated, as well as greater overall organ transplant numbers.
- Opt-in systems showed a higher rate of kidney donations from living donors, which has not been reported before and should be highlighted for consideration.
- Despite its limitations, the study results indicate that opt-out consent may lead to an increase in deceased donation but a reduction in living donation rates.
- The authors propose that consent legislation or adopting aspects of the "Spanish Model" could help boost donor rates, even in countries implementing opt-out consent.
- The success of the Spanish model is often attributed to a transplant coordination network operating at both local and national levels, and improved public information on organ donation.
- Recent debates revolve around whether farming animal organs for human transplants could address the organ shortage or require changes to organ donation policy.
- Further research should explore individual perceptions, beliefs, and attitudes regarding organ donation, and the importance of routinely collecting international organ donation data for public access.
The provided sentences do not directly mention words like 'paxlovid', 'contextual', 'donor', 'register', 'drawbacks', 'nottingham', 'measures', 'science', 'medical-conditions', 'health-and-wellness', 'policy-and-legislation', 'politics', and 'general-news'. However, they indirectly relate to these topics by discussing organ donation policies, research findings in organ donation, potential issues in organ donation systems, international organ donation data, and future research in organ donation.
