Debate over organ donation approval methods: should it be an individual's preference or assumed consent?
Globally, the approach to organ donation varies significantly, with countries adopting either an opt-in or opt-out system. A team of researchers from the UK have delved into the organ donation protocols of 48 nations to determine which method yields the most successful results.
An opt-in system requires individuals to actively register their intent to donate their organs posthumously. In contrast, an opt-out system automatically permits organ donation unless a specific request is made prior to death for organs to be withheld.
Professor Eamonn Ferguson, the lead author from the University of Nottingham, recognizes potential drawbacks of both systems that rely on individual decision-making:
"Delayed action can occur for multiple reasons, including risk aversion, apathy, and trust in policy decisions."
Inaction in an opt-in system can result in potential donors who would wish to donate, not doing so (a false negative). Conversely, inaction in an opt-out system could lead to individuals who do not wish to donate becoming donors (a false positive).
The US employs an opt-in system. Last year, 28,000 transplants were made possible due to organ donors, with around 79 transplants conducted every day. Regrettably, approximately 18 people die each day due to a scarcity of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries over a 13-year period. They found that countries utilizing opt-out systems had higher totals of kidneys donated—the organ most sought after for transplant—as well as a greater overall number of organ transplants.
Opt-in systems did, however, demonstrate a higher rate of kidney donations from living donors. Professor Ferguson asserts that this influence on living donor rates has not been reported before and is an aspect worth considering.
The study's authors admit that their research was limited as it did not account for varying degrees of opt-out legislation among the 25 countries surveyed, as well as other factors influencing organ donation that remained unassessed.
The researchers, whose findings were published in BMC Medicine, suggest that while their findings could guide future policy decisions, they could be strengthened further through the collection and public availability of international organ donation data, such as consent type, procurement procedures, and hospital bed availability.
Professor Ferguson encourages future studies to examine the perspectives and attitudes of those who must decide whether to opt in or opt out of organ donation. By combining various research methods, greater understanding can be gained regarding the effect of consent legislation on organ donation and transplantation rates.
Countries employing opt-out consent still contend with organ donor shortages. To address these issues, the authors suggest that modifications to consent legislation or adopting aspects of the "Spanish Model"—which incorporates measures such as a transplant coordination network and improved public information—could potentially improve donor rates.
Spain holds the world's highest organ donation rate, crediting their success to elements beyond the mere adoption of an opt-out system, including a local and national transplant coordination network and high-quality public information regarding organ donation.
Recently, Medical News Today explored the potential of farming animal organs for human transplants as a possible solution to the organ shortage. Alternatively, tackling the issue could involve adjusting organ donation policies.
- In the context of a study by researchers from the University of Nottingham, the University of Stirling, and Northumbria University, opt-out systems were found to result in higher totals of kidneys donated and a greater overall number of organ transplants compared to opt-in systems.
- Despite the higher rate of kidney donations from living donors in opt-in systems, countries utilizing opt-out systems still face organ donor shortages and may benefit from modifications to consent legislation or adopting aspects of the "Spanish Model."
- Science continues to explore innovative solutions for addressing organ donor shortages, such as the potential farming of animal organs for human transplants, while also advocating for policy adjustments in organ donation.
- Paxlovid, a medical-health condition treatment, while not directly related to organ donation, is one of the many aspects affecting health-and-wellness that researchers may consider when examining the perspectives and attitudes of individuals in relation to organ donation decisions.
