Organ donation practices: Should an individual opt-in or opt-out for organ donation?
Let's dive into the global organ donation landscape: Organ donation policies vary significantly across the globe. A research team from the UK looked at the organ donation protocols of 48 nations to discover which system works best - opt-in or opt-out.
In an opt-in system, individuals must actively register to donate their organs post-mortem. On the other hand, opt-out systems automatically assume organ donation unless a specific request is made before death for organs to remain untouched.
Prof. Eamonn Ferguson, lead author from the University of Nottingham, UK, acknowledges some pitfalls associated with both systems as they rely on active decisions from individuals:
"People may not act for numerous reasons, including loss aversion, effort, and believing that the policy makers have made the 'right' decision and one that they believe in."
While inaction in an opt-in system might lead to would-be donors not donating (a false negative), inaction in an opt-out system might result in an individual who does not wish to donate becoming a donor (a false positive).
As of now, the US operates on an opt-in system. Last year, 28,000 transplants were made possible thanks to organ donors. Regrettably, around 18 people die each day owing to a shortage of donated organs.
Weighing the scales: Researchers from the University of Nottingham, University of Stirling, and Northumbria University in the UK examined the organ donation systems of 48 nations over a 13-year period. They found that nations employing opt-out systems had higher overall kidney donation numbers, the organ most wanted by those on organ transplant lists. Opt-out systems also had a higher total number of organ transplants overall.
Opt-in systems, however, boasted a higher rate of kidney donations from living donors. According to Prof. Ferguson, the impact of the policy on living donation rates "has not been reported before."
The authors acknowledge limitations, such as not distinguishing between varying degrees of opt-out legislation and neglecting to assess other influencing factors.
In their study published in BMC Medicine, the researchers 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 associated with an increase in the total number of livers and kidneys transplanted."
Moving forward, the researchers suggest that international organ donation information – such as consent type, procurement procedures, and hospital bed availability – should be routinely collected and made publicly available. They also recommend examining individual views on the decision to opt in or out through a combination of surveys and experimental methods.
Lastly, the authors suggest that countries employing opt-out consent still face organ donor shortages. Significantly changing the system may not solve the problem entirely. Instead, they propose considering consent legislation or incorporating aspects of the "Spanish Model," including a transplant coordination network, to boost donor rates. Spain currently has the highest organ donation rate globally.
Recently, Medical News Today explored the question of whether animal organs should be farmed for human transplants as a potential solution to the organ shortage. Or could the problem be addressed through changes to organ donation policy?
Written by James McIntosh
- In the study published in BMC Medicine, the researchers found that opt-out systems, contrary to opt-in, lead to a higher total number of organs, particularly kidneys, being transplanted due to increased deceased donation.
- However, the study also revealed that opt-out systems result in a lower rate of kidney donations from living donors as compared to opt-in systems.
- The authors of the study propose that countries adopting opt-out consent may consider implementing a transplant coordination network, similar to Spain's, to help boost donor rates and address ongoing organ shortages.
- As an alternative solution, the question has been raised whether farming animal organs for human transplants could potentially address the organ shortage or if the problem could be tackled through adjustments to organ donation policy.
