Organ donation: Should it be an 'opt-out' or 'opt-in' method?
Organ donation policies around the globe display striking variance. The question of whether an 'opt-in' or 'opt-out' system is more effective has been a topic of debate. To shed light on this issue, a team of researchers from the UK analyzed organ donation protocols in 48 countries over a 13-year period.
In an opt-in system, you must actively sign up to a register to donate organs after death. In contrast, an opt-out system implies that organ donation will occur automatically unless a specific request for non-donation is made before death.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, UK, acknowledges potential drawbacks associated with both systems:
"Individuals may not act for numerous reasons, including loss aversion, effort, and believing that policy makers have made the 'right' decision."
In an opt-in system, inaction can lead to false negatives, meaning that individuals who wish to be donors may ultimately not donate. In contrast, an opt-out system can result in false positives, where individuals who do not wish to donate might unintentionally become donors.
The United States currently employs an opt-in system. Last year, over 28,000 transplants were facilitated due to organ donors, with approximately 79 transplants happening every day. Unfortunately, approximately 18 people die daily due to a scarcity of donated organs.
After scrutinizing the organ donation systems of 48 countries, the researchers found that opt-out systems resulted in a higher number of total kidneys donated. Opt-out systems also saw a greater total number of organ transplants. However, opt-in systems had a higher rate of kidney donations from living donors.
Although the study had limitations, such as not differentiating between varying degrees of opt-out legislation and neglecting other factors affecting organ donation, the results demonstrate that opt-out consent might increase deceased donation rates but lower living donation rates. Additionally, opt-out consent is associated with an increase in the number of livers and kidneys transplanted.
To strengthen future decisions on policy, the authors recommend the routine collection and public availability of extensive organ donation data, including consent type, procurement procedures, and hospital bed availability. They also propose additional research examining the opinions, beliefs, wishes, and attitudes of those making the decision to opt-in or opt-out.
While opt-out systems can result in higher organ donation rates, they do not necessarily eliminate the organ donor shortage issue. The authors suggest considering changes to consent legislation or adopting aspects of the "Spanish Model" to improve donor rates.
Spain boasts the world's highest organ donation rate, with their success attributable to initiatives such as a transplant coordination network operating both locally and nationally and the provision of high-quality information regarding organ donation.
Recently, a spotlight feature on Medical News Today raised the question of whether farming animal organs for human transplants could serve as a solution for the organ shortage or if addressing the issue through changes to organ donation policy is preferable.
- The study on organ donation systems in 48 countries found that opt-out systems result in a higher number of total kidneys donated and a greater total number of organ transplants, but have a lower rate of kidney donations from living donors.
- In an opt-out system, organ donation will occur automatically unless a specific request for non-donation is made before death, while in an opt-in system, individuals must actively sign up to a register to donate organs after death.
- The authors of the study recommend the routine collection and public availability of extensive organ donation data, including consent type, procurement procedures, and hospital bed availability, to strengthen future decisions on policy.
- Scientists in the field of health and wellness are calling for increased research on addressing the organ donor shortage issue, with questions being posed about whether farming animal organs for human transplants could serve as a solution or if changes to organ donation policy are more preferable.
- Policies around organ donation around the globe display striking variance, and the debate over whether an opt-in or opt-out system is more effective continues, even with the results of the study that suggests opt-out consent might increase deceased donation rates but lower living donation rates.
