Organ Donation: Which System – Opt-In or Opt-Out – Is More Effective?
"Let's Dive into the Organ Donation Debate: Opt-in vs Opt-out"
So, what's the best method for organ donation - opting in or opting out? To find answers, a team of researchers from the UK examined the organ donation protocols of 48 countries worldwide.
With opt-in systems, individuals must explicitly sign up to donate their organs following their death. On the flip side, opt-out systems assume consent and organs are donated unless a specific request is made not to.
Prof. Eamonn Ferguson, the study's lead author from the University of Nottingham, UK, recognizes that systems relying on an individual's decision can lead to drawbacks. "[People] may fail to act for various reasons, like fear of loss, lack of effort, or simply trusting the government's decision."
Inaction within opt-in systems may result in individuals who wish to donate not doing so (a false negative). Conversely, inaction in opt-out systems could lead to an individual that does not wish to donate unintentionally becoming a donor (a false positive).
Currently, the US employs an opt-in system. Last year, 28,000 transplants were made possible due to organ donors. Unfortunately, around 18 people die daily due to a shortage of donated organs.
The researchers, along with colleagues from the University of Stirling and Northumbria University in the UK, analyzed organ donation systems in 48 countries for 13 years - 23 with opt-in systems, and 25 with opt-out systems.
They discovered that countries using opt-out organ donation systems had higher numbers of kidneys donated - the organ most sought after by those on the transplant list. Opt-out systems also boasted a greater overall number of organ transplants.
Opt-in systems, however, had higher rates of kidney donations from living donors. This apparent influence on living donation rates "has not been reported before," says Prof. Ferguson, "and requires further attention."
The study's authors acknowledge limitations, as they did not distinguish between varying degrees of opt-out legislation, and some countries required permission from family members for organs to be donated. They also addressed the observational nature of the study, which left room for unassessed factors impacting organ donation.
The researchers concluded their results, published in BMC Medicine, demonstrate 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 suggest future decisions on policy could benefit from routine international organ donation data collection and public availability. Additionally, future research may delve into the beliefs, wishes, and attitudes of individuals confronted with the choice to opt in or opt out.
The authors note that countries using opt-out consent still experience organ donor shortages. Completely revising the consent system may not resolve such issues. They propose exploring consent legislation or adopting aspects of the "Spanish Model" to improve donation rates.
Spain holds the record for the world's highest organ donation rate, achieved through its opt-out consent system, a robust transplant coordination network, and improved public information about organ donation.
Recently, Medical News Today featured a discussion on the possibility of farming animal organs for human transplants to address the organ shortage. Is this a viable solution, or should we focus on policy change regarding organ donation?
Written by James McIntosh
- The study published in BMC Medicine suggests that opt-out systems could lead to an increase in overall deceased donations, particularly kidneys, which are most in demand by those on the transplant list.
- Although opt-out systems may result in more organ transplants, they also demonstrate lower rates of kidney donations from living donors compared to opt-in systems.
- In the context of science and medical-conditions, researchers are innovating to address the organ shortage, investigating the possibility of using organ farming from animals for human transplants, a concept discussed in Medical News Today.
- Recognizing the limitations of opt-out systems, such as Spain's record-high organ donation rate, the study's authors propose exploring consent legislation or adopting elements of the Spanish Model to boost donation rates, rather than solely relying on changing the consent system.
