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2021年5月13日 · This paper argues that there is little difference between opt-in and opt-out organ donation systems for increasing donor numbers when used in isolation. Independently diverting to an opt-out system confers no obvious advantage and can harm efforts to bolster
- Table 1
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- Table 1
This page answers to some of the most common questions about the coming law change regarding organ donation and the opt out system, including: How is the law changing? | What is Max and Keira's Law? | Why do we need an opt out system? | Am I losing
- Overview
- In or out?
- Moving forward
Around the world, organ donation policies vary greatly. Is it best to have a donation system where people have to opt in or opt out? To investigate, a team of researchers from the UK have analyzed the organ donation protocols of 48 countries to see which approach is working best.
With an opt-in system, people have to actively sign up to a register to donate their organs after death. In opt-out systems, organ donation will occur automatically unless a specific request is made before death for organs not to be taken.
Prof. Eamonn Ferguson, lead author from the University of Nottingham, UK, acknowledges that because the two systems are reliant on an active decision from individuals, it can lead to drawbacks:
“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.”
However, inaction in an opt-in system can lead to individuals who would want to be a donor not donating (a false negative). In contrast, inaction in an opt-out system can potentially lead to an individual that does not want to donate becoming a donor (a false positive).
The US currently uses an opt-in system. According to the US Department of Health & Human Services, 28,000 transplants were made possible last year due to organ donors. Around 79 people receive organ transplants every day. Unfortunately, around 18 people die every day, unable to have surgery due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling and Northumbria University in the UK analyzed the organ donation systems of 48 countries for a period of 13 years – 23 using an opt-in system and 25 using an opt-out system.
The study authors measured overall donor numbers, numbers of transplant per organ and the total number of kidneys and livers transplanted from both deceased and living donors.
They found that countries using opt-out systems of organ donation had higher total numbers of kidneys donated – the organ that the majority of people on organ transplant lists are waiting for. Opt-out systems also had the greater overall number of organ transplants.
Opt-in systems did, however, have a higher rate of kidney donations from living donors. The apparent influence that policy had on living donation rates “has not been reported before,” says Prof. Ferguson, “and is a subtlety that needs to be highlighted and considered.”
The researchers state that their results, published in BMC Medicine, show 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 that although the results could be used in the future to inform decisions on policy, they could be strengthened further through the routine collection of international organ donation information – consent type, procurement procedures and hospital bed availability, for example – which should then be made publicly available.
Prof. Ferguson suggests that future studies could also analyze the opinions of those who have to make the decision to opt in or opt out:
”Further research outside of this country-level epidemiological approach would be to examine issues from the perspective of the individual in term of beliefs, wishes and attitudes, using a mixture of survey and experimental methods.”
“By combining these different research methods researchers can develop a greater understanding of the influence of consent legislation on organ donation and transplantation rates,” he says.
The authors note that countries using opt-out consent still experience organ donor shortages. Completely changing the system of consent is, therefore, unlikely to solve such a problem. They suggest that consent legislation or adopting aspects of the “Spanish Model” could be ways to improve donor rates.
2019年3月15日 · One of the most topical discussions in global organ procurement is the relative merits of an opt-out system for organ donation (termed “presumed or deemed consent”) versus the opt-in system (termed “explicit consent”) to increase organ donor rates, with both
- Adam Arshad, Benjamin Anderson, Adnan Sharif
- 2019
2021年1月12日 · This may, in part, explain the seemingly counter-intuitive result that opt-out systems do not outperform opt-in systems. And the opt-in system of donation does, in fact, provide a mechanism to bridge the gap between intent and action, by providing two pathways to obtain a “yes” to organ donation.
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2016年7月14日 · In 2015, Hong Kong's organ donation rate, at 5.8 donors per million people ("pmp"), is among the lowest in the world. Currently, Hong Kong adopts an opt-in system based on voluntary decisions of people to donate and the family consent to the donation after death.
2022年7月4日 · Recently England and Netherlands changed their consent system for deceased organ and tissue donation from Opt In to Opt Out. The aim of this article is to give insight into the process of changing the law, implementation and initial impact.
