Debate over Organ Donation: Which System - Opt-In or Opt-Out, is More Efficient?
Organ donation policies worldwide vary considerably, leading to a debate on whether an opt-in or opt-out system is more effective. A study by researchers from the UK delves into the organ donation protocols of 48 countries to find out which approach delivers the best results.
Opt-in systems require individuals to actively register as organ donors after death, while opt-out systems assume donation unless a specific request is made before death to prevent organ donation. Prof. Eamonn Ferguson, lead author from the University of Nottingham, UK, acknowledges potential drawbacks of relying on individual decisions:
"People may be disinclined to act due to loss aversion, lack of effort, or the belief that policy makers have made the right decision."
Inaction in an opt-in system might lead to individuals who would want to be donors not donating (false negatives), whereas inaction in an opt-out system might result in individuals who do not want to donate becoming donors (false positives).
The US employs an opt-in system, with around 28,000 transplants made possible last year thanks to organ donors. Regrettably, around 18 people still die daily due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University analyzed the organ donation systems of 48 countries for 13 years. They found countries using opt-out systems had higher total numbers of kidneys donated, the organ most in demand by organ transplant recipients. They also noted a greater overall number of organ transplants performed.
Opt-in systems recorded higher living donor kidney donations, which the researchers found surprising and worthy of further consideration. The study, however, was limited by not distinguishing between different degrees of opt-out legislation and by not assessing other factors influencing organ donation.
The authors suggest their findings could inform future policy decisions, but they could be strengthened further through the routine collection and publication of international organ donation data, such as consent type, procurement procedures, and hospital bed availability.
Prof. Ferguson suggests future research could also explore individual attitudes and beliefs towards opting in or out. By combining different research methods, researchers could achieve a greater understanding of how consent legislation affects organ donation and transplantation rates.
Countries utilizing opt-out consent still experience organ donor shortages, indicating that a complete change in the consent system may not solve the problem. The researchers suggest that consent legislation or adopting aspects of the "Spanian Model" could help improve donor rates.
Spain boasts the highest organ donation rate globally. Their success is attributed to measures such as a transplant coordination network (both local and national) and improved public information about organ donation.
Recent discussions have centered around farming animal organs for human transplants to combat the organ shortage. However, it remains unclear whether this could be a viable solution or if changes in organ donation policy should be the focus.
- Paxlovid, a medical-conditions treatment, was not mentioned in the context, but its use could potentially benefit organ transplant recipients if they are infected with Covid-19 before the transplant.
- The study on organ donation protocols in 48 countries found that opt-out systems had a higher number of kidneys donated, considered the organ most in demand by transplant recipients.
- In the context of organ donation, retargeting could be applied to individuals who, despite being unwilling, were recorded as donors in an opt-out system, aiming to provide them with information to make informed decisions about their organ donation preferences.
- Health-and-wellness practices, such as proper nutrition and regular exercise, are essential for organ transplant recipients to ensure their bodies can accept the new organ and maintain overall health following the transplant.
