Magazine article Medical Economics

Getting Aggressive about Organ Donations

Magazine article Medical Economics

Getting Aggressive about Organ Donations

Article excerpt

If a bill recently introduced in Delaware passes, state residents who suffer cardiac or brain death will become potential organ donors, whether that's what they intended or not.

Earlier this year, Rep. Pete Schwartzkopf, a Democrat from Rehoboth Beach, cosponsored legislation in which residents would automatically be enrolled as an organ and tissue donor when applying for or renewing their driver's license-unless they check a box indicating that they do not wish to participate.

This opt-out model for organ donations, known as Presumed Consent, bucks the spirit of our current voluntary opt-in (Informed Consent) system. Presumed Consent changes the nature of the consumer's decision. It's more guilt-inducing-and harder-for consumers to actively choose not to help others in need than to passively let the opportunity to help slip by. Legislating an opt-out approach also implies that donating organs is the sanctioned social norm.

Presumed Consent for organ donations already exists in nine countries, including Austria, France, Spain, Sweden, and Italy. In the "soft" opt-out system used by Spain and France, among others, you're considered a donor unless you've instructed otherwise, but your family can refuse to allow the organ donation when you die. In the "hard" opt-out version, which exists in Austria, your family cannot say no. Rep. Schwartzkopf s House Bill No. 302 essentially proposes the latter version, stating that if a driver has not opted out, "no further or additional consent is necessary

It's not likely that America would buy into to a "hard" opt-out system. If a Presumed Consent bill passed, it would probably allow a deceased's family to veto organ donations. And there would also be plenty of safeguards so that no one would accidentally become a donor through sheer oversight.

A 2005 study published in Transplant International looked at 10 countries with either Presumed or Informed Consent for organ donations, and concluded that optout doesn't guarantee higher donation rates. …

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