Removing organs for transplant unless person explicitly opts out of donation before death not best way to address scarcity, raises sticky ethical questions
Changing the organ donation process in this country from opt-in -- by, say, checking a box on a driver's license application -- to opt-out, which presumes someone's willingness to donate after death unless they explicitly object while alive, would not be likely to increase the donation rate in the United States, new Johns Hopkins research suggests.
Some organ donation advocates have pushed for a switch to an opt-out system, arguing it would be a positive step toward addressing the nation's profound organ shortage. They say most people support donation but never formally record their wishes and that an opt-out system -- known commonly as presumed consent -- might ease the burden of decision-making on grieving families at the time of death. Many thousands of people die every year waiting for organs that never come, and many viable organs are never made available for donation.
"Opt-out is not the magic bullet; it will not be the magic answer we have been looking for," says Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study published online in the journal Transplantation. "With opt-out the perception becomes, We will take your organs unless you take the time to fill out a form. That's a dangerous perception to have. We only want to use donated organs from people who intended to donate."
Enforcing an opt-out policy raises tricky ethical questions and could challenge the relationship between the transplant community and the general public, which should be mutually supportive, Segev adds.
Segev and his team conducted in-depth interviews with transplant experts in 13 European nations with presumed consent legislation. They found that, despite the laws, the process of organ do
|Contact: Stephanie Desmon|
Johns Hopkins Medical Institutions