Navigation Links
Presumed consent not answer to solving organ shortage in US, researchers say
Date:11/29/2011

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 donation in those countries does not differ dramatically from the process in countries, such as the United States, that require explicit consent. They also found that the United States ranked third among the nations surveyed in rates of organ donation from the deceased, with 26.3 deceased donors per million population. Only Spain (34.1) and Portugal (26.7) did better.

"It does not appear that by simply having presumed consent legislation on the books that donation rates will rise," says Brian J. Boyarsky, the Hopkins researcher who conducted the interviews.

Segev says that in the United States, whether or not someone is declared as an organ donor prior to death, physicians will approach family members and ask whether they would still like to donate their loved one's organs. The family gets to make the final decision, regardless of the deceased's stated intentions, Segev says.

What he and his colleagues learned was that even in the countries with presumed consent, donation was still discussed with the potential donor's family at the time of death, even though doctors were legally permitted to transplant those organs. In six of the 13 countries, there is actually a legal requirement that doctors speak with relatives. This is done to be transparent with the family about the donation process and to obtain a complete medical and social history of the potential donor. Donation would not proceed if the family objected, just as in the United States, in all but one of the countries surveyed (Portugal), the researchers found. This is because of a fear of negative press, the participants told Segev's team, and a desire to respect the wishes of the grieving family so as to prevent psychological harm.

Implementing presumed consent legislation, Segev argues, would take a huge amount of time and energy with minimal payoff. Many countries with presumed consent have much lower rates of organ donation than the United States, he notes.

Segev says there are still lessons to learn from countries like Spain, whose donation rate far surpasses the United States. In Spain, there are dedicated physicians at every hospital who are knowledgeable about transplant issues and who screen for potential donors, manage their care and approach families. He believes these dedicated physicians are a key reason why Spain has a higher rate of donation, not the mere existence of presumed consent.

"We need to foster more awareness of transplantation and transplant issues to procure more organs for lifesaving transplants rather than force people to donate their relatives' organs if they fail to opt-out before death," he says.

The most important thing, Segev adds, "is that people need to be very clear with their next of kin while they are still alive about whether or not they want to be organ donors. That's who will ultimately make the decision."


'/>"/>
Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Congresswoman Maloney To Be Keynote Speaker: Momentum Builds for Hysterectomy Informed Consent Legislation
2. Clinical trials abroad: Making non-English language consent forms readable
3. Clinical trials: Comprehension unaffected by simplified consent forms or payment
4. Parents experience difficulty with consent process in pediatric cancer trials
5. Increased age of sexual consent in Canada may not protect teens at greatest risk: UBC study
6. Informed-consent forms should be shortened, simplified, Johns Hopkins bioethicists confirm
7. Informed-Consent Forms for HIV Research Too Long: Study
8. Penn-developed online informed consent tool could boost number of patients in cancer clinical trials
9. New Book Reveals How Qigong Could Be The Eastern Answer To Botox
10. SciAnswers.com Grows and Adds a Technical and Healthcare Professionals Job Board.
11. BestFoodFacts.org -- Food, Fiber and Fuel Questions Answered
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... While it’s often important to take ... an inventor from Austin, Texas, has identified a solution. , She developed a prototype ... restricted lighting. As such, it eliminates the need to turn on a light when ...
(Date:10/13/2017)... ... ... PurhealthRX , a leading Health and Nutrition Company, is announcing the ... spectrum CBD oil will revolutionize the rapidly growing CBD market by reducing the amount ... into liquid products, while reducing costs to end users. , The team of researchers ...
(Date:10/13/2017)... ... October 13, 2017 , ... Apple Rehab Shelton Lakes , ... mock evacuation of the facility as part of a disaster drill on October 3rd. ... EMS and Shelton City Emergency Manager, as well as the Connecticut Long Term ...
(Date:10/13/2017)... New York, NY (PRWEB) , ... October 13, 2017 , ... ... most influential people in business to advocate for action towards gender equality at their ... 18,000 views from around the globe, and reached a social audience of over 3 ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, actor ... on sciatica in a new episode of "Success Files," which is an award-winning ... innovation and investigates each subject in-depth with passion and integrity. , Sciatica occurs ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... , Oct. 11, 2017  Caris Life Sciences ® ... fulfilling the promise of precision medicine, today announced that ... Caris, Precision Oncology Alliance™ (POA) as its 17 th ... the St. Jude Crosson Cancer Institute will help develop ... use of tumor profiling, making cancer treatment more precise ...
(Date:10/11/2017)... 2017  Hill-Rom Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today ... Las Piedras, Puerto Rico , where ... Following a comprehensive ... minor structural damage, temporary loss of power and minimal ... completed, manufacturing operations have resumed, and the company expects ...
(Date:10/10/2017)... EXTON, Pa. , Oct. 10, 2017   ... leader in innovative solutions for injectable drug administration, today ... of West,s ID Adapter for improving the intradermal administration ... the Fourth Skin Vaccination Summit in May 2017 by ... Team Lead, Polio Department, World Health Organization (WHO), and ...
Breaking Medicine Technology: