STAT, July 6, 2017
Leah Samuel


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The shortage of organs for transplantation is a thorny problem. Nearly 118,000 people in the U.S. are on waiting lists for transplants of kidneys, hearts, livers, and other organs; an estimated 8,000 of them will not live to receive a transplant.

The desperate situation has spurred various searches for solutions. Scientists are working on ways to preserve donated organs longer and are developing algorithms that factor in a patient’s proximity to a transplant center along with their health characteristics. Others have suggested ways to increase the organ supply, maybe through financial compensation for donors, or via relaxed standards for donated organs.

But one of the most effective means might be a simple policy switch — from requiring donors to specifically sign up, to assuming everyone is a donor unless stated otherwise.

It’s called opt-out organ donation or “presumed consent” and it means that basically every resident is an organ donor unless they remove themselves from that list. Some version of opt-out organ donation already exists in 25 European countries including Spain, Belgium, and, as of January, France. The U.K. is currently considering opt-out policies.

And those policies have been on the whole incredibly effective. A 2012 studyfound that organ donation rates are “typically exceeding 90 percent in opt-out countries and failing to reach even 15 percent in opt-in countries.”

But so far those policies have gotten little traction in the U.S., despite scattered efforts by states to introduce opt-out legislation. And so it remains an open question whether the policy change could solve America’s organ shortage — or whether, as some fear, it might actually make it worse. [...]

bioethics health law policy human tissue public health regulation