Controversial Subject

The topic of organ donation and transplantion is shrouded in controversy. I thought I would touch on a few of these topics over the next few blog posts. And I hope to do it as objectively as I can considering my situation and my feelings about organ donation.

There is a lot of discussion in the "transplant" community about the supply and demand issues with organ donation. The demand obviously outpaces supply and it always will with the current system. There are lots of people smarter than me out there trying to figure out new and innovative ways to deal with this grower problem. Presumed Consent, while a controversial subject, is one of these options to help with the growing need for more organs.

Presumed Consent is an "opt-out" model for organ donations, rather than the United States' current voluntary "opt-in" (Informed Consent) system (meaning you'd automatically be enrolled as an organ donor unless you specifically decided to opt-out.) Presumed Consent changes the nature of the consumer’s decision. It’s harder for consumers to actively choose not to help others in need than to passively let the opportunity to help slip by.

Presumed Consent for organ donations already exists in nine countries, including Austria, France, Spain, Sweden, and Italy (and is being considered in several others, including Great Britain.) 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. Several States in the United States are actually considering legislation to create an "opt-out" system.

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 opt-out doesn’t necessarily guarantee higher donation rates. Other studies suggest that health education expenditures, death rates from accidents, and process and logistical issues may play a greater role.

Still, something needs to be done to boost the number of organs available. According to The Organ Procurement and Transplantation Network, some 98,000 people in the US are on waiting lists for organs (including about 74,000 for kidneys, 16,000 for livers, and 2,700 for hearts). It’s estimated that every 18 minutes, a patient dies for lack of an available organ.
Educating the public about the importance of organ donation may be the most reasonable approach.

I am a lucky one- someone didn't have to die for me to receive an organ transplant. But I do know what it's like to receive a life-changing transplant. These are people who (in most cases) did nothing to deserve the hand they've been dealt. And they want to be productive members of society. I don't know that presumed consent is the answer, but I do know that SOMETHING needs to be done. You never know if you or someone you love could be on "the list" one day. Think about it. (For more information, see http://www.organdonor.gov/.)