Abstract
Background: In Saudi Arabia, the gap between the demand for and availability of organs persists, with a total of 13,731 patients on the waiting list in 2019. Family refusal is a major obstacle limiting donation since their consent must be obtained prior to the retrieval of organs. The cause of family refusal is mainly due to their lack of knowledge of their loved ones' wish to become a donor. This paper aimed to compare three systems of obtaining consent in terms of effectiveness, respect for autonomy, and the cultural role of families in Saudi Arabia to ensure feasibility and effectiveness in increasing the number of donors. Policy alternatives and implications: The consent systems include informed consent, presumed consent, and mandated choice. The mandated choice policy might be the optimal solution since it is the most likely to balance the respect for individual autonomy and the cultural role of families in Saudi Arabia. Conclusions and recommendations: Mandated choice ensures the respect of autonomy while influencing the next of kin's decision to donate the organs. Additionally, a recommendation to decision makers is to utilize the Tawakkalna app to send alerts to the next of kin when a user registers as a donor with the users' consent. Moreover, more research should be dedicated to investigating the Saudi public's current culture and perceptions towards organ donation to ensure feasibility.
Highlights
Organ transplantation is one of the major advances of modern medicine: it saves and enhances the quality of the lives of patients with organ failure
Despite Saudi Arabia's efforts to increase the number of donors within the past three decades, the shortage persists, with a total of 13,731 patients who remain on the waiting list in 2019 (Saudi Center for Organ Transplantation, 2019)
This paper aims to analyze the different types of consent systems to address the issue of the high rate of family refusal
Summary
Organ transplantation is one of the major advances of modern medicine: it saves and enhances the quality of the lives of patients with organ failure. Since the argument of the article is based on the claim that family refusals are mainly caused by the family’s lack of knowledge of the potential donor wishes (which could be addressed, according to the authors, by a mandated choice policy), stronger evidence is needed to support this claim, especially in the context of Saudi Arabia.
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