Abstract
Chile, a middle-income country, recently joined Israel and Singapore as the world’s only countries to require reciprocity as a precondition for organ transplantation. The Chilean reform includes opt-out provisions designed to foster donation and priority for organ transplantation for registered people. Although the reform has had serious difficulties in achieving its mission, it can be reviewed by other countries that seek to address the serious shortage of organs. As increased organ donation can substantially enhance or save more lives, the effect on organ availability due to incentives arising from rules of preference should not be underestimated.
Highlights
In recent years, technical, political and public opinion in many countries has shifted towards the view that opt-out provisions can help promote organ donation
To promote organ donation, legislating the principle of priority provides a strong incentive by signalling to people that registering as a non-donor decreases their chance of receiving a donated organ when needed
Singapore has experienced an increase in the number of donors after introducing a priority system, the effect of the priority system is unclear because a presumed consent system was implemented at the same time
Summary
Technical, political and public opinion in many countries has shifted towards the view that opt-out provisions can help promote organ donation. A survey showed that over 70% of respondents were unaware of the scope of the new law and 16% felt that the organ donation and transplantation system was subject to market forces.[15] In the same survey, 12% of participants believed that access to procured organs was limited to wealthy individuals, whereas 13% feared that health-care professionals would let registered donors die to harvest their organs.[16] opting out was relatively easy: individuals merely had to state their choice when obtaining or renewing identity cards or driver’s licences To address this large-scale opt-out, Chile amended the Organ Donor Act with Law 20673 in October 2013. In 2014, the number of organ donations rebounded again to 123.12
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