The problem of organ donation

Abstract

The recent debate about organ donation was surprisingly heated. People complained about a ‘nanny state’ infringing on their post-mortem rights; some threatened to tear up their donor cards if the proposed change to an ‘opt-out’ system went ahead. ‘Opt out’ means presumed consent, or a legal system in which people no longer have to actively join the organ donor register (ODR) in order to become donors. Everyone is automatically treated as a potential donor, unless they actively opt-out. Supporters of presumed consent propose this system as a means of increasing the number of organs available for transplantation. Opponents say it violates their right to their body after their death. The government has recently appointed a taskforce to examine the proposed change to a presumed consent system, triggering a public debate about the pros and cons of presumed versus informed consent. This public debate, for all the strong emotions it arouses, has focused on the wrong issues. Moving to a presumed consent system is unlikely to produce the sorely-needed increase in the number of organs available for transplantation. The empirical evidence shows that opt-in (informed consent) and opt-out (presumed consent) typically yield similar results in terms of number of organs procured, so a change to opt-out will not in itself solve the problem of organ shortage. Instead of arguing about the type of legal system that ought to be in place, we should focus on investment in infrastructure, public education and organisational change, as these are the measures that will in fact increase the number of organs available for life-saving tran