Opt-out System Of Organ Donation Research Articles

Attitude of Jordanians towards a new enactment for an opt-out organ donation system: a cross-sectional study

BackgroundOrgan donation entails saving or transforming lives through the provision of organs, either from living donors or deceased individuals. In Jordan, low donation rates are attributed to religious misconceptions, limited...

“I am in favour of organ donation, but I feel you should opt-in”—qualitative analysis of the #options 2020 survey free-text responses from NHS staff toward opt-out organ donation legislation in England

BackgroundIn May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding awareness and support of the change. This paper analyses the free-text responses from the survey.MethodsThe #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed.ResultsThe #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes.ConclusionsThe overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings.Trial registrationNational Institute of Health Research (NIHR) [IRAS 275992].

Analysis of content and online public responses to media articles that raise awareness of the opt-out system of consent to organ donation in England.

Preceded by a national media campaign, in May 2020, England switched to a soft opt-out system of organ donation which rests on the assumption that individuals meeting specific criteria have consented to organ donation unless they have expressed otherwise. We aimed to learn more about how the changes were communicated, how people responded and any discrepancies between key messages and how they were interpreted by the public. Summative content analysis of 286 stories and related reader-generated comments in leading UK online news sources (April 2019 to May 2021). Further detailed thematic analysis of 21 articles with reader-generated content, complemented by thematic content analysis coding of all 286 stories. Most media coverage on both organ donation and the law change was positive, with little variation over time or between publications. The importance of organ donation, benefits of the law change, and emotive stories (often involving children) of those who had donated an organ described as "superheroes" or those who had received organs as benefiting from a "miracle" were frequently cited. In contrast, reader-generated comments were markedly more negative, for example, focusing on loss of individual freedom and lack of trust in the organ donation system. Commentators wished to be able to choose who their organs were donated to, were dismissive and blaming towards minority ethnic groups, including undermining legitimate worries about the compatibility of organ donation with religious beliefs and end of life cultural norms, understanding and acceptance of brain-stem death and systemic racism. Misinformation including use of inflammatory language was common. The portrayal of donors and recipients as extraordinary is unlikely to help to normalise organ donation. Undermining legitimate concerns, in particular those from ethnic minorities, can alienate and encourage harmful misinformation in underrepresented groups. The discrepancies between the tone of the articles and the readers comments suggests a lack of trust across the public, health, policy and media outlets. Easily accessible, ongoing and tailored sources are needed to mitigate misinformation and disinformation and ensure key messages are better understood and accepted in order to realise the ambitions of soft opt-out organ donation policies.

Assessing the factors that influence the donation of a deceased family member's organs in an opt-out system for organ donation

RationaleFamily, and sometimes longstanding friends, have considerable influence over organ donation, through agreeing or disagreeing to the donation of a deceased individual's organs. To date, most research has been undertaken within opt-in systems. ObjectiveThis study advances on previous research by assessing next-of-kin approval under opt-out legislation. We tested whether next-of-kin approval varies when the deceased is a registered donor (opted-in), registered non-donor (opted-out) or has not registered a decision under an opt-out policy (deemed consent). We also tested if the deceased's wishes influenced next-of-kin approval through relatives anticipating regret for not donating and feelings of uncertainty. Finally, we assessed whether next-of-kin's own beliefs about organ donation influenced whether they followed the deceased's wishes. MethodsParticipants (N = 848) living in a country with opt-out legislation (Wales, UK) were asked to imagine a relative had died under an opt-out system and decided if their relatives' organs should be donated. Participants were randomly allocated to imagine the deceased had either (i) opted-in, (ii) opted-out or (iii) not registered a decision (deemed consent). The outcome variable was next-of-kin approval, with uncertainty and anticipated regret as potential mediators and next-of-kin's beliefs about organ donation as moderators. ResultsNext-of-kin approval was lower when the deceased had opted-out than under deemed consent. This was due to next-of-kin anticipating more regret for not donating under deemed consent than opt-out. Further analyses revealed the deceased's wishes influence next-of-kin approval, via anticipated regret, when next-of-kin did not hold negative beliefs about organ donation. ConclusionsThe deceased's wishes were less likely to be followed when next-of-kin had negative beliefs towards donation. Developing large-scale campaigns to improve these beliefs in the general public should make people more likely to follow the deceased's wishes. As a result, these campaigns should improve the availability of donor organs.

Opt-Out Consent at Different Levels of Attitude to Organ Donation: A Household Survey in Qatar

PurposeDemand for an organ transplant is surpassing the number of organ donors and hence increasing waiting lists worldwide, compelling many countries to adopt an opt-out consent system for organ donation. Opt-out is used in several European countries and has increased organ registration rate. No study on this subject has been published from the gulf region to associate sociodemographic characteristics, knowledge, attitude, beliefs, and intention domains regarding an opt-out consent for organ donation.Materials and MethodsA household survey was conducted between October and November 2016 using a validated questionnaire. Integer codes were assigned for qualitative data to interpret results at par with quantitative data for each domain to allow data for advanced statistical analysis.ResultsOf 1044 surveyed participants, 724 (69.34%) those aged 37.7±10.4 agreed to adopting an opt-out consent system of which 231 (29.4%) were Qatari citizens and 353 (48.8%) were males. Mean levels of indices such as attitude, behavioral beliefs, and intention domains to organ donation were found higher in opt out participants. After adjusting statistical significant variables, multivariate analysis showed that attitude index was associated to opt out system (OR: 16.7, 95% C.I.:10.6–26.3, p=0.001) whereas; knowledge index (OR: 0.25, 95% C.I.: 0.07–0.83, p=0.03), behavioral beliefs (OR: 0.55, 95% C.I.: 0.35–0.86, p=0.009) and intention indices (OR: 0.42, 95% C.I.: 0.20–0.87, p=0.02) were associated with opt-in system for organ donation in Qatar. Regression model was able to discriminate (AUC: 84%, 95% C.I.:81% to 87%) for opt-out consent. Future probabilities for opt-out consent were 0.80, 0.88, 0.92,0.95,0.96,0.97,0.99 and 0.993 for 0.20, 0.30, 0.40, 0.50, 0.60, 0.70, 0.80 and 0.90 attitude levels after using 200 re-samples to make traditional multivariate regression model to realistic model for the population.ConclusionThe majority of the survey participants showed a good attitude but less knowledge, behavioral beliefs, and intention towards adopting an opt-out system for organ donation in Qatar.

Evaluation of staff training on legislation change in organ and tissue donation.

British Journal of NursingVol. 29, No. 16 Nhs Blood and TransplantEvaluation of staff training on legislation change in organ and tissue donationCathy Miller, Louise Hubner, Claire Roberts, Sonya PatersonCathy Miller(E-mail Address: [email protected])Legislation Project Lead, Education and Governance, Organ Donation and TransplantationSearch for more papers by this author, Louise HubnerEducation and Professional Development Manager, Legislation ImplementationSearch for more papers by this author, Claire RobertsProfessional Development Specialist, Legislation ImplementationSearch for more papers by this author, Sonya PatersonProfessional Development Specialist, Legislation Implementation, NHS Blood and TransplantSearch for more papers by this authorCathy Miller; Louise Hubner; Claire Roberts; Sonya PatersonPublished Online:9 Sep 2020https://doi.org/10.12968/bjon.2020.29.16.974AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Bethell J. House of Lords Debate, 18 May 2020, c905. https://tinyurl.com/yxunpvob (accessed 24 August 2020) Google ScholarD'Ardis M. Forum theatre for practice simulation and skills development in nurse education: a student's perspective. Nurse Education Today 2014;34(8):1136–1137. https://doi.org/10.1016/j.nedt.2013.12.002 Crossref, Medline, Google ScholarHubner L, Miller C, Roberts C. Implementing a legislation change in organ and tissue donation in England. Br J Nurs. 2020;29(3):168-169. https://doi.org/10.12968/bjon.2020.29.3.168 Link, Google ScholarHuman Tissue Authority. F. Donation of solid organs and tissue for transplantation. Part one: living organ donation. Code of practice. 2020. https://tinyurl.com/y4rhstpe (accessed 24 August 2020) Google ScholarKnowles MS. The modern practice of adult education: from pedagogy to andragogy. 2nd edn. Engelwood Cliffs (NJ): Cambridge Books; 1980 Google ScholarMiller C, Hubner L, Griffiths A. Legislation change in organ and tissue donation: educating specialist staff. Br J Nurs. 2020;29(5):318-320. https://doi.org/10.12968/bjon.2020.29.5.318 Link, Google ScholarNoyes J, McLaughlin L, Morgan K et al.. Process evaluation of specialist nurse implementation of a soft opt-out organ donation system in Wales. BMC Health Serv Res. 2019;19(1):414. https://doi.org/10.1186/s12913-019-4266-z Crossref, Medline, Google ScholarScales A, Bentley H. Organ donation: nursing roles and responsibilities. Br J Nurs. 2020;29(1):60-61. https://doi.org/10.12968/bjon.2020.29.1.60 Link, Google Scholar FiguresReferencesRelatedDetailsCited byConsolidating education on organ and tissue donation legislation changesCathy Miller, Louise Hubner, Bobbee Cotter26 November 2020 | British Journal of Nursing, Vol. 29, No. 21 10 September 2020Volume 29Issue 16ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 9 September 2020 Published in print 10 September 2020 Information© MA Healthcare LimitedPDF download

Progress in Organ Donation and Transplantation: A Critical Review of Literature

The majority of countries are battling with a high incidence of organ failure such as the kidneys, heart, lungs, pancreas, and liver. The only solution that can remedy the plight of patients facing the strong likelihood of death as a result of malfunctioning body organs is organ donation and transplantation. The intention of this literature study is to assess progress in organ donation and transplantation. This study has benefitted immeasurably from previous scientific investigations. Four hundred and thirty-one published papers were selected from different accredited journals. The study found that many of the countries that have implemented the opt-in system are struggling to close the gap between the high demand for and the actual availability of life-saving organs due to low rates of registered and committed organ donors. The majority of patients that are contending with end-stage diseases are added to the organ donation waiting lists, but have little hope of receiving life-prolonging organs. Among the factors that deter people from contributing to organ donation and transplantation are a lack of knowledge, the failure to obtain consent from family members or next-of-kin, social attitudes, socio-cultural aspects, and myths. This study recommends urgent measures that could be taken to increase organ transplants in public and private hospitals due to the chronic shortage of organs for transplantation and by introducing the opt-out system of organ donation.

Deemed consent to organ donation: what critical care nurses need to know.

British Journal of NursingVol. 29, No. 15 NHS Blood and TransplantDeemed consent to organ donation: what critical care nurses need to knowPhil Walton, Cathy Miller, Steven Maycock, Kristian NicolPhil WaltonLegislation Project Lead—Organ Donation & Nursing, NHS Blood and TransplantSearch for more papers by this author, Cathy MillerLegislation Project Lead—Education and Governance, NHS Blood and TransplantSearch for more papers by this author, Steven MaycockCharge Nurse, Intensive Therapy Unit/High Dependency Unit, Withybush General Hospital, HaverfordwestSearch for more papers by this author, Kristian NicolPractice Development Charge Nurse, Intensive Care, Kettering General Hospital NHS Foundation TrustSearch for more papers by this authorPhil Walton; Cathy Miller; Steven Maycock; Kristian NicolPublished Online:13 Aug 2020https://doi.org/10.12968/bjon.2020.29.15.910AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health and Social Care. Consultation outcome. Organs and tissues to be excluded from the opt-out organ donation system: government response. 2020. https://tinyurl.com/y5szt79g (accessed 5 August 2020) Google ScholarHulme W, Allen J, Manara AR, Murphy PG, Gardiner G, Poppitt E. Factors influencing the family consent rate for organ donation in the UK. Anaesthesia. 2016;71(9):1053-1063. https://doi.org/10.1111/anae.13535 Crossref, Medline, Google ScholarHuman Tissue Authority. Codes of practice and standards. 2020. https://tinyurl.com/yx8zngc3 (accessed 3 August 2020 Google ScholarNational Institute for Health and Clinical Excellence. Organ donation for transplantation: improving donor identification and consent rates for deceased organ donation. Clinical guideline CG135. 2016. https://www.nice.org.uk/guidance/cg135 (accessed 3 August 2020) Google ScholarNHS Blood and Transplant. Timely Identification and Referral of potential organ donors. 2014. https://tinyurl.com/yxa54cvzf (accessed 3 August 2020) Google ScholarNHS Blood and Transplant. Approaching the families of potential organ donors. 2015. https://tinyurl.com/y4cgeoqg (accessed 3 August 2020) Google ScholarNHS Blood and Transplant. Organ donation and transplantation activity report 2018/19. 2019. https://tinyurl.com/vazfuw6 (accessed 3 August 2020) Google ScholarNoyes J, Morgan K, Walton P, Roberts A, Mclaughlin L, Stephens M. Family attitudes, actions, decisions and experiences following implementation of deemed consent and the Human Transplantation (Wales) Act 2013: mixed-method study protocol. BMJ Open. 2017;7:e017287. https://doi.org/10.1136/bmjopen-2017-017287 Crossref, Medline, Google ScholarNoyes J, McLaughlin L, Morgan K et al.. Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study. BMJ Open. BMJ Open. 2019;9:e025159. https://doi.org/10.1136/bmjopen-2018-025159 Medline, Google Scholar FiguresReferencesRelatedDetailsCited byEmbedding changes in legislation for organ and tissue donation across England and JerseyCathy Miller, Louise Hubner, Sonya Paterson, Bobbee Cotter, Phil Walton, Helen Bentley, Claire Roberts18 March 2021 | British Journal of Nursing, Vol. 30, No. 5 13 August 2020Volume 29Issue 15ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 13 August 2020 Published in print 13 August 2020 Information© MA healthcare LimitedPDF download

Legislation change in organ and tissue donation: educating specialist staff

British Journal of NursingVol. 29, No. 5 NHS Blood and TransplantLegislation change in organ and tissue donation: educating specialist staffCathy Miller, Louise Hubner, Angharad GriffithsCathy Miller(E-mail Address: [email protected])Legislation Project Lead, Education and Governance, Organ Donation and TransplantationSearch for more papers by this author, Louise HubnerLegislation Project Team ManagerSearch for more papers by this author, Angharad GriffithsLegislation Professional Development Specialist, NHS Blood and TransplantSearch for more papers by this authorCathy Miller; Louise Hubner; Angharad GriffithsPublished Online:13 Mar 2020https://doi.org/10.12968/bjon.2020.29.5.318AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Hubner L, Miller C, Roberts C. Implementing a legislation change in organ and tissue donation in England. Br J Nurs. 2020;29(3):168–169 Link, Google ScholarHuman Tissue Authority. Code of practice. F.: Donation of solid organs and tissue for transplantation 2017. https://tinyurl.com/w7vaaum Google ScholarKnowles MS. The modern practice of adult education. From pedagogy to andragogy (2nd edn). Engelwood Cliffs (NJ): Cambridge Books; 1980 Google ScholarNoyes J, McLaughlin L, Morgan, K et al.. Process evaluation of specialist nurse implementation of a soft opt-out organ donation system in Wales. BMC Health Services Research. 2019;19(1):414. https://doi.org/10.1186/s12913-019-4266-z Crossref, Medline, Google Scholar FiguresReferencesRelatedDetailsCited byEvaluation of staff training on legislation change in organ and tissue donationCathy Miller, Louise Hubner, Claire Roberts, Sonya Paterson9 September 2020 | British Journal of Nursing, Vol. 29, No. 16 12 March 2020Volume 29Issue 5ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 13 March 2020 Published in print 12 March 2020 Information© MA Healthcare LimitedPDF download

Max and Keira’s law: an overview on the advantages, disadvantages and alternatives to an opt-out organ donation system in the UK

Summary: Despite definite implementation of the law, there have been concerns over the presumed consent given for retrieving organs from the deceased; ignorance and lethargy from certain members of the public may mean that true informed consent can never be obtained when collecting organs. To combat this, expensive national campaigns would need to be launched to make the public aware of the new process, as well as educating them on how to opt out of the process if necessary. Regardless of these challenges, there are many advantages to the new law. Advantages include an increase in successful organ donations and transplant, as well as potentially an increased availability of organs for use in medical research, drug development and university teaching. Relevance: To increase the number of organ donors in England, the government will implement Max and Keira’s Law: all adults over the age of 18 living in the United Kingdom become potential organ donors after their death, unless they choose to opt out. The law will be employed by spring 2020. Despite there being presumed consent for the retrieval of organs, families of the deceased will still be contacted to recheck consent, and ensure that family wishes are upheld. Take Home Messages: Based on the advantages, the move to the opt-out system appears to be a sensible method to increase the number of organs available for use in medicine. Proposed alternatives such as xenotransplantation and 3D bioprinting have the obvious benefit of providing an almost infinite supply of organs. However, these alternatives remain in the preclinical stages, with ethical challenges and infection risks that need to be overcome before they can be used in hospitals.

Students’ perceptions of debating as a learning strategy: A qualitative study

Debate has been shown to develop critical thinking skills, enhance communication, and encourage teamwork in a range of different disciplines, including nursing. The objective of this study was to explore students' perceptions of the educational value of debate. A semi-structured focus group was conducted with 13 undergraduate Operating Department Practice students following a debate on the opt-out system of organ donation. Transcripts were analysed thematically, identifying three main themes that described the students’ perceptions of the debate. These were: (1) openness to diverse viewpoints; (2) developing non-technical skills, and (3) encouraging deep learning. The analysis showed participants perceived debate to be a valuable educational method that enhanced their learning. Engaging in debate encouraged students to critically reflect on their prior beliefs about organ donation—in some cases leading them to reconsider their original position. The findings from this study suggest that debate can be a valuable pedagogical tool to incorporate into healthcare education. Future research should consider the use of debate to develop non-technical skills that have utility in healthcare.

What Intensivists Say About an Opt-Out System for Organ Donation

BackgroundSingapore has had an opt-out organ donation system since the inception of the Human Organ Transplant Act in 2009. This law allows all Singapore citizens and permanent residents to donate their organs after confirmation of brain death, usually in the setting of devastating brain injury or stroke in an intensive care unit (ICU) setting, and such cases are referred to the National Organ Transplant Unit team by intensivists after the presumed clinical brain stem death testing. The further confirmatory tests, coordination with surgeons to find suitable recipients, and communication with family members is then carried out by the transplant coordinators from the National Organ Transplant Unit and not the clinicians. Despite a decade of the institution of the Act, the rates of organ donation remain low. This survey is the first aimed to assess the concerns and recommendations of the intensivists in Singapore. MethodsThis was an anonymous survey sent to 120 intensivists registered in Singapore with a 58% response rate. The survey included 14 open-ended questions. The respondents included both private and public sector intensivists. A qualitative analysis was carried out to analyze the emergent themes from the survey. ResultsA total of 79% of the respondents mentioned raising awareness through publicity, education, and advertising; 34% mentioned educating physicians and engaging ICU physicians in further planning of the organ transplant program in Singapore; 35% felt that publicizing more real stories of recipients would help. Generally, there was unease at the opt-out system infringing basic rights. ConclusionThis is the first survey to elicit the responses of the referring physicians for organ transplant. Their opinions suggest that a wider awareness and buy-in is needed both by the public and the ICU physicians, and addressing their valid moral concerns is essential in bridging this gap.

Process evaluation of specialist nurse implementation of a soft opt-out organ donation system in Wales

BackgroundWales introduced a soft opt-out organ donation system on 1st December 2015 with the aim of improving consent rates. In the first 18 months consent rates improved but the difference could not solely be attributed to the soft opt-out system when compared with similar improvements in consent rates in other UK nations.MethodsWe conducted an 18 month post-intervention qualitative process evaluation involving 88 family members of 60/211 potential organ donor cases, and 19 professionals. Views and experiences of Specialist Nurses in Organ Donation who implemented the new system and family members who were involved in decision making were collected to see how their respective behaviours impacted on implementation. Data collection included interviews, focus groups and qualitative questionnaire data.ResultsImplementation was considered a success by Specialist Nurses in Organ Donation. The bespoke retraining programme and responsive approach to addressing initial implementation issues were identified as examples of best practice. Specialist Nurses in Organ Donation were valued by family members. Six implementation issues had an impact on consent rates – the media campaign had gaps, the system was more complex, challenges in changing professional behaviours, inability to obtain the required standard of evidence from family members to overturn a donation decision, increased complexity of consent processes, and additional health systems issues.ConclusionThis is the first comprehensive process evaluation of implementing a soft opt-out system of organ donation. Specific elements of good implementation practice (such as investment in the retraining programme and the responsiveness of Specialist Nurses in Organ Donation and managers to feedback) were identified. The key message is that despite retraining, nursing practice did not radically change overnight to accommodate the new soft opt-out system. Policy makers and health service managers should not assume that nurses simply need more time to implement the soft-out as intended. Additional responsive modification of processes, ongoing training and support is required to help with implementation as originally intended. Scotland, England and the Netherlands are introducing soft opt-out systems. There is an opportunity to learn from initial implementation in Wales, by acknowledging gaps, good practice and opportunities to further improve processes and nursing practices.

Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study

ObjectivesTo determine the short-term impact of a soft opt-out organ donation system on consent rates and donor numbers.DesignBefore and after observational study using bespoke routinely collected data.SettingNational Health Service Blood...

The role of specialist nurses for organ donation: A solution for maximising organ donation rates?

To explore the role that Donor Transplant Co-ordinators have played and the future potential of Specialist Nurses for Organ Donation (SN-ODs), within organ donation strategies in the UK and other countries. Organ donation and transplantation rates vary extensively around the world. However, there is a universal shortage of deceased donors, prompting different approaches to increase transplantation rates. Within the UK, the Clinical Lead for Organ Donation and Specialist Nurse in Organ Donation undertake a key role in the implementation of the Organ Donation Strategy. The Human Transplantation (Wales) Act 2015 is a recent development which facilities a deemed (presumed) consent approach to organ donation, the Specialist Nurse in Organ Donation undertakes a major role identifying the potential donor in this situation by confirming the deemed consent status of the donor and supporting bereaved relatives. UK governments in England and Scotland are currently seeking legislative changes to an opt-out system of organ donation, in line with the Wales change. This discursive paper explores the role from Donor Transplant Co-ordinator to Specialist Nurse in Organ Donation (SN-OD) within organ donation policy in different settings, but with a specific focus on the UK. The paper clarifies the current and future potential of nurses working with bereaved families when requesting authorisation for donation. The current scope and future potential of Donor Transplant Co-ordinator and Specialist Nurse in Organ Donation roles need better recognition. Little empirical data exist about the key role that these nurses play in the organ donation process, especially in relation to gaining authorisation to proceed to donation. There is a need to clarify the role of the Specialist Nurse in Organ Donation and their impact on improving rates of organ donation.

Kidney transplantation legislation north of the border

Intended legislative change in Scotland is aiming to save lives by building a soft opt-out system for organ donation. Ewen Maclean discusses the situation in this part of the UK, from legal setbacks to how this new policy will work, along with the campaigns that are in motion to help increase organ donation rates over the coming months and years.

Is an opt-out organ donation system desirable? Comments on a new law.

A law that introduces an opt-out system for organ donation has recently come into force in Wales. The debate surrounding the effectiveness and ethical acceptability of an opt-out system continues, though the available data have still not provided definitive proof that an opt-out system is more efficient than an opt-in system. Systems based on implied consent but with specific safeguards would appear more suitable and more respectful of ethical principles than those based on a more aggressive form of presumed consent.

Ograniczanie niedoboru narządów. System Aktywnej Rejestracji Dawców jako alternatywa dla polskiej regulacji sprzeciwu

In the article I argue for replacing the opt-out system of organ donation, currently applied in Poland, with the Active Donor Registration system (ADR). The basic idea of the ADR system is to send a special form to all adult citizens, which would give them an opportunity to consent or dissent to the removal of organs, or to delegate their decision to their next of kin. Granting priority to declared donors – an additional assumption of ADR – would make it possible for them to acquire better access to transplantation if they ever contract a disease whose effective treatment will require transplantation. I highlight the basic assumptions of both systems and describe the functioning of the Polish opt-out regulations. I also analyze the statistical data illustrating the scale of organ shortage in Poland, and I present and criticize the basic ethical principles of evaluating organ procurement systems and compare the Polish system with the ADR system from the perspective of those principles.

Opt-outs and upgrades. Ethics and law in the United Kingdom.

We report on two areas in which UK law and ethics seem out of step with each other. 2013 saw the passing of the Human Transplantation (Wales) Bill, which will introduce an opt-out system of organ donation in Wales from 2015. In the first section, we discuss the convoluted evolution of the Bill and some potential problems that we consider may prevent it from achieving its intended goal of increasing the number of organs transplanted. The prospect of being able to enhance human cognition through cognitive-enhancing drugs ("smart drugs") also presents a nexus of questions associated with future ambitions, hopes, and concerns as a society. How these drugs might affect the future of work and employment is beginning to generate wide public engagement in the UK and forms the focus of the second section.

Improving rates of organ donation for transplantation

Journal of Renal NursingVol. 4, No. 2 ProfessionalImproving rates of organ donation for transplantationBelinda LindenBelinda LindenSearch for more papers by this authorBelinda LindenPublished Online:29 Sep 2013https://doi.org/10.12968/jorn.2012.4.2.100AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesGeneral Medical Council (2010) Treatment and Care Towards the End of Life: Good Practice in Decision Making. www.gmc-uk.org/End_of_life.pdf_32486688.pdf (accessed 1 February 2012) Google ScholarMeyer K, Bjork IT, Eide H (2012) Intensive care nurses’ perceptions of their professional competence in the organ donor process. J Adv Nurs 68: 104–15 Crossref, Google ScholarNational Institute for Health and Clinical Excellence (2011) Organ Donation for Transplantation: Improving Donor Identification and Consent Rates for Deceased Organ Donation. Clinical Guideline 135. http://guidance.nice.org.uk/CG135 (accessed 1 February 2012) Google ScholarNHS Blood and Transport (NHSBT) (2011) Organ Donation Statistics. www.uktransplant.org.uk/ukt/statistics/statistics.jsp (accessed 1 February 2012) Google ScholarOrgan Donation Taskforce (2008) The Potential Impact of an Opt-Out system for Organ Donation in the UK: An Independent Report from the Organ Donation Taskforce. www.dh.gov.uk/en/Publicationsandstatistics/Publications/ (accessed 1 February 2012) Google Scholar FiguresReferencesRelatedDetails 1 March 2012Volume 4Issue 2ISSN (print): 2041-1448ISSN (online): 2052-2894 Metrics History Published online 29 September 2013 Published in print 1 March 2012 Information© MA Healthcare LimitedKeywordsorgan donationtransplantationpolicy updatenational institute for health and clinical excellencePDF download