Is an opt-out system likely to increase organ donation?

English, Veronica; Johnson, Emma; Sadler, Blair L.; Sadler, Alfred M.

doi:10.1136/bmj.l967

Cited by 12 publications

(13 citation statements)

References 10 publications

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“…According to this model, organs can be used for transplantation after death unless the individual has expressed an objection (17). Several studies have reported an association between assumed consent and high organ donation rates (18,19).…”

Section: Discussionmentioning

confidence: 99%

Brain Death and Deceased Organ Donation in a Hospital in İstanbul, Turkey: The Effect of Early Identification of Brain Dead on Organ Donation Rates: A Retrospective Study

Tugce¹,

Özcan²

2020

Istanbul Med J

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Amaç: Yoğun bakımda takip edilen Glasgow Koma skoru 7'nin altındaki hastalarda beyin ölümü gelişme ihtimaline karşı uyanık olunmalıdır. Kadavradan organ nakli; nakil sırası bekleyen hasta sayısını düşüreceğinden hayat kurtarıcıdır. Bu nedenle her beyin ölümü tanısı konan hastaya potansiyel donör gözüyle bakılmalıdır. Çalışmamızın amacı hastanemizde dokuz yıllık süreçte tanı alan beyin ölümü olgularını inceleyerek beyin ölümü nedenlerini araştırmak, tanı alma sürecindeki testleri ve kadavradan organ nakil oranını incelemektir. İkincil amacımız beyin ölümü tanı konma süresinin bağış oranına etkisini araştırmaktır. Yöntemler: Etik Kurul onayı alınarak 1 Ocak 2004 ve 1 Ocak 2013 tarihleri arasında hastanemiz yoğun bakım ünitesinde beyin ölümü tanısı alan hastalar retrospektif olarak incelendi. Hastaların yaşı, beyin ölümü tanısında uygulanan testler, hastaneye gelişten beyin ölümü tanısı alana kadar geçen süre, tanı sonrası hastaların sağkalım süresi, ailelerin organ bağışına onay verip vermemeleri ve organ nakil oranları incelendi. Bulgular: Altmış hasta beyin ölümü tanısı aldı, 21'i (%35) kadın, 39'u (%65) erkekti. Ortalama yaş 28'di. Sadece 6 (%10) aile organ bağışı için onay verdi. Beyin ölümünün en sık nedeni travmatik beyin hasarı (37; %65) olarak bulundu. Beyin ölümü klinik testlerin yanı sıra 36 (%60) hastaya internal karotis dopler, 14 (%23) hastaya serebral anjiyografi, 2 hastaya da elektroensefalografi yapılarak tanı konuldu. Hastaneye geliş ile tanı konmasına dek geçen süre ortalama 5,16±3,06 gün; donör grubunda 2,0±0,4 gün, donör olmayan grupta 5,5±0,4 gün olarak bulundu. Tanıdan kardiyak ölüme dek geçen süre donör olmayan grupta 2,4±0,3 gün olarak bulundu. Tanı konduktan sonra donör grubunda organ nakline kadar geçen süre 1,08±0,2 gündü. Sonuç: Hastanemizde beyin ölümü sonrası organ bağış oranı oldukça düşük bulundu. Potansiyel donörlerin erken fark edilmesi ile organ bağış oranı artışı arasında istatistiksel anlamlı fark tespit edildi. Beyin ölümü tanısının erken konulması organ bağış oranını yükselterek nakil sırası bekleyen hastalar için umut ışığı olacaktır. Anahtar Kelimeler: Beyin ölümü, organ nakli, kadavradan organ nakli, transplantasyon

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Section: Discussionmentioning

confidence: 99%

Brain Death and Deceased Organ Donation in a Hospital in İstanbul, Turkey: The Effect of Early Identification of Brain Dead on Organ Donation Rates: A Retrospective Study

Tugce¹,

Özcan²

2020

Istanbul Med J

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“…Organ donation rates were higher when the default option was to donate (82%) than when the default option was to not donate (42%). These findings have influenced public policy decisions; Argentina (La Nacion, 2005), Uruguay (Trujillo, 2013), Chile (Zúñiga-Fajuri, 2015), England (English et al, 2019), and Wales (Griffiths, 2013;Madden et al, 2020) have adopted default organ-donor status policies. Organ donation statistics from the Organization for Economic Cooperation and Development (OECD) countries show that, on average, organ donation rates are higher in countries where the default option is to donate (Opt-Out system) than in countries where the default option was not to donate (Opt-In system) (Li & Nikolka, 2016).…”

Section: Present Researchmentioning

confidence: 99%

Defaults versus framing: Revisiting Default Effect and Framing Effect with replications and extensions of Johnson and Goldstein (2003) and Johnson, Bellman, and Lohse (2002)

Chandrashekar¹,

Adelina²,

Zeng³

et al. 2022

Preprint

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People tend to stick with a default option instead of switching to another option. For instance, Johnson and Goldstein (2003) found a default effect in an organ donation scenario: if organ donation is the default option, people are more inclined to consent to it. Johnson et al. (2002) found a similar default effect in a health-survey scenarios: if receiving more information about your health is the default, people are more inclined to consent to it. Much of the highly cited, impactful work on these default effects, however, has not been replicated in well-powered samples. In two well-powered samples (N = 1920), we conducted a close replication of the default effect in Johnson and Goldstein (2003) and in Johnson, Bellman, and Lohse (2002). We successfully replicated Johnson and Goldstein (2003). In an extension of the original findings, we also show that default effects are unaffected by the permanence of these selections. We, however, failed to replicate the findings of Johnson, Bellman, and Lohse’s (2002) study; we did not find evidence for a default effect. We did, however, find a framing effect: participants who read a positively-framed scenario consented to receive health-related information at a higher rate than participants who read a negatively framed scenario. We also conducted a conceptual replication of Johnson et al. (2002) that was based on an organ-donation scenario, but this attempt failed to find a default effect. Our results suggest that default effects depend on framing and context. Materials, data, and code are available on: https://osf.io/8wd2b/.

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“…As the need for organ transplants increases globally, many countries have adopted an opt-out approach or are actively considering adopting such a system to meet demand (Cook 2019 ; Symons 2018 ; Arshad et al 2019 ). This may be one reason why Spain has the highest rate of deceased organ donation in the world, followed by other opt-out countries like Portugal and Belgium (English et al 2019 ). Some scholars, however, argue that there is limited evidence to suggest that opt-out systems are responsible for increased organ donation rates (Abadie and Gay 2006 ; Rithalia et al 2009 ; Rodríguez-Arias et al 2010 ; Matesanz et al 2011 ; Matesanz and Domínguez-Gil 2019 ).…”

Section: The Ethics Of Consent To Organ Donationmentioning

confidence: 99%

An Ethical Defense of a Mandated Choice Consent Procedure for Deceased Organ Donation

Symons

Poulden

2022

ABR

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Organ transplant shortages are ubiquitous in healthcare systems around the world. In response, several commentators have argued for the adoption of an opt-out policy for organ transplantation, whereby individuals would by default be registered as organ donors unless they informed authorities of their desire to opt-out. This may potentially lead to an increase in donation rates. An opt-out system, however, presumes consent even when it is evident that a significant minority are resistant to organ donation. In this article, we defend a mandated choice framework for consent to deceased organ donation. A mandated choice framework, coupled with good public education, would likely increase donation rates. More importantly, however, a mandated choice framework would respect the autonomous preferences of people who do not wish to donate. We focus in particular on the Australian healthcare context, and consider how a mandated choice system could function as an ethical means to increase the organ donation rate in Australia. We make the novel proposal that all individuals who vote at an Australian federal election be required to state their organ donation preferences when voting.

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Is an opt-out system likely to increase organ donation?

Cited by 12 publications

References 10 publications

Brain Death and Deceased Organ Donation in a Hospital in İstanbul, Turkey: The Effect of Early Identification of Brain Dead on Organ Donation Rates: A Retrospective Study

Brain Death and Deceased Organ Donation in a Hospital in İstanbul, Turkey: The Effect of Early Identification of Brain Dead on Organ Donation Rates: A Retrospective Study

Defaults versus framing: Revisiting Default Effect and Framing Effect with replications and extensions of Johnson and Goldstein (2003) and Johnson, Bellman, and Lohse (2002)

An Ethical Defense of a Mandated Choice Consent Procedure for Deceased Organ Donation

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