Presumed versus Expressed Consent in the US and Internationally

Zink, Sheldon; Zeehandelaar, Rachel; Wertlieb, Stacey

doi:10.1001/virtualmentor.2005.7.9.pfor2-0509

Cited by 7 publications

(1 citation statement)

References 10 publications

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“…10 The controversy surrounding presumed consent stems from the loss of patient autonomy and fear that such a system would decrease organ donation. 11 However, variations of this policy have been adopted in several other countries and have yielded mixed results. 12,13,14,15,16 Nonetheless, in the United States, a suboptimal 54% of adults are registered organ donors, and evidence suggests that lack of consent plays a role in preventing a donation from 20% to 40% of otherwise eligible deceased donors.…”

Section: Introductionmentioning

confidence: 99%

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant

et al. 2019

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Key PointsQuestionWhat are the plausible implications of a presumed consent transplant policy for waiting list outcomes in the United States?FindingsIn this simulation study of 524 359 potential organ recipients in a decision analytical model, a presumed consent policy was estimated to be associated with a reduction in waiting list removals. This estimation translated to an increase in life-years gained for patients in this simulation.MeaningThis study suggests that implementation of a presumed consent policy could be the most immediate way to expand organ donation, although presumed consent alone is not likely to solve organ shortages in the United States.

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Section: Introductionmentioning

confidence: 99%

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant

et al. 2019

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Filling the Organ Donor Pool by Giving Priority

Meng

Clarke

2019

Journal of Health Politics, Policy and Law

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Context: Many of the alternatives for procuring donor organs are considered either ineffective, unethical, or illegal. One possibility that may not face such challenges is a priority system whereby individuals who register as an organ donor are given priority to receive an organ over those who have not registered. However, providing extrinsic rewards can sometimes paradoxically reduce the target behavior, especially for those who are more altruistically motivated. Methods: Two behavioral experiments were employed and data were analyzed using regressions as well as examining open-ended responses. Findings: The results suggest that giving priority to receive an organ to those who register to donate postmortem could increase overall registration rates. Further, the effect of providing priority appears to work by inducing anticipated regret, which can be used to overcome common obstacles to registration. Finally, it was found that a priority system is most effective in increasing donor rates for those individuals who are less altruistically motivated and does not reduce registration rates for those who are more altruistically motivated. Conclusions: Given the unabated shortage of transplant organs, the finding that a priority system could increase the willingness to register as a donor without crowding out altruistically motivated individuals is highly encouraging.

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Changing the method of consent to increase the numbers of cadaveric donors in Saudi Arabia: the autonomy paradox

2022

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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.

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Presumed versus Expressed Consent in the US and Internationally

Cited by 7 publications

References 10 publications

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant

Estimated Association Between Organ Availability and Presumed Consent in Solid Organ Transplant

Filling the Organ Donor Pool by Giving Priority

Changing the method of consent to increase the numbers of cadaveric donors in Saudi Arabia: the autonomy paradox

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