scholarly journals Opt-out policies capacity to increase organ donors is limited

2021 ◽  
Author(s):  
Alberto Molina Pérez ◽  
David Rodríguez-Arias ◽  
Janet Delgado
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Default Rule ◽  
Relative Impact ◽  
Post Mortem ◽  
Presumed Consent ◽  
Organ Retrieval ◽  
Opt Out ◽  
The Family ◽  
The Impact

Objectives: To increase post-mortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. However, studies on the relative impact of opt-in or opt-out on deceased organ donation rates are inconclusive. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the impact of consent policies when considering the role of the family in decision-making. Design: By systematically combining the three components of the decision-making process --the default rule, the deceaseds preferences, and the family s preferences,-- we identify all situations that affect the retrieval outcome under opt-in and opt-out policies. Then, by gathering empirical data from a wide array of countries, we estimate the relative frequency of these situations. Main outcome measures: We measure the relative impact that opt-in and opt-out policies have per se on post-mortem organ retrieval. Results: Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. These policies only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The actual impact of consent policies is typically circumscribed to a range of 0% to 5% of all opportunities for organ retrieval. Conclusions: This study may warn contemporary organ retrieval policymakers that, by emphasizing the need to introduce presumed consent, they might be overestimating the influence of policy defaults and underestimating the power granted to families in expressing their preferences and making decisions about organ donation. Governments should reassess the opportunity and effectiveness of adopting opt-out policies for organ retrieval.

The ‘opt-out’ approach to deceased organ donation in England: A misconceived policy which may precipitate moral harm

2019 ◽  
Vol 14 (2) ◽  
pp. 63-69
Author(s):  
Tobias K Cantrell
Keyword(s):  
Organ Donation ◽  
Public Awareness ◽  
Recent Attempt ◽  
Individual Autonomy ◽  
Presumed Consent ◽  
Opt Out ◽  
The Family ◽  
Deceased Organ Donation ◽  
Tissue Act ◽  
Human Tissue Act

In an effort to solve the shortage of transplantable organs, there have been several proposals to introduce an opt-out approach to deceased organ donation in England (also termed ‘deemed’, or ‘presumed’ consent). In seeking to enact the so-called ‘opt-out proposal’ via an amendment to the Human Tissue Act 2004, The Organ Donation (Deemed Consent) Bill 2017–19 represents the most recent attempt at such legal reform. Despite popular calls to the contrary, I argue in this paper that it would be premature for England, or, indeed, any country, to adopt an opt-out approach at this time. Not only is the available evidence inconclusive on whether introduction of the opt-out proposal would increase the supply of transplantable organs (a common misconception), but there is also a chance that doing so might bring about an otherwise avoidable moral harm through an unjustified interference with individual autonomy. I maintain that the resources required to change the law to such effect would be better expended on alternative, provenly efficacious and less contentious mechanisms for increasing the supply of transplantable organs, such as: improving communication with the family of the deceased, developing infrastructure, raising public awareness and enhancing staff training, attitudes and understanding towards organ donation.

scholarly journals Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe

2021 ◽  
Author(s):  
Alberto Molina Pérez ◽  
Janet Delgado ◽  
Mihaela Frunza ◽  
Myfanwy Morgan ◽  
Gurch Randhawa ◽  
...  
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Organ Procurement ◽  
Public Knowledge ◽  
The Public ◽  
Organ Retrieval ◽  
Knowledge And Attitudes ◽  
The Family ◽  
Deceased Organ Donation

Goal: To assess public knowledge and attitudes towards the role of the family in deceased organ donation in Europe. Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science. These databases were last searched on December 15th, 2017. Eligibility criteria were empirical studies conducted in Europe from 2008 to 2017 and addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Each record was screened by two or more independent reviewers in three phases. Data collection from each report was performed by two or more independent reviewers. Results: Of the 1,482 results, 467 reports were assessed in full-text form, and 33 were included in this synthesis. Studies show that a majority of the public support the family′s involvement in organ retrieval decision-making and, in particular, their role as surrogate decision-maker when the deceased has expressed no preference. Conclusions: A common conceptual framework and validated well-designed questionnaires are needed to address the role of the family in future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation.

Spousal Attitude Towards Exerting Conflict Resolution Strategies in Decision Making

Paradigm ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 75-90
Author(s):  
Shivendra Singh ◽  
Atul Dhyani
Keyword(s):  
Decision Making ◽  
Negative Impact ◽  
Marital Power ◽  
Consumption Decisions ◽  
Northern India ◽  
The Family ◽  
Conflict Resolution Strategies ◽  
Decision Satisfaction ◽  
The Impact ◽  
Selection Of

Family is one entity that has complex variables underplaying the consumption decisions, and marketers must understand how couples behave in concert to resolve conflict across major decisions. In this study, the family aspects are investigated to shed more light on spouse attitude towards family decision-making for selection of car and school/college for their ward and assess the impact of attitudinal factor on decision satisfaction. The drop-off/pick-up method was used to collect the data from Northern India. The result reveals that spousal attitude is formed by marital power, assertiveness, subtle manipulation, love, bargaining and being submissive. Results of multiple regression analysis show that subtle manipulation is most and marital power has a negative impact on spouses’ decision satisfaction. Thus, when targeting a family for a significant trades assay, the salesperson should focus on both husband and wife and stimulate a conversation between them to appeal to their conjoint kinship.

scholarly journals A global pandemic is not a good time to introduce ‘opt-out’ for organ donation

2020 ◽  
Vol 20 (2) ◽  
pp. 155-166
Author(s):  
Jordan A. Parsons ◽  
Greg Moorlock
Keyword(s):  
Organ Donation ◽  
Media Coverage ◽  
Public Awareness ◽  
Good Time ◽  
Organ Donors ◽  
Resuscitation Orders ◽  
Global Pandemic ◽  
Opt Out ◽  
The Impact ◽  
New System

Following several international examples, England introduced a system of deemed consent for organ donation in May 2020. This had been planned for over a year. However, the unprecedented circumstances of the COVID-19 pandemic raise issues that make the timing of this change unfortunate. The planned public awareness campaign has thus far been overshadowed by media coverage of the pandemic, and will likely continue to be, creating a situation in which a significant portion of the population may be unaware of having become potential organ donors. Further, the immediate impact of the new policy is likely to be significantly weakened by the suspension of the majority of organ donation and transplant activity. In this article, we first outline the details of the new model introduced in England, before considering the impact of the pandemic on transplantation services. We put forward three ethical reasons why, given the unprecedented circumstances, the change should have been postponed. We argue that (1) COVID-19 dominating headlines will prevent widespread awareness of the change, thereby undermining the autonomy of those who do not wish to be donors; (2) a lack of transplant activity during the pandemic will make the impact of the change difficult to measure; and (3) trust in the new system may be damaged given controversial decisions regarding Do Not Attempt Cardiopulmonary Resuscitation orders and the allocation of scarce intensive care resources. These reasons combined make for a shaky start at best and present a risk of the new system failing to achieve its desired and essential effect of increasing the number of voluntary organ donors.

The global mobility decisions of professional sailors’ spouses

2017 ◽  
Vol 5 (2) ◽  
pp. 203-219 ◽  
Author(s):  
Joanne Mutter
Keyword(s):  
Decision Making ◽  
Longitudinal Research ◽  
Cross Sectional ◽  
Conceptual Foundation ◽  
Content Type ◽  
Work Related ◽  
Global Mobility ◽  
The Family ◽  
The Impact ◽  
Stay Behind

Purpose The purpose of this paper is to identify the factors informing spousal global mobility decisions within the context of sporting expatriation. Findings contribute to the non-corporate global mobility literature as well as providing an empirical enhancement to the family relatedness of work decisions framework. Design/methodology/approach In this qualitative study, in-depth interviews gave voice to 21 spouses of professional sailors who have experienced both trailing their spouse and staying behind. Findings Access to empathetic social support, the potential impact on children, and the spouse’s career were all found to influence the spouse’s dynamic global mobility decision making. Research limitations/implications The study is limited by the cross-sectional nature of the research. Future longitudinal research into the impact of spousal preferences would identify the on-going effect of their decision(s) to relocate or to stay behind. Practical implications Providing organisations with an understanding of the familial issues their global talent may factor into their work mobility decisions will allow them to implement appropriate family-focussed support, irrespective of the choice to engage, or not engage, in global mobility. Originality/value By grounding the study in the under-researched sporting arena, the author contributes to the emerging non-corporate expatriate conversation. Furthermore, the family relatedness of work-related decisions framework was found to provide a useful conceptual foundation for understanding decision making in an international context.

scholarly journals Promoting organ donation through Basic Life Support Training –outcomes from the #conversations study.

2020 ◽  
Author(s):  
Caroline Wroe ◽  
Natasha Newell ◽  
Yitka Graham ◽  
Marcus Diamond ◽  
Michael O'Malley ◽  
...  
Keyword(s):  
Organ Donation ◽  
Basic Life Support ◽  
Life Support ◽  
Cultural Influences ◽  
Organ Donor ◽  
Educational Interventions ◽  
Recent Change ◽  
Baseline Survey ◽  
Opt Out ◽  
The Impact

Abstract Background: More than 6000 people are waiting for an organ transplant in the UK. Although a recent change in organ donor legislation to an opt out system is hoped to address this disparity expert review highlights that ‘opt out’ is only one of several factors that impact organ donation rates. Studies show that ethnicity, religion and cultural influences impact opinions towards organ donation. The importance of education is well established and interpersonal educational interventions have been shown to be more effective than mass media approaches to changing behaviour around organ donation. This study evaluates the impact of an educational intervention delivered with Basic Life Support training prior to the change in legislation to positively influence views on organ donation.Methods: An educational film promoting organ donation was developed from patient’s stories, evaluated, reviewed and embedded into BLS training. All staff attending BLS training were invited to participate in the study, complete a baseline survey, watch the film and complete another survey 3-5 working days after the training.Results: During the study period 338 attended BLS training, 8 out of 10 agreed to participate in the study, 6 out of 10 stayed behaving for the intervention and 3 out of 10 completed all stages of the study. Support for organ donation was almost universal in the baseline survey and of those who completed the study, >9 out of 10 felt the intervention had helped them understand the need for organ donation and 1 in 2 had subsequently discussed organ donation with their family and friends. 1 in 4 did not support the forthcoming change in organ donation legislation.Conclusions: A brief targeted intervention delivered through BLS training is effective in promoting discussion and improves support for organ donation. The mandatory nature of BLS training reduces bias in engagement and offers huge potential for delivery of a limited intervention around organ donation at pace and scale. Further understanding of NHS staff awareness of and opinions to the change in organ donation legislation is warranted. Trial Registration#conversations was prospectively registered with the ISRCTN on 23/01/2019.ISRCTN 36338010IRAS project ID 233611

scholarly journals The Impact of Presumed Consent Law on Organ Donation: An Empirical Analysis from Quantile Regression for Longitudinal Data

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Giácomo Balbinotto Neto ◽  
Everton Nunes da Silva ◽  
Ana Katarina Campelo
Keyword(s):  
Longitudinal Data ◽  
Quantile Regression ◽  
Organ Donation ◽  
Coefficient Estimate ◽  
Presumed Consent ◽  
Human Organs ◽  
Organ Donations ◽  
The Impact ◽  
The Relationship ◽  
Positive Effect

Human organs for transplantation are extremely valuable goods and their shortage is a problem that has been verified in most countries around the world, generating a long waiting list for organ transplants. This is one of the most pressing health policy issues for governments. To deal with this problem, some researchers have suggested a change in organ donation law, from informed consent to presumed consent. However, few empirical works have been done to measure the relationship between presumed consent and the number of organ donations. The aim of this paper is to estimate that impact, using a new method proposed by Koenker (2004): quantile regression for longitudinal data, for a panel of 34 countries in the period 1998-2002. The results suggest that presumed consent has a positive effect on organ donation, which varies in the interval 21-26% for the quartiles {0.25; 0.5; 0.75}, the impact being stronger in the left tail of the distribution. Health expenditure has an important role on the response variable as well, the coefficient estimate varying between 42-52%.

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