Opt-out organ procurement and tacit consent

2011 ◽  
Vol 38 (2) ◽  
pp. 74-75 ◽  
Author(s):  
T M Wilkinson
Keyword(s):  
Organ Procurement ◽  
Opt Out ◽  
Tacit Consent

scholarly journals Governance quality indicators for organ procurement policies

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252686
Author(s):  
David Rodríguez-Arias ◽  
Alberto Molina-Pérez ◽  
Ivar R. Hannikainen ◽  
Janet Delgado ◽  
Benjamin Söchtig ◽  
...  
Keyword(s):  
Organ Procurement ◽  
Policy Support ◽  
Sample Survey ◽  
General Tendency ◽  
Convenience Sample ◽  
Quantitative Survey ◽  
Ethical Implications ◽  
National Differences ◽  
Opt Out ◽  
Governance Quality

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data.

Lives and choices, give and take: Altruism and organ procurement

2017 ◽  
Vol 26 (2) ◽  
pp. 587-597 ◽  
Author(s):  
Vicky Thornton
Keyword(s):  
Organ Donation ◽  
Positive Impact ◽  
Organ Procurement ◽  
Statistical Evidence ◽  
Opting Out ◽  
Procurement Policy ◽  
Opt Out ◽  
Utilitarian Approach ◽  
Cadaveric Organ

In 2015, Wales introduced a deemed consent: soft opt-out system for organ procurement in order to address the chronic shortage of organs for transplant. Early statistical evidence suggests that this has had a positive impact on cadaveric organ donation. Such a system for procurement has previously been dismissed by the Organ Donation Taskforce, who suggested that opting out could potentially undermine the concept of donated organs as gifts and this could then negatively impact the number of organs offered for transplant. Considerable weight was placed upon the need to retain the altruistic gift element associated with an opt-in system. This article will consider the role of altruism in an organ procurement policy. A broad utilitarian approach will be taken when putting forward the arguments in favour of adopting a weak altruism position in a soft opt-out system for procurement with a combined registry.

Fewer Mistakes and Presumed Consent

2021 ◽  
Author(s):  
Alexander Zambrano
Keyword(s):  
Organ Donation ◽  
Patient Autonomy ◽  
Organ Procurement ◽  
Major Premise ◽  
Presumed Consent ◽  
Procurement Policy ◽  
Opt Out ◽  
Explicit Consent ◽  
Major Argument ◽  
Better Than

Abstract “Opt-out” organ procurement policies based on presumed consent are typically advertised as being superior to “opt-in” policies based on explicit consent at securing organs for transplantation. However, Michael Gill (2004) has argued that presumed consent policies are also better than opt-in policies at respecting patient autonomy. According to Gill’s Fewer Mistakes Argument, we ought to implement the procurement policy that results in the fewest frustrated wishes regarding organ donation. Given that the majority of Americans wish to donate their organs, it is plausible that a presumed consent policy would result in fewer frustrated wishes compared to the current opt-in policy. It follows that we ought to implement a policy of presumed consent. In this paper, I first consider and find wanting an objection to the Fewer Mistakes Argument developed recently by Douglas MacKay (2015). I also consider an objection put forth by James Taylor (2012) but argue that there is a methodological reason to prefer my own argument to Taylor’s. Finally, I argue for two theses: first, that Gill’s major argument in favor of the crucial premise of the Fewer Mistakes Argument is flawed, and second, that the major premise of the Fewer Mistakes Argument is false.

scholarly journals Deemed consent: assessing the new opt-out approach to organ procurement in Wales

2018 ◽  
Vol 44 (5) ◽  
pp. 314-318 ◽  
Author(s):  
Andreas Albertsen
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Organ Procurement ◽  
Excellent Opportunity ◽  
Opt Out ◽  
To Come ◽  
The Uk ◽  
High Level

In December 2015, Wales became the first country in the UK to move away from an opt-in system in organ procurement. The new legislation introduces the concept of deemed consent whereby a person who neither opt in nor opt out is deemed to have consented to donation. The data released by the National Health Service (NHS) in July 2017 provide an excellent opportunity to assess this legislation in light of concerns that it would decrease procurement rates for living and deceased donation, as well as sparking an increase in family refusals. None of these concerns have come to pass, with Wales experiencing more registered donors, fewer family refusals and more living donations. However, as the number of actual donors has dropped slightly from a high level, the situation must be monitored closely in the years to come.

Increasing Donation Opportunities for Vascularized Composite Allografts

2016 ◽  
Vol 26 (4) ◽  
pp. 372-377 ◽  
Author(s):  
Katrina A. Bramstedt
Keyword(s):  
Organ Procurement ◽  
Tissue Donation ◽  
Corporate Websites ◽  
Vascularized Composite Allograft ◽  
Opt Out ◽  
Personal Nature ◽  
Organ Procurement Organizations ◽  
Card System ◽  
Website Content ◽  
Registration Card

There are 40 vascularized composite allotransplant programs across 5 continents served by 31 organ procurement organizations (or equivalent). The organizations’ websites inform about organ and tissue donation. This research explored worldwide educational efforts on vascularized composite allograft (VCAG) donation via their corporate websites as well as options within donor registries and donor card systems to indicate a VCAG donation preference. Of these, 13 (41.9%) of 31 had VCAG content and 7 (22.6%) of 31 offered a mechanism for individuals to voice a preference about VCAG donation through an opt in donor registry or card or an opt out registry. In North America, the only donor registration/card system that facilitated VCAG donation is in Mexico. The resistance to consent for VACG donation is likely due to poor public education and the personal nature of face, hand, uterus, and penile allografts. Efforts to reduce this resistance can begin with the assistance of website content, registries, and donor cards.

Opt-out paradigms for deceased organ donation are ethically incoherent

2021 ◽  
pp. medethics-2021-107630
Author(s):  
G M Qurashi
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donor ◽  
Organ Shortage ◽  
Opt Out ◽  
Deceased Organ Donation ◽  
The Dead

The Organ Donation Act 2019 has introduced an opt-out organ donor register in England, meaning that consent to the donation of organs upon death is presumed unless an objection during life was actively expressed. By assessing the rights of the dead over their organs, the sick to those same organs, and the role of consent in their requisition, this paper interrogates whether such paradigms for deceased organ donation are ethically justifiable. Where legal considerations are applicable, I focus on the recent changes in England as a case in point; however, this paper ultimately challenges the justifiability of opt-out systems in any form, concluding that ethical solutions to organ shortage do not lie in opt-out systems of deceased organ procurement.

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