Question of the Month
April
2006
In U.S. states and
countries around the world, what type of consent is required for organ
donation upon death?
In the United States, more than 89,000
people are on waiting lists for organ transplantation, and on average,
17 people die each day waiting for a transplant. To reduce these
numbers, proponents of organ donation advocate for donor systems and
policies that streamline the process and make it easier for
individuals to become organ donors upon their death. There are several
types of programs, used nationally and internationally, that attempt
to remove questions about individuals’ intentions for organ donation
after death, including first-person consent and presumed consent. It
is believed that removing as much doubt as possible about what a
person wished in regard to organ donation will ease the process and
result in more transplants.
According to the United Network for
Organ Sharing, all but seven states have first-person consent laws in
regard to organ donation. Under first-person consent, donor
designation is indicated on a driver’s license or other official,
signed donor document, giving hospitals legal authority to proceed
with organ procurement regardless of the wishes of the family. All of
the Midwestern states have such laws; Illinois is among the
most recent to move to first-person consent, its law having taken
effect in January.
Many European nations, including Spain,
Austria, Portugal, France, Denmark, Finland, Sweden and Italy, use a
presumed-consent approach. Under presumed consent, all adults are
considered organ donors except those who opt out by placing themselves
on a registry. Proponents believe that this system removes confusion
about individual wishes, eases trauma on the family at the time of
death, and makes more organs available for transplant. In nations
using presumed consent, the opt-out rate is about 2 percent.
While presumed consent has gained
little momentum in the United States, legislation has been introduced
this year in Ontario to revise its donor program so that
hospitals could procure organs unless a dying patient objects
beforehand.
More information is available from the
United Network (www.unos.org) and the Presumed Consent
Foundation (www.presumedconsent.org).
For
more information on this or any other public policy issue, please call
630-925-1922 or complete the online
form for research services.
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