Just an example: In Austria by default all deceased people are potential donors—you have to file an explicit opt-out.
I am very much in favour of this sort of policy; it would do no end of good.
The effect of pretending to have opt-out organ donation is small. Austria is unique in really having opt-out organ donation (everywhere else, next of kin decide in practice), so it’s hard to judge the effect, but it’s not an outlier. In the 90s, Spain became the high outlier and Italy ceased being the low outlier, so rapid change is possible without doing anything ethically sensitive. graph. More Kieran Healy links here.
“Reform of the rules governing consent is often accompanied by an overhaul and improvement of the logistical system, and it is this—not the letter of the law—that makes a difference. Cadaveric organ procurement is an intense, time-sensitive and very fluid process that requires a great deal of co-ordination and management. Countries that invest in that layer of the system do better than others, regardless of the rules about presumed and informed consent.”
In our country, we have an opt-out donation, but I guess the relatives can have a veto. I have seen a physician on TV, who said some scary things openly. Our doctors are standardly overworked and underpayed. Imagine a doctor, who, towards the end of the long shift, sees a patient dying with some of the organs intact. If he decides to report the availability of the organs, he creates an extra, several hours work for himself and others, paperwork included. There is either none or very little financial reward for reporting the organs, I do not remember exactly. They might feel heroic for the first couple of times, but, eventually, they resign and stop making these reports, after they work long enough.
I have seen this on TV cca 3 years ago, do not know the current situation.
The effect of pretending to have opt-out organ donation is small. Austria is unique in really having opt-out organ donation (everywhere else, next of kin decide in practice), so it’s hard to judge the effect, but it’s not an outlier. In the 90s, Spain became the high outlier and Italy ceased being the low outlier, so rapid change is possible without doing anything ethically sensitive. graph. More Kieran Healy links here.
An interesting article.
“Reform of the rules governing consent is often accompanied by an overhaul and improvement of the logistical system, and it is this—not the letter of the law—that makes a difference. Cadaveric organ procurement is an intense, time-sensitive and very fluid process that requires a great deal of co-ordination and management. Countries that invest in that layer of the system do better than others, regardless of the rules about presumed and informed consent.”
In our country, we have an opt-out donation, but I guess the relatives can have a veto. I have seen a physician on TV, who said some scary things openly. Our doctors are standardly overworked and underpayed. Imagine a doctor, who, towards the end of the long shift, sees a patient dying with some of the organs intact. If he decides to report the availability of the organs, he creates an extra, several hours work for himself and others, paperwork included. There is either none or very little financial reward for reporting the organs, I do not remember exactly. They might feel heroic for the first couple of times, but, eventually, they resign and stop making these reports, after they work long enough. I have seen this on TV cca 3 years ago, do not know the current situation.