Where Have All the Organs Gone?

Despite the fact that a shortage of organs causes easily avoidable deaths in the UK, there is a lack of awareness surrounding organ donation. Could an opt-out system be the way forward?

The effect of presumed consent in comparison to informed consent for organ donations (Source: Journal of Health Economics)

The effect of presumed consent in comparison to informed consent for organ donations (Source: Journal of Health Economics)

Right now, as you are reading this, 7,000 people wait for organs on the transplant list. Some have been waiting for days, others months, and unfortunately, many have waited for years. In fact, the average waiting time for a kidney transplant is three and a half years. What if I then told you that 800 viable kidneys are buried or burned in the UK every day because people simply haven’t signed up to donate?

Think about how many people die or spend years of their lives waiting for organs that are actually there. It’s not the same as hopelessly waiting for a magic cure for multiple sclerosis or Alzheimer’s. You are sitting and waiting, day-in and day-out, for someone to decide that actually, they want to save a life when they die. The shocking thing is, in recent UK government polls, 90 per cent of people have said that they would donate their organs, although, in reality only 30 per cent actually become organ donors. This is due to many reasons: a lack of awareness and lack of accessibility; however, the main reason is that we don’t like to think about death. For this reason, only one in four Americans have living wills. These are legal documents that outline which life sustaining procedures should be taken in the event of a terminal condition, permanent vegetative state or end-stage condition.

When considering the lack of awareness, I realised that although I am too young to be an organ donor, I wouldn’t know where to go if I wanted to donate my organs. Do you know where to go? It turns out that you can sign up to donate your organs in “less than 2 minutes” on www.organdonation.nhs.uk. It might be easy, but why would anyone ever stumble upon that site?

For this reason we need an opt-out system as opposed to the current opt-in system. This would mean that unless specified, it would be assumed that everyone over the age of 18 is an organ donor. The law as it stands condemns many, some of them children, to an unnecessary death, simply because of the shortage of willing donors while, as the BMA puts it, “bodies are buried or cremated complete with organs that could have been used to save lives.” In addition, as previously mentioned, only 10 per cent of people object to organ donation whereas 90 per cent would happily donate their organs. This would be like asking people to declare that they ate meat as opposed to that they were vegetarian. Seven per cent of Brits are vegetarian whereas 93 per cent are happy omnivores. In this case, markets and society cater to the majority, so why shouldn’t the law surrounding organ donation also cater to the majority?

This would also work extremely well because those who are opposed to organ donation are much more passionate than those who passively agree with it. This means that they would feel the need to sign up to not be a donor. Hence, there would little risk of those who do not wish to have their organs removed donating any.

The effect of presumed consent in comparison to informed consent for organ donations (Source: Journal of Health Economics)

The effect of presumed consent in comparison to informed consent for organ donations (Source: Journal of Health Economics)

This concept is also supported by its past success. Opt-out (presumed consent) systems have been in place in Austria and Spain since 1990. An example of how poorly the opt-in policy works is Germany; there are only 12 donors per million. However in Austria, a country which uses an opt-out system, with a very similar culture and level of economic development, there are 24 per million. In addition the average consent rate is 99.98 per cent in Austria as opposed to 25 in Germany. The graph above clearly shows that the most successful countries tend to be those with opt-out systems so it seems illogical to continue with a perhaps faulty, opt in system.

Lastly, every added donor makes a massive difference. One person can save nine lives and improve many more. If we are unable to switch an opt-out system based on presumed consent we should at least make it easier to donate our organs. Canada is a prime example of this. Whenever a Canadian citizen renews their driving licence (once every 10 years) they must also fill out a form about whether or not they would like to be a donor. This is an improvement on the UK’s system as at least people are reminded to donate their organs. This would be great because most people don’t have a problem with organ donation so the government would be making everyone aware of this when currently information is not widespread.

Successes such as Spain and Austria prove that an opt-out system is successful. The problem of organ shortages needs drastic solutions if lives are to be saved – something which should be the ultimate aim of us all. With this in mind, we have no excuse for not acting now.

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Jessie Morgan
Jessie Morgan

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2 Responses

  1. Adam Fitchett says:

    Of course, another effective way to increase organ donations is to offer to pay people for them. This is a big ethical hurdle that people need to get over.

    • Jessie Morgan says:

      This would indeed work. However this ethical ‘hurdle’ you speak of is a massive one. You will have those who are desperate for money selling organs and forcing some people’s hands into donating even though they are morally against it. it is also an extremely slippery slope. in extreme cases it could lead to murder for body part of even escalate to the state of china where prisoners are killed for organs. it would work in theory but there are so many ways a policy like that can go wrong

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