The impact of presumed consent legislation on cadaveric organ donation: A cross-country study

Abstract

In the U.S., Great Britain and in many other countries, the gap between the demand and the supply of human organs for transplantation is on the rise, despite the efforts of governments and health agencies to promote donor registration. In some countries of continental Europe, however, cadaveric organ procurement is based on the principle of presumed consent. Under presumed consent legislation, a deceased individual is classified as a potential donor in absence of explicit opposition to donation before death. This article analyzes the impact of presumed consent laws on donation rates. For this purpose, we construct a dataset on organ donation rates and potential factors affecting organ donation for 22 countries over a 10-year period. We find that while differences in other determinants of organ donation explain much of the variation in donation rates, after controlling for those determinants presumed consent legislation has a positive and sizeable effect on organ donation rates. We use the panel structure of our dataset to test and reject the hypothesis that unmeasured determinants of organ donation rates confound our empirical results.

Underlying wishes and nudged choices.

“…Defaults also provide the decision-maker with important signals from policy-makers as to what ought to be the appropriate behavior in situations of uncertainty (Davidai, Gilovich, & Ross, 2013;Johnson & Goldstein, 2003;McKenzie, Liersch, & Finkelstein, 2006). In fact, several studies have shown that default opt-out systems have substantially increased registered donations (Abadie & Gay, 2006;McKenzie et al, 2006;Shepherd et al, 2014;van Dalen & Henkens, 2014).…”

A Market for Human Organs: An Ethical Solution to the Organ Shortage

“…60 Legislation, in favor of presumed consent, will almost certainly increase the number of organs available for transplantation. 61 Hence, Spain, often regarded as the model presumed consent nation, has the highest cadaver organ procurement rate in the world.…”

Doctors’ Attitudes Towards Opting-Out and the Implication of This Legislation for a Small Island State

“…This is clearly above the EU average of 17.8 per million population. (English, 2007;Wright, 2007), religion and religious beliefs (Gimbel et al, 2003;Rumsey et al, 2003), the efficiency of a country's transplant co-ordination (Johnson & Goldstein, 2004); GPD and health expenditure per capita (Healy, 2005), awareness of organ donation (Oz et al, 2003), blood donation rate (Abadie & Gay, 2006), knowledge of someone who had donated an organ after death and awareness of any one who received a donated organ (Rumsey et al, 2003), education (Gimbel et al, 2003), and attitudes towards organ donation and presumed consent (Roels et al, 1997).…”

“…The impact of presumed consent legislation on cadaveric donation was studied for a 10 year period in 22 countries by Abadie and Gay (2006). The researchers found that while differences in other determinants of organ donation explain much of the variation in donation rates, after controlling for those determinants, presumed consent legislation has a positive and sizeable effect on organ donation rates.…”