Should organ donation be an opt-out? | The Hill

March 13, 2016

A patient of mine, let’s call him David, was a disciplined man. He never drank excessively or smoked, his meals were balanced and he jogged around his neighborhood every day to stay active. He took good care of his body and expected it to function well in return. However, in 2010, doctors detected a giant tumor in his abdominal cavity that encased vital organs, including his intestines and liver. He was unable to eat by mouth and became weak, requiring liquid feeds to be pumped into his veins through an IV. For him to live, several internal organs would need to be replaced. David had never heard of anyone surviving such an ordeal, and prepared to leave his family. Meanwhile, he was put on the wait list for a multi-organ transplant. He marked his son’s graduation on his calendar, but didn’t expect to attend.

Five years later, David regularly sees me in clinic. He received a new intestine, liver and pancreas. For the first time in years, he enjoys food again. He wasn’t as likely to receive those organs as an American, however, because our policy doesn’t protect those who depend on organ donation to survive.

The U.S. performs more organ transplants than any other country. Since the first successful human transplant—a kidney—was performed in 1954, scientific advances have led to intestinal transplants, multi-organ transplants, facial transplants and even the first uterine transplant in November of 2015. This month, doctors at John Hopkins University announced preparation for the first transplant between HIV patients. Despite these successes, around eighteen Americans die every day while waiting for an organ, and every ten minutes another name is added to the waiting list. One organ donor can save eight lives and improve the lives of up to fifty people. The U.S. donation rate is 4th worldwide but still fails to meet the demand for organs. Studies show the majority of Americans want to donate, but only a fraction of these people are registered to donate. The U.S. has an opt-in policy, which requires individuals to sign up to donate. An opt-out policy, known as “presumed consent,” assumes people want to donate unless they specify otherwise. In December 2015, Wales, hoping to improve organ donation rates, became the first UK nation to join the twenty-four European countries that already have opt-out transplant policies. Should the U.S. follow suit?