One should always be particularly wary of laws that are named after specific individuals or events — almost certainly the story of some child or tragedy has been deployed in order to tug at our heart strings so that we wave through a state intervention while struggling to hold back our tears.
It is this clear-cut need that prompts well-meaning legislators, wait-listed potential transplant patients, and community-minded citizens to conclude that our forty-year-old Opt-In, Explicit Consent EC organ donation system is broken and needs to be fixed by implementing Opt-Out Presumed Consent PC.
The Facts Suggest Presumed consent This finding reconfirms a British Medical Journal article that studied inter-country European donation data and found that Presumed Consent and Explicit Consent donation rate variances were not statistically definitive[v].
This insignificant difference in DPM suggests that social, cultural, and operational Presumed consent, rather than legal structures are at play. Thus, it is very likely that religion plays a far more dominant and successful role in increasing organ donation in Europe than Presumed Consent.
Most significant in this assessment of PC vs EC is the fact that the European countries that developed and maintain presumed Consent in their laws do not rely on it to actually recover organs. A survey of practices reports[vi] that donation professionals in all of these countries require family consent prior to recovery of organs.
The fact that all countries that have PC laws do not actually rely on the right of the state to take organs speaks to the public trust and autonomy issues that arise when countries seek to claim any type of property, and makes it clear that the variance in donation rates is a function of cultural and operational aspects rather than legal characteristics of their donation programs.
While these data are convincing that Presumed Consent does not improve organ donation, there are those who still suggest that California is somehow different and implementing a PC system would further improve our already impressive donation rates. Yet, when confronting the unavoidable end of life and the need to make final decisions, individuals and families seek and are receptive to information that prompts them to choose to donate.
With these serious misconceptions out there, it is very realistic to conclude that an Opt-Out, Presumed Consent decision, made early in life, without access to accurate information would lead to millions of ill-informed decisions and no chance to address these misconceptions when the opportunity to donate occurred.
So, if Presumed Consent is not the solution, how can we increase organ donation to ensure that no one dies while waiting for an organ? Versions of this system are also used in the US, with in-house Organ Procurement Coordinators and Intensivist consultants, and have been shown to be remarkably effective, and merit expansion across all major hospitals.
One substantial step taken seven years ago in California was the establishment of the Donate Life California Registry, now the largest donor registry in the world with 9. Adding to the value of the registry is the long-standing element of California law that recognizes that a registered choice by an individual to donate is a legally binding final wish to help others known as First Person Consent and akin to an Advanced Directive for Health Care which cannot be overturned by others, including family.
Imagine how much more valuable this registry could be with a substantive schools-based public education program to help young drivers and new immigrant families to dispel myths fully understand the life-saving value of this choice. Finally, as one ponders the imposition of a Presumed Consent system, it is worth identifying and considering if there are any models in law where the state opts to take possession of the belongings of an individual for the public good, over their possible objections.
Certainly, it exists in eminent domain seizure of property and only after exhaustive hearings. However, in areas of health care and the body, all of the actions of the past fifty years have been to ensure the right of individuals to make their own informed decisions, such as efforts that outlawed involuntary castration and laws to ensure that patients consent to the procurement and utilization of organs, tissue, and cells for research or for-profit use.
At the CPC, October , PM Theresa May pledged to introduce a system of presumed consent for organ donation in England. I object very strongly to this change. presumed consent definition: the idea that someone is believed to have given permission for something unless they say they do not, used, for example, in some countries for organ donation (= allowing your body parts to be used after you die). Learn more. ‘‘Presumed consent’’ is the name that has been given to a proposal to change the current system. 1 A policy of presumed consent would include the default assumption that individuals do .
And even the clear-cut public benefit of vaccination regularly runs into opposition from parents seeking personal choice. With these personal rights so vigorously protected, does anyone really feel that we should exclude organs and tissues for transplant from this same personal protection of Voluntary Consent?
Should we do so knowing that our Voluntary Consent system currently is more successful than any Presumed Consent organ donation system in the world? The four California Organ Procurement Organizations and our 54 colleagues across the country have been quite successful in helping three-quarters of those who can donate to do so in order to save thousands of lives each year.A review of the accompanying chart indicates the wide disparity within European Presumed Consent countries donation rates, from a high of Spain’s to a low of Greece’s , with a simple average of nDPM, which is insignificantly different from the Explicit Consent average of nDPM.
‘‘Presumed consent’’ is the name that has been given to a proposal to change the current system. 1 A policy of presumed consent would include the default assumption that individuals do .
presumed consent definition: the idea that someone is believed to have given permission for something unless they say they do not, used, for example, in some countries for organ donation (= allowing your body parts to be used after you die). Learn more.
A Report of the Presumed Consent Subcommittee of the Ethics Committee (June ) Introduction: Alternatives for Reforming Organ Donation. The Presumed Consent Subcommittee of the UNOS Ethics Committee was charged with evaluating the ethics of presumed consent as a legal-policy regime for the regulation of the donation of cadaveric organs and tissues for transplantation.
presumed consent Transplantation The assumption that a particular action would have been approved by a person or party if permission had been sought. See Cadaveric organ transplantation, Mandated choice, Organ brokerage, Transplantation. Supporters of presumed consent concede that it would not be ethically justifiable or effective merely to shift legislation from express consent to presumed consent without the development and effective implementation of these social practices over time.