Tug Of War Between Opt-In And Opt-out Organ Donation Systems

The demand for organ transplants is far greater than the supply of transplantable organs. Every day, twenty people in the United States die as they await an organ transplant; this equates to roughly 7,300 people annually. Whilst organ donation can be highly effective for prospective patients, not all individuals want to take part in such an action. A person’s decision not to partake in organ donation can stem from their ethics, morality, religion, and much more. For individuals that live in the United States and do not want to donate their organs upon death, they do not have to take any affirmative actions to ensure this result because the United States is an opt-in system. Opt-in policies require an individual to “manifestly express their preferences for being a deceased organ donor.” Generally, an individual’s organs will not be donated unless the individual has expressly stated that they would like to ‘opt-in’ to donating their organs upon death. Alternatively, some nations utilize an opt-out system; this system presumes that everyone is a willing donor unless they “specifically ‘opt-out’ of doing so.” Within the past few years, several nations including Iceland, England, Scotland, Canada, and the Netherlands have switched to an opt-out system. It may be a common assumption that opt-out systems should generate more successful organ transplants since everyone would presumably be a willing donor, and because this system expands the pool of potential donors to include nearly all citizens. In Peter Singer’s example, he tells us to imagine walking past a pond and seeing a child about to drown where there is no one else readily able to help the child. Singer believes that there is a duty to rescue the child since it is “neither difficult nor dangerous” and because the benefit to the child outweighs any costs that may incur to the rescuer; this would be known as an easy rescue. However, Singer’s example of having a duty to rescue may take a different shape when within the realm of organ donation. Those in need of a new organ can be complicated recipients due to their specific medical complexities and/or conditions. Further, some argue that donees incur little costs; they argue that “donating would not clash with any of the people’s important values, beliefs, preferences, or projects.” However, can a transaction including an organ really be considered an easy rescue? Is there both a duty to save a drowning child and a duty to give your organs to that child upon your death? This article will explore the opt-in and opt-out systems within the organ donation field, and how these different systems have manifested themselves in different nations. It will be revealed that opt-in and opt-out systems do not differ much from one another; both systems come with their own respective tradeoffs.

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