We hear the statistics every year about those needing an organ transplant. As we write this editorial, over 120,000 are on waiting lists around the country. It is a medical tragedy in our nation that so many people are uselessly suffering and many dying waiting for a life-saving organ because the proper organ donation system is not in place.
This is a crisis that is being ignored. Increasing donations through state Division of Motor Vehicle offices and donor registry drives are heartfelt attempts, but are sorely inadequate and a passive attempt to make a dent in the overwhelming need. In Missouri, there is an amazing 71% registry rate (the registry is a list that is maintained by the state Dept. of Health of all the citizens who have indicated they would be a donor. All organ procurement agencies have access to this list at all times). Unfortunately, it just doesn’t convert to help today, or even in five years. A survey conducted by respected transplant surgeon Tom Peters from the University of Florida College of Medicine and colleagues in June 2014 and published online in JAMA Surgery last month examined the willingness of voting U.S. citizens to become living kidney donors and to determine the potential influence of compensation for donation. The researchers found that 689 (68%) would donate a kidney to anyone. If just half of that 68% of the U.S. population that claimed they were willing to donate actually donated a kidney, we would have over 112 million kidneys at our disposal. End of organ shortage.
But altruism isn’t always that reliable. People change their minds.
A number of countries have implement presumed consent laws. In essence, it means you agree to donate all your organs upon your death unless you specify otherwise. HB 1752, The Presumed Consent bill, has been introduced in the state legislature in Missouri by Rep. Randy Dunn.
The bill specifies that “a person is presumed to have consented to organ donation at the time a person applies for or renews his or her driver’s license unless he or she signs a statement opting out.” Mr. Dunn has no personal story to back the need for improving organ donation; he just saw an opportunity and wanted to make a positive change.
Similar presumed consent bills have been proposed throughout the nation—New York in 2010, Virginia in 2014, and Vermont in 2015. All have met defeat.
According to the Presumed Consent website (www.presumedconsent.org), “ Presumed consent works well in other countries where it has been instituted – Austria, Spain, Portugal, Italy, Belgium, Bulgaria, France, Luxembourg, Norway, Denmark, Finland, Sweden, Switzerland, Latvia, Czech Republic, Slovak Republic, Hungary, Slovenia, Poland, Greece, and Singapore —where the opt-out rate has been around 2%.”
There are challenges with presumed consent; family members may disrupt the process, for example, and deny access to the organs. But if done right, presumed consent could have a dramatic impact on the number of organs available for transplant, significantly reducing the waiting list and the number of deaths on the waiting list, and relieve the pain and suffering of thousands.
It is disappointing that the transplant organizations defer to the commonly-spouted view that Americans would feel violated with such an invasion of their personal rights. We disagree: most Americans are very charitable in a crisis. And the lack of organs in this country is indeed a crisis. It is time for the transplant community to think outside the box and focus on the crisis that is affecting our kidney patients’ hopes and futures. Presumed consent is one way to make positive change.