Opt-in vs. opt-out organ procurement systems
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Position arguments (debate):
On a Microsoft Word document, you have to make at least three arguments in support of your pre-assigned position (opt-out) in organ procurement policy. You should anticipate and address at least one objection to one of your arguments. Please find the case below with the required reading. Remember your position is OPT-OUT IN THIS ESSAY. PLS USE THE PAPERS LISTED BELOEw IF YOU WANT, BUT YOU HAVE TO CITE SOURCES. TO SUPPORT YOUR ARGUMENTS.
Case 3.2 – Got to get you into my life
Opt-in vs. opt-out organ procurement systems
The opt-in and opt-out systems (also known as explicit and presumed consent systems,
respectively) of cadaveric organ retrieval constitute two different legal systems for organ
procurement. Many factors, other than the consent system, affect organ retrieval rates
(e.g., the nature of people’s deaths, the number of transplant surgeons, the number of
intensive care units; logistical issues; societal attitudes, etc.). Because many factors –
some difficult to measure—affect retrieval rates, it is difficult to compare the real impact of
consent systems on retrieval rates.
Some things that are important when discussing donation systems:
1. In almost no country is required advanced consent from the donors.
2. In almost all countries there is what is usually called a double veto system: Either the
individual or the family can veto organ retrieval. Even if the deceased agreed in his/her
days to donate, the family can veto the organ retrieval. Even if the family wants to donate,
evidence that the deceased objected to the practice will veto the organ removal for
donation. Family veto exists both in the opt-in and the opt-out systems.
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Associate Professor of Medical Ethics (Education)
Department of Medicine
3. The family veto in most countries, including the U.S., is seen as clinical decision on
behalf of the brain-dead donor, unaffected by the organ donation law.
In evaluating what systems of retrieval should be implemented, the claims of different
stakeholders are of relevance: those of the deceased; those of the deceased’ family; and
those of potential organ recipients and their families.
Opt-in and opt-out systems give different weight to the claims of the stakeholders.
The US –and other countries such as Australia, Canada, Japan, Germany, Brazil and the
U.K—have what is called an opt-in system, where people have to explicitly consent to
organ donation –usually by registering their choice in some public way (v.gr. driver’s
This system presupposes that individuals have a right over their own bodies, and that such
right extends to deciding over what to do with it after death. Whether individuals have such
right is a controversial issue and it is at the heart of whether explicit consent should be
required for organ donation. It is important to recall here that almost all countries in fact
allow the removal of organs from the dead for transplantation without the explicit consent
of the donor, as long as the family consents and there is not known objection from the
A number of countries, including Austria, Belgium, the Czech Republic, Finland, France,
Greece, Hungary, Israel, Italy, Luxembourg, Norway, Poland, Slovenia, Spain, Sweden
and Turkey, have opt-out systems. In this system, individual’s consent is considered as
implicitly given, unless the individual has expressed a refusal to become a potential donor.
Many argue that opt-in systems increase organ availability. As mentioned earlier, whether
this is the case is difficult to determine because many factors affect the rate to retrieval.
That the system might in fact increase organ availability is not sufficient support it.
Further assumptions underlie this system, namely, that either the individuals have no rights
over their dead bodies, or that they do not have the right to leave dispositions for what to
do with their body after they die, or that this right does not outweigh the interests of those
who need organs in order to survive.
Some claim that most people want to donate (in the US, for instance, over 90% of people
are in favor of organ donation) but they often do not find the time or incentive to explicitly
declare their intentions, and that if this were the case, opt-out systems would be more
respectful of people’s wishes. However, “people’s wishes” or “people’s rights” are in this
field just colloquial and rather imprecise terms. It is the individuals, not “the people” who have individual rights (life, freedom of speech, freedom of movement, right to due process,
property rights, etc.), therefore, the fact that 90% agrees with donating cannot be used to
presume that the other 10% also does agree without violating the rights of that 10%.