Organ Donation: "Presumed Consent"

From the LA Times

Most Americans volunteer to become organ donors by affixing a sticker to their driver's license. But that method isn't producing enough donors to meet the nation's profound need. More than 89,000 Americans are awaiting organ transplants — surgeries that have become highly successful at prolonging the lives of people who might otherwise die — but only about 20,000 organs became available last year.

Even when an individual's driver's license indicates a willingness to donate, some families override those wishes at the time of death.

That's why some people suggest it's time for the United States to do what more than a dozen other countries do: assume people want to donate unless they specify otherwise, by adding their names to a government-operated registry.

Known as presumed consent, some ethicists and organ transplant activists are advocating for the concept even though they acknowledge it's controversial. It's uncertain whether such a system would ever be endorsed in this country, as it has in many European countries.

"The driving factor behind presumed consent is the fact that the waiting list continues to rise at a rapid rate," said Richard Darling, a Palm Desert dentist and three-time liver transplant recipient who is active in transplantation issues. "As we get close to 100,000 people awaiting donation, that's going to open people's eyes."

In June, the American Medical Assn. adopted a policy on organ donation that encourages pilot studies investigating the effectiveness of presumed consent. The California Medical Assn.'s ethics committee will also discuss presumed consent later this year.

The Advisory Committee on Organ Transplantation, a federal government panel, and the United Network for Organ Sharing, the agency that oversees organ procurement and distribution nationwide, are also discussing the idea of presumed consent.

"It's one additional avenue to consider," said Margaret Allee, chairman of the Organ Procurement and Transplantation Network-UNOS ethics committee.

Presumed consent is among several ideas that have been proposed for increasing organ donation. Other suggestions include some form of financial compensation to families, such as payment for funeral expenses or monetary rewards to families who donate.