Free riding and organ donation

October 1, 2009

With the gap between the number of transplantable organs and the number of people needing transplants widening, many have argued for moving from an opt-in to an opt-out system of deceased organ donation. In the first system, individuals must register their willingness to become donors after they die. In the second system, it is assumed that individuals wish to become donors unless they have registered an objection to donation. Opting out has also been described as presumed consent. Spain has had the most successful presumed consent policy, resulting in a substantial increase in the donation rate.1 Despite support for an opt-out system from the British Medical Association and other groups since 1999, the report of a task force delivered in November 2008 recommended that the current opt-in system in the UK be retained.2 The USA has also retained an opt-in system. [Premium (Journal of Medical Ethics)]