The Opt-Out System of Organ Donation

In the amount of time it will take to read through this entire piece, another person in the
United States will be added to the waiting list for an organ transplant. Every day, seventy-nine
people receive an organ from a gracious donor, but eighteen will die without ever finding a
match (The Need is Real: Data 1). Each day, the number of people placed onto the waiting list
for an organ donation continues to climb, with little hope of ever reaching equilibrium with the
number of possible donors. If these individuals receive a transplant, they have a 70% or higher
chance of survival for at least an additional five years (1). In a 2009 New York Times interview,
Steve Jobs stated that [He] wouldnt be here without such generosity after receiving a liver
transplant (Thaler 1). Without these transplants, the lives of many patients are on a slow journey
to their unfortunate demise.
In this day in age, kidneys, heart, liver, and lungs are some of the most common organ
transplantations (What Organs Can Be Donated? 1). With new information and technology,
eyes, veins, tendons, pancreas, intestines, and bones have been added to that list (1). One organ
donor has the capability of saving up to eight lives with the donations of some of their major
organs (Organ Donation Facts 1). Tissue and eye donations alone can improve the lives of up
to fifty people (1). Registering as an organ donor gives every single individual the possibility to
save or improve the lives of fifty-eight people. This incredible decision made by people across
the country every single day is as simple as a trip to the local driver and vehicle service center.
In the United States, drivers are given the opportunity to help fill this void while applying
for and receiving their drivers license. With little background knowledge, new drivers are asked
a simple question, Do you want to be an organ donor?, right before their temporary license is
issued. For many, the excitement of the new freedom completely overshadows this life changing

decision. Currently in Pennsylvania, only 46% of the population over the age of 18 is registered
as an organ donor in the case of unforeseen death (Donate Life America 5). Compared to many
European and Asian countries that use an alternative organ donation system, the number of
registered donors in the United States is relatively low (Presumed Consent 1). As the waiting
list for organ donations continues to grow, the United States is in need of a more informed
society willing to make the decision to get registered and also a opt-out system that works in the
favor of the wait listed patients.
One of the greatest problems surrounding this issue is the misinformation that has spread
through society. Unless an individual consciously searches for information on organ donation,
they are typically subject to believe the many myths currently surrounding these transplantations.
Some of the most common myths include the idea that the emergency medical service or hospital
staff will not work as hard to save the life of a hurt patient because there are over 100,000 people
in need of tissues and organs (Organ Donation: Dont Let These Myths Confuse You 1). Also,
some misinformed individuals believe people of higher socioeconomic status will be given a
chance at a new life over those of lesser wealth (1). Another common myth highlights the idea
that their current health and fitness will make their body useless to a future recipient (1).
According to the Mayo Clinic Staff, in all of these cases, these myths are entirely false. Organ
donation has been surrounded by an incredible amount of misinformation that has led many
people astray in making the decision to save someones life after theirs has ended.
In an effort to escape the prevalence of this misinformation, many states have begun to
devote a page of the states drivers manual for information on organ donation. Before these
novices are even allowed on the road, each new driver must pass a permit examination. In some
states, this requires knowledge of the myths surrounding organ donation while others refrain

from including this information. Currently, Alabama, Virginia, Minnesota, Ohio, Idaho, and
New Hampshire all include information on this decision in their drivers manual. In each of
these six states, the donor registration rate ranges from 55-77% of the population (Donate Life
America 1). By creating a page for each drivers manual of every state in the United States,
society will have the information needed in order to make a better decision on organ donation
within a newly imposed system favored by many European and Asian countries.
Unlike the United States, many countries use a structure of organ donation known as the
opt-out system. This system, used by France, Belgium, Finland, Denmark, Italy, Spain, Norway
and Sweden, favors the idea that organ donation is of presumed consent (Crofut-Brittingham 1).
Unless an individual has filed paperwork against the use of their organs after death, the
deceaseds organs will be donated. Currently, the United States requires an individual to register
as a donor; the organs of an individual that has not registered may not be used and thus become
wasted potential. This has created a severe gap in the available donors and wait-listed patients.
Considering the match rate is extremely low to begin with, the current opt-in system creates an
insurmountable problem. In combination with a more knowledgeable society, the organ
donation system of the United States should transition into an opt-out system as opposed to the
current opt-in system.
This new opt-out system would be modeled after the structure found in many European
countries. Instead of requiring the drivers of America to check a box stating that they would like
to become an organ donor and have this displayed on their drivers license, all people would be
under the clause of presumed consent. If an individual chose to not register as an organ donor,
they would have the option of filling out a form in order to remove themselves from the registry.
Currently, unless someone is applying for a drivers license, they cannot easily register to

become an organ donor. This new policy would include all people, drivers and not, in the organ
donor registry, but also would allow those who do not wish to comply the option of deciding the
future of their internal organs.
In an effort to include all people, the registry would be formatted similarly to the current
system, only noting the individuals that have opted-out of organ donation. This switch would be
feasible because there is already a current system in place keeping track on the number of
registered donors. When deciding if an individual can become an organ donor after being
pronounced brain dead, a quick look at the registry and discussion with the deceased family
could determine the destination of their organs, very similar to the current system. This increase
in organ donors because of the higher percentage of the population indicated could be easily
handled by the current medical system. No changes would need to be made within hospitals
because organ donation and transplantation is a common practice. As far as the implementation
of this policy, the U.S. Department of Transportation would continue to be in charge of
organizing this information, just as they have been doing effectively for many years. All
decisions to not take part in organ donation would be discussed with the Department of
Transportation because this organization has been handling these situations and is already
currently set up to allocate these distinctions. With the Department of Transportation already in
place, the opt-out system would be feasible to carry out.
Similar to the United States, Belgium used its current governing bodies to implement the
new program. Instead of the 46% registration rate found in the United States, Belgiums registry
currently includes 97% of the population (Crofut-Brittingham 1). Only 3% of the population in
Belgium has chosen to opt out of the organ donation proceedings after death. Similar to the
program that will be implemented in the United States, individuals were asked to file a form to

remove themselves from the registry. The switch caused the severe and prevailing increase in
the number of available donors. The number of available donors does not necessarily mean that
every person in need will receive a new organ in a timely manner, but it will increase the pool of
available matches within the population. The goal of the policy is to increase the availability of
donors so that patients on the waiting list have a greater chance of receiving a match.
In order to increase this availability of organs, the number of people on the registry must
increase. In doing so, people are not going to be denied their right to abstain from being an
organ donor. Every single American will still be given their right to go about their funeral
proceedings without the added task of organ donation. Instead, the process of becoming a donor
becomes more available to the general public, and abstaining from the act only requires one
request form. Also, in order to increase the fairness of this policy, one page of information on
organ donation will be required in the drivers manuals of every state. As discussed earlier, the
states that included information about organ donation in their drivers manuals had a donor
registration rate over 50%, while states that did not include this information fell into much lower
categories, some as low at 26% as seen in New York (Donate Life America 6). By including one
page of information about organ donation, society will be better informed about the process and
the many myths that surround organ donation. Overall, the policy does not restrict ones ability
to refrain from organ donation if they do not wish to partake in the act, but seeks a way in order
to better inform every single American.
Currently, abstaining from organ donation requires one check of a box at the local DMV.
In an uninformed society that is surrounded by myths, it is understandable that 50% of the
population is not registered as an organ donor. The opt-out system is better than the current opt-
in system because it increases the number of registered donors without compromising the rights

of its citizens. By increases the knowledge of society and creating a system where every single
American is aware of their decision, more lives can be saved. Without a change in the
registration system, the United States will continue to have sub-par percentages of the population
registered compared to many European countries. The current medical system can handle the
increased number of donations as the waiting list slowly diminishes and more matches are found.
The greater pool of possible matches will counter the current deficit. The alternative to this
policy is simply letting the waiting lists for organs continue to climb and not increase the
registry. By using the opt-out system instead of the opt-in system, the possibilities of finding
matches for all wait-listed patients are greatly increased.
As the waiting list for organ donations continues to rise, citizens of the United States
have a duty to save their fellow mankind. The European opt-out system has been effective in a
number of countries in creating a greater pool in the number of available donors. The current
system in the United States is restricted to newly licensed drivers and those taking the initiative
and seeking out a way to get registered. Along with this new system modeled after those found
in Europe, creating a page of information on organ donation to be placed in each every states
drivers manual will help to get the word out about organ donation. This policy does not restrict
those from not donating if they do not wish. Creating an opt-out system in the United States
serves to increase the number of registered donors and possibly increase the number of matches
for the waiting patients.






















Works Cited
Crofut-Brittingham, Amelia. "Opt-out Versus Opt-in Donation Systems." Organ
Transplantation. N.p., 2007. Web. 30 Mar. 2014.
<http://pub.mtholyoke.edu/journal/Organ/entry/opt_out_versus_opt_in>.
Donate Life America. National Donor Resignation Report Card. N.p.: Donate Life America,
2012. Print.

"The Need Is Real: Data." Organdonor.gov. U.S. Department of Health and Human Services,
n.d. Web. 30 Mar. 2014.
<http://www.organdonor.gov/about/data.html?gclid=CIW3nbvorr0CFUuXOgodJXoA2g
>.
"Organ Donation: Don't Let These Myths Confuse You." Mayo Clinic. Mayo Foundation for
Medical Education and Research, 3 May 2013. Web. 29 Mar. 2014.
<http://www.mayoclinic.org/healthy-living/consumer-health/in-depth/organ-donation/art-
20047529>.
"Organ Donation Facts." New York Organ Donor Network. New York Organ Donor Network
Inc., n.d. Web. 30 Mar. 2014. <http://www.donatelifeny.org/about-donation/quick-facts-
about-donation/>.
"Presumed Consent." Donate Life California. Donate Life America, 2014. Web. 30 Mar. 2014.
<http://donatelifecalifornia.org/education/faqs/presumed-consent/>.
Thaler, Richard H. "Opting In Vs. Opting Out." The New York Times. The New York Times, 26
Sept. 2009. Web. 31 Mar. 2014.
<http://www.nytimes.com/2009/09/27/business/economy/27view.html?_r=2&>.
"What Organs Can Be Donated?" New York Organ Donor Network. New York Organ Donor
Network Inc., n.d. Web. 30 Mar. 2014. <http://www.donatelifeny.org/about-
donation/what-can-be-donated/>.