Doctors around the world are eager to increase the number of organ donations. One obvious strategy is to pass legislation that assumes that citizens are happy to donate organs unless they explicitly refuse. Austria, for example, has such an “opt out” system and in 2002, 99.98 per cent of the population were potential organ donors. By contrast, Denmark has an “opt in” system, under which citizens have to volunteer, and in 2002 only 4.25 per cent of the population had signed up. In 2008, Austria had a deceased organ transplant rate of 20.6 per million people (pmp), much higher than Denmark’s, at 11.8pmp.
An overall comparison of transplant rates, however, produces a more complicated picture. Like Austria, Poland has an opt-out system, but, in 2008, a transplant rate of only 11.2pmp. The US has an opt-in system, and a rate of 26.3pmp. So legislation helps, but does not decide everything. Rafael Matesanz, director of the Spanish National Transplant Organisation, argues that funding and regional organisation are, if anything, more important. Spain has a rate of 34.2pmp, the highest in the world.
Sources: Science, 2003; Newsletter Transplant, 2009; “The potential impact of an opt-out system for organ donation in the UK”, Department of Health, 2008; Organ donor registers, 2006