'Opt out' system could solve donor organ shortage, says researcher

October 31, 2008 Dr. John Troyer, University of Bath

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Dr. John Troyer joined the Center for Death and Society at the University of Bath in September. Credit: Nic Delves-Broughton, University of Bath

A system of presumed consent for organ donation - where people have to opt out of donating their organs when they die - is the best way to tackle a growing waiting list for transplant.

That is the opinion of Dr John Troyer, an expert in organ donation and the illegal trade of body parts, who has recently joined the University of Bath's Centre for Death & Society.

There are more than 7,500 patients in the UK currently on the waiting list for organ donations.
Whilst nearly 16 million people in the UK, a quarter of the population, are registered as organ donors, bereaved families have the final say as to whether the organs of their loved ones are used in a transplant. This can lead to delays and can sometimes mean that the deceased person's organs are not used.

Dr John Troyer, who started a RCUK fellowship at the University in September, said: "In the UK we currently have an 'opt in' system of organ donation, where donors can register their consent for their organs to be used after their death.

"I believe a better alternative to this would be an 'opt out' or so-called presumed consent system where organs are used unless the person has specified their wish otherwise. This would encourage people to talk to their loved ones about donating their organs when they die and could have a real impact on the huge waiting list."

Dr Troyer says there is currently an illegal global trade in most body parts, with teeth, nails and bones being sold on the black market to be used as pharmaceutical products and skin being used to treat burns victims.

Organs such as kidneys are also being sold by living donors for large sums of money, with organs from the third world sometimes being used for first world patients who are desperate for a life-saving operation.

Some experts are calling for the selling of organs to be regulated rather than outlawed, to try and increase organ donation and to ensure a fair price to donors and their families. However, Dr Troyer believes this would be a dangerous step to take.

He said: "The reasoning behind regulating the organ trade is that by increasing the domestic supply of organs, the trade on the black market could be reduced.

"Another suggestion is that, instead of cash, families of deceased potential donors could be offered incentives to allow organ donation such as health insurance, funeral expenses or a gift to a charity.

"I believe that organ donation should remain altruistic – like blood donation – with the choice to opt out if preferred. This would make a big difference to the number of organs available and reduce the demand on the black market. It will also reduce the exploitation of poor people who sell their organs and endanger their health because they are desperate for money."

"Currently, the US has central organ database that matches available organs to patients on the waiting list. Whilst the UK has a national register of potential donors, there is no fast and easy way for doctors to check which organs are available."

He added: "Discussing death and dying is always going to be a taboo subject. The British are typically uncomfortable discussing death – the only time people seem to want to talk about it is around Halloween!

"My father was in funeral industry so I grew up around dead bodies, which probably explains why I was drawn to studying the field I do.

"But having my background I almost feel it's my obligation to start the debate and get people thinking about the difficult issues surrounding death and dying."

Earlier this year, ministers backed proposals to overhaul the donation system, although presumed consent was not amongst the proposals. However, over the next two weeks, the Welsh Assembly is holding a series of public debates to discuss the need to introduce a system of presumed consent.

Source: University of Bath


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  • JerryPark - Oct 31, 2008
    • Rank: 1 / 5 (1)
    "Opt-out" and "presumed-consent' are just PC for "what you won't surrender, we will take from you".

    If there is any right worth preserving it is a person's right to his/her own body and all its parts.

    Opt-out proponents are thieves. We should always oppose opt-out schemes.
  • matelot - Oct 31, 2008
    • Rank: not rated yet
    In the US we have opt-in via a Drivers' license checkoff, but it's worthless because MDs won't use it for approval to harvest organs. Why should a dead person "care" if organs are used to extend someone else's life?
  • Roj - Nov 01, 2008
    • Rank: 3 / 5 (1)
    US MDs won't use it for approval to harvest organs


    With my US drivers license at age 15, there was clear reservations against being a donor.

    My early vision was of a system working for recipient imperatives, by overriding proper diagnose and treatment as officials may standby with extracting utensils waiting for donors to die.

    At an early age it was president Nixon on US TV, incriminating himself in public and getting away with it, that taught me any official post was potentially lawless.
  • Paradox - Nov 02, 2008
    • Rank: 1 / 5 (1)
    The "Opt Out" baloney should be against the law...
  • CreepyD - Nov 03, 2008
    • Rank: 5 / 5 (1)
    Imo not allowing someone to use your organs to help them survive once you're dead is one of the most selfish acts you can possibly commit.
  • kazzy - Nov 08, 2008
    • Rank: not rated yet
    I dont know if i fully agree with the opt out system. I do get cross when i hear others saying that its just the powers that be ordering us what we have to do..as this is not the case with the opt out. Whereas now you have to registrer yourself (opt in)if the opt out came into force you would then have the option to remove yourself from the list (opt out)
    This is possible as everyone will know that they are automatically added onto a list so its up to them to call and remove themselves. Not all who agree with donating their organs after their death get around to registering due to busy lives etc. This way every one is added making more numbers on the register but the option is there to take yourself off....Wheres the problem??
    Before anyone replies to me about rights and wrongs and what i would do if a loved one of mine was in need of an urgent transplant please just visit http://www.thelew...tion.org

    This is a registered charity set up in memory of my beautiful son Lewis who was in need of an urgent heart transplant., The call we prayed for never arrived and we had to turn off our sons life support. Lewis was two years and eight months of age.
    We miss him so much, we blame a system that is not set up properly, our son would now be seven and looking forward to Christmas. We know we cannot change the past, we cannot have our son back but through his name and charity we can make a difference to the future.
    Just think on all of those who think o'h it will never happen to a member of my family, it does and it can. You then will be praying that someone somewhere tok the time out of their busy hectic life to register, chances are that unless a new system or a change comes about you to will not get the call you pray for.
    There is no greater pain than having to sit helplessly by the side of a loved ones intensive care bed and wait, whether they are an adult or child, i know i have been there.
    Talk to your family, inform them of your wishes, dont just sit back and think it wont happen to me.
    Karen Prior.

October 31, 2008 all stories

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