The U.S. Should Follow France's Lead And Make Every Citizen An Organ Donor By Default

by Melissa L. Fenton
Originally Published: 

My 9-year-old was going through my wallet recently and stumbled upon my driver’s license. He giggled at my picture, conferred with me on correct address, height, and weight, and then asked the funniest of serious questions. “Mom, are you an organ donor like it says here?” I replied, “Yes, of course.” A few seconds of silence, and then, “Which organs have you donated?”

And that led to a long discussion on how and why we donate our organs. A bit morbid at times, and of course lots of gruesome questions because 9-year-old boy minds tend to make everything a zombie joke, and 10 minutes later I was glad he had stumbled on my license and we had the chance to talk about organ donation. But most importantly, I am glad my intent to donate my organs after my death was made clear to both him and other family members who were listening.

Currently in the U.S., we have what’s called an “opt-in” system for organ donations. Citizens sign and give consent to organ donation through state registries or when applying for state-issued ID cards or driver’s licenses. But many other countries have what’s called an “opt-out” system of organ donation, with the most recent large industrialized country to pass such legislation being France.

Beginning January 1 of this year, all French citizens are presumably mandatory organ donors, under what is called “presumed consent.” According to the new law, if French citizens prefer not to donate their organs, they must join the National Rejection Register, or they can put their wishes not to donate in writing. Upon their death, physicians will check the registry and confer with family members, and organs will be donated as required. France’s biomedicine agency explained the reasoning behind this on their website, “In the name of national solidarity, the principle of presumed consent was chosen,” reads the website. “The law says that we are all donors of organs and tissues, unless we have expressed our refusal.”

Lawmakers in the U.S. have attempted several times to pass similar legislation, only to have failed each time. Countries with opt-out registries typically see an increase in organ donation, but medical ethicists are quick to downplay the success of opt-out registries, citing the biggest challenge to both the success of opt-in and opt-out laws can be family members. In an interview with U.S. News, Arthur Caplan, director of the Division of Medical Ethics at the New York University Langone Medical Center states, “Family plays a huge role in organ donation, no matter what legislatures or lawyers think” and that individuals need to be explicit with their loved ones about their organ donation preferences.

A 2013 Health and Human Services study agrees, and found that approximately 95% of Americans expressed support for organ donation in 2012. In addition, 60% of those surveyed who weren’t registered to donate their organs said they would sign up through a state registry. Under presumed consent, these people would be considered donors, and if they had made their wishes known to family members, the process would be even easier.

According to the United Network for Organ Sharing, “Every 10 minutes, someone is added to the national transplant waiting list,” and sadly, “[o]n average, 22 people die each day while waiting for transplant.” One donor can save the lives of up to eight people, and since data has been kept, it is estimated that over 500,000 people have been saved from an organ transplant.

If you haven’t signed up to be an organ donor yet, you can do so quickly and easily. Grab your spouse and your children, and together visit the United Network for Organ Sharing website. Continue to talk openly about your wishes to family members, ensuring that if tragedy strikes, they will be comforted and secure in knowing what your wishes truly were. Even with advanced medical technologies and donor education, the gap between patients and viable donors looms large. Close that gap, and register today to be an organ donor.

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